2015—2023年上海市成人急性呼吸道感染病例中肺炎支原体感染特征

邱琪; 时慧琳; 刘嘉婧; 姜晨彦; 滕峥; 吴寰宇; 郑雅旭; 陈健

doi:10.16462/j.cnki.zhjbkz.2025.03.009

2015—2023年上海市成人急性呼吸道感染病例中肺炎支原体感染特征

doi: 10.16462/j.cnki.zhjbkz.2025.03.009

邱琪¹,
时慧琳²,
刘嘉婧³,
姜晨彦¹,
滕峥³,
吴寰宇^{1, 4},
郑雅旭^2, ,,
陈健^1, ,

1.
上海市疾病预防控制中心急性传染病防治科，上海 200336
2.
上海市预防医学研究院，上海 200336
3.
上海市疾病预防控制中心病毒检测实验室，上海 200336
4.
上海市重大传染病和生物安全研究院，上海 200032

邱琪和时慧琳为共同第一作者

基金项目:

上海市加强公共卫生体系建设三年行动计划(2023—2025年)优秀人才培养计划 GWVI-11.2-YQ13

上海市公共卫生体系建设三年行动计划(2023-2025年)重点学科建设项目 GWVI-11.1-03

上海市科技重大专项 ZD2021CY001

上海市“医苑新星”青年医学人才培养资助计划公共卫生领导者项目 SHWSRS(2022)_065

详细信息

通讯作者:
陈健，E-mail: chenjian@scdc.sh.cn

郑雅旭，E-mail: zhengyaxu@scdc.sh.cn

中图分类号: R183.3
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出版历程
- 收稿日期: 2024-08-12
- 修回日期: 2024-11-11
- 网络出版日期: 2025-04-11
- 刊出日期: 2025-03-10

Characteristics of mycoplasma pneumoniae infection in acute respiratory tract infection adult cases in Shanghai, 2015-2023

QIU Qi¹,
SHI Huilin²,
LIU Jiajing³,
JIANG Chenyan¹,
TENG Zheng³,
WU Huanyu^{1, 4},
ZHENG Yaxu^{2
, ,},
CHEN Jian^{1
, ,}

1.
Department of Acute Infectious Disease Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
2.
Shanghai Institute of Preventive Medicine, Shanghai 200336, China
3.
Laboratory of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
4.
Shanghai Institute of Infectious Disease and Biosecurity, Shanghai 200032, China

QIU Qi and SHI Huilin contributed equally to this article

Funds:

Outstanding Youth Training Program of Three-year Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System (2023-2025) GWVI-11.2-YQ13

Key Discipline-Infectious Diseases of Three-year Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System (2023-2025) GWVI-11.1-03

Shanghai Municipal Science and Technology Major Project ZD2021CY001

Shanghai "Rising Stars of Medical Talents" Youth Development Program, Youth Medical Talents-Public Health Leadership Program SHWSRS(2022)_065

More Information

Corresponding author: ZHENG Yaxu, E-mail: zhengyaxu@scdc.sh.cn; CHEN Jian, E-mail: chenjian@scdc.sh.cn

摘要

摘要: 目的分析2015—2023年上海市成人急性呼吸道感染病例中肺炎支原体感染的流行特征和混合感染情况，为肺炎支原体防控提供科学依据。方法收集2015—2023年在上海市20所医院门(急)诊就诊和住院的成人急性呼吸道感染病例，采集其基本信息和咽拭子、痰液标本，利用多重聚合酶链式反应技术进行常见呼吸道病原体的核酸检测。通过描述性流行病学方法分析肺炎支原体的感染状况和流行特征。结果共纳入10 971例成人急性呼吸道感染病例，肺炎支原体总阳性率为1.87%(205/10 971)，严重急性呼吸道感染(severe acute respiratory infection, SARI)病例(2.11%)的阳性率高于流行性感冒(简称流感)样病例(influenza-like illness, ILI)(1.52%)(χ²=4.68, P=0.030)。205例肺炎支原体阳性病例的发病时间主要在第4季度，占37.07%(76/205)。随着年龄的增长，肺炎支原体阳性率呈下降趋势(χ²=11.81, P＜0.001)，18~＜46岁年龄组阳性率(4.12%)高于其他年龄组(0.63%~1.76%)。205例肺炎支原体阳性病例中，与其他呼吸道病原体混合感染占比为22.93%(47/205)，ILI和SARI病例中混合感染占比分别为38.81%(26/67)和15.22%(21/138)，主要为肺炎支原体与甲型流感病毒的混合感染。结论 2015—2023年上海市成人急性呼吸道感染病例中，肺炎支原体感染以青壮年人群为主，需进一步加强流行季节成人肺炎支原体监测，重点关注与流感病毒等其他病原体的混合感染。
- 急性呼吸道感染 /
- 肺炎支原体 /
- 流行特征 /
- 混合感染
Abstract: Objective To study the epidemiological characteristics and mixed infection of mycoplasma pneumoniae (M. pneumoniae) in acute respiratory tract infection adult cases in Shanghai from 2015 to 2023, and to provide a scientific basis for the prevention and control of M. pneumoniae. Methods Acute respiratory tract infections were collected from 20 hospitals in Shanghai from 2015 to 2023. Relevant information was registered, and throat swab specimens, sputurn specimens were sampled to detect respiratory pathogens by multiplex polymerase chain reaction. Infection status and epidemiological characteristics of M. pneumoniae were analyzed by descriptive study methods. Results A total of 10 971 cases of acute respiratory tract infection were included, the positive rate of M. pneumoniae was 1.87% (205/10 971), and the positive rate of severe acute respiratory infection (SARI) was significantly higher than that of influenza-like illness (ILI) (χ²=4.68, P=0.030). The incidence of M. pneumoniae positive cases was mainly distributed in the fourth quarter, accounting for 37.07% (76/205). The positive rate decreased with age (χ²=11.81, P < 0.001), being higher in 18-< 46 age group (4.12%) than that of other age groups (0.63%-1.76%). Mixed infection accounted for 22.93% of 205 positive cases, the mixed infection rates of ILI and SARI were 38.81% (26/67) and 15.22% (21/138), respectively, and the main mixed pathogen of M. pneumoniae was influenza A virus. Conclusions M. pneumoniae infection among acute respiratory infections in Shanghai is more common in young adults. It is necessary to further strengthen the surveillance of M. pneumoniae in adults during the epidemic season, with a focus on the mixed infection of M. pneumoniae with other pathogens such as influenza virus.
- Acute respiratory infection /
- Mycoplasma pneumoniae /
- Epidemic characteristics /
- Mixed infection

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图 1 2015—2023年上海市成年人急性呼吸道感染病例中肺炎支原体阳性病例时间分布

ILI，流行性感冒样病例；SARI，严重急性呼吸道感染。

Figure 1. Temporal distribution of positive cases of Mycoplasma pneumoniae among adult acute respiratory infections in Shanghai from 2015 to 2023

ILI, influenza-like illness; SARI, severe acute respiratory infection.

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表 1 2015—2023年上海市205例肺炎支原体阳性病例的基本信息和临床特征

Table 1. Basic information and clinical characteristics of 205 positive cases of Mycoplasma pneumoniae in Shanghai from 2015 to 2023

变量 Variable	合计Total^① (n=205)	流行性感冒样病例 Influenza-like cases^① (n=67)	严重急性呼吸道感染病例 Severe acute respiratory infection cases^① (n=138)	χ²值value	P值 value
性别Gender				1.50	0.220
男Male	90(43.90)	34(50.75)	56(40.58)
女Female	115(56.10)	33(49.25)	82(59.42)
年龄组/岁Age group/years				12.85	0.002
18~ < 46	138(67.32)	51(76.12)	87(63.04)
46~60	30(14.63)	13(19.40)	17(12.32)
＞60	37(18.05)	3(4.48)	34(24.64)
职业Occupation				53.57	＜0.001
职员Staff	52(25.37)	2(2.99)	50(36.23)
退休人员Retired personnel	31(15.12)	1(1.49)	30(21.74)
其他Others	122(59.51)	64(95.52)	58(42.03)
发病时间/季度Onset/quarter				17.88	＜0.001
1	30(14.63)	19(28.36)	11(7.97)
2	29(14.15)	7(10.44)	22(15.94)
3	70(34.15)	15(22.39)	55(39.86)
4	76(37.07)	26(38.81)	50(36.23)
体温Body temperature/℃				5.35	0.021
38.0~ < 39.0	122(59.51)	48(71.64)	74(53.62)
≥39.0	83(40.49)	19(28.36)	64(46.38)
临床症状Clinical symptoms
咳嗽Cough	178(86.83)	56(83.58)	122(88.41)	0.54	0.461
咽痛Sore throat	62(30.24)	30(44.78)	32(23.19)	8.97	0.003
肌肉酸痛Muscle soreness	45(21.95)	25(37.31)	20(14.49)	12.41	＜0.001
采样前使用抗生素Antibiotics are used before sampling				20.69	＜0.001
是Yes	94(45.85)	15(22.39)	79(57.25)
否No	111(54.15)	52(77.61)	59(42.75)
标本类型Specimen type				13.51	＜0.001
咽拭子标本Throat swab specimens	173(84.39)	66(98.51)	107(77.54)
痰液标本Sputum specimens	32(15.61)	1(1.49)	31(22.46)
注：①以人数(占比/%)表示。 Note: ① Number of people (proportion/%).

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表 2 急性呼吸道感染病例中肺炎支原体阳性率(%)的影响因素

Table 2. Factors influencing the positive rate (%) of Mycoplasma pneumoniae in acute respiratory infection cases

变量 Variable	合计 Total	流行性感冒样病例 Influenza-like cases	严重急性呼吸道感染病例 Severe acute respiratory infection cases	χ²值 value	P值 value
性别Gender				5.86	0.016
男Male	1.57(90/5 734)	1.63(34/2 090)	1.54(56/3 644)
女Female	2.20(115/5 237)	1.42(33/2 328)	2.82(82/2 909)
年龄组/岁Age group/years				142.35	＜0.001
18~46	4.12(138/3 352)	2.12(51/2 400)	9.14(87/952)	140.74	＜0.001
46~60	1.76(30/1 705)	1.56(13/833)	1.95(17/872)	19.52	＜0.001
＞60^①	0.63(37/5 914)	0.25(3/1 185)	0.72(34/4 729)
职业Occupation				58.14	＜0.001
职员Staff	2.35(52/2 210)	0.15(2/1 324)	5.64(50/886)	33.00	＜0.001
退休人员Retired personnel^①	0.70(31/4 456)	0.14(1/714)	0.80(30/3 742)
其他Others	2.83(122/4 305)	2.69(64/2 380)	3.01(58/1 925)	58.34	＜0.001
发病时间/季度Onset/quarter				26.72	＜0.001
1^①	1.09(30/2 759)	1.68(19/1 129)	0.67(11/1 630)
2	1.28(29/2 266)	0.82(7/858)	1.56(22/1 408)	0.40	0.529
3	2.22(70/3 157)	1.04(15/1 437)	3.20(55/1 720)	11.31	0.001
4	2.72(76/2 789)	2.62(26/994)	2.79(50/1 795)	19.85	＜0.001
体温Body temperature/℃				33.05	＜0.001
38.0~＜39.0	1.46(122/8 382)	1.36(48/3 526)	1.52(74/4 856)
≥39.0	3.21(83/2 589)	2.13(19/892)	3.77(64/1 697)
临床症状Clinical symptoms
咳嗽Cough	2.25(178/7 919)	2.13(56/2 634)	2.31(122/5 285)	22.32	＜0.001
咽痛Sore throat	1.29(62/4 810)	1.10(30/2 723)	1.53(32/2 087)	15.69	＜0.001
全身酸痛Muscle soreness	2.09(45/2 148)	1.85(25/1 352)	2.51(20/796)	0.75	0.388
采样前使用抗生素Antibiotics are used before sampling				27.30	＜0.001
是Yes	2.92(94/3 224)	2.59(15/579)	2.99(79/2 645)
否No	1.43(111/7 747)	1.35(52/3 839)	1.51(59/3 908)
标本类型Specimen type				13.94	＜0.001
咽拭子标本Throat swab specimens	1.72(173/10 046)	1.50(66/4 395)	1.89(107/5 651)
痰液标本Sputum specimens	3.46(32/925)	4.35(1/23)	3.44(31/902)
注：①表示与该组比较。 Note: ① Indicates comparison with this group.

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表 3 47例肺炎支原体阳性病例的混合感染情况

Table 3. Mixed infections in 47 Mycoplasma pneumoniae infection among influenza-like cases and severe acute respiratory infection

混合感染Co-infection	合计Total^① (n=47)	流行性感冒样病例 Influenza-like cases^①	严重急性呼吸道感染病例 Severe acute respiratory infection cases^①
肺炎支原体+甲型流感病毒Mycoplasma pneumoniae + influenza A virus	39(82.96)	20(76.90)	19(90.48)
肺炎支原体+副流感病毒Mycoplasma pneumoniae + parainfluenza virus	1(2.13)	1(3.85)	0(0)
肺炎支原体+人偏肺病毒Mycoplasma pneumoniae + human metapneumovirus	1(2.13)	1(3.85)	0(0)
肺炎支原体+乙型流感病毒Mycoplasma pneumoniae + influenza B virus	1(2.13)	0(0)	1(4.76)
肺炎支原体+冠状病毒Mycoplasma pneumoniae + coronavirus	1(2.13)	0(0)	1(4.76)
肺炎支原体+甲型流感病毒+博卡病毒Mycoplasma pneumoniae + influenza A virus + bocavirus	1(2.13)	1(3.85)	0(0)
肺炎支原体+甲型流感病毒+冠状病毒Mycoplasma pneumoniae + influenza A virus + coronavirus	1(2.13)	1(3.85)	0(0)
肺炎支原体+人偏肺病毒+鼻病毒/肠道病毒Mycoplasma pneumoniae + human metapneumovirus + rhinovirus/enterovirus	1(2.13)	1(3.85)	0(0)
肺炎支原体+甲型流感病毒+博卡病毒+副流感病毒+人偏肺病毒 Mycoplasma pneumoniae + influenza A virus + bocavirus + parainfluenza virus + human metapneumovirus	1(2.13)	1(3.85)	0(0)
合计Total	47(100.00)	26(55.32)	21(44.68)
注：①以人数(占比/%)表示。 Note: ① Number of people (proportion/%).

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参考文献(18)

[1]	Waites KB, Xiao L, Liu Y, et al. Mycoplasma pneumoniae from the respiratory tract and beyond[J]. Clin Microbiol Rev, 2017, 30(3): 747-809. DOI: 10.1128/CMR.00114-16.
[2]	孙国磊, 王一民. 肺炎支原体感染诊断方法的研究进展[J]. 医学综述, 2021, 27(10): 1961-1965. DOI: 10.3969/j.issn.1006-2084.2021.10.016. Sun GL, Wang YM. Research progress of diagnosis methods of Mycoplasma pneumoniae infection[J]. Medical Recapitulate, 2021, 27(10): 1961-1965. DOI: 10.3969/j.issn.1006-2084.2021.10.016.
[3]	WHO. WHO surveillance case definitions for ILI and SARI[EB/OL] (2024-11-20). https://wwwwhoint/teams/global-influenza-programme/surveillance-and-monitoring/case-definitions-for-ili-and-sari 2014.
[4]	Salez N, Vabret A, Leruez-Ville M, et al. Evaluation of four commercial multiplex molecular tests for the diagnosis of acute respiratory infections[J]. PLoS One, 2015, 10(6): e0130378. DOI: 10.1371/journal.pone.0130378.
[5]	Si YJ, Zhao ZZ, Chen R, et al. Epidemiological surveillance of common respiratory viruses in patients with suspected COVID-19 in Southwest China[J]. BMC Infect Dis, 2020, 20(1): 688. DOI: 10.1186/s12879-020-05392-x.
[6]	卢瑞萍, 朱丽. 西安市2021—2023年成人肺炎支原体感染情况及影响因素[J]. 中国国境卫生检疫杂志, 2023, 46(6): 598-601. DOI: 10.16408/j.1004-9770.2023.06.022. Lu RP, Zhu L. Infection status and influencing factors of Mycoplasma pneumoniae in adults in Xi 'an from 2021 to 2023[J]. Chinese Journal of Frontier Health Quarantine, 2023, 46(6): 598-601. DOI: 10.16408/j.1004-9770.2023.06.022.
[7]	钱莉. 南京市浦口区不同人群肺炎支原体感染的流行病学调查分析[D]. 南京: 南京医科大学, 2019. Qian L. Epidemiological investigation and analysis of mycoplasma pneumoniae infection in different populations in Pukou District of Nanjing[D]. Nanjing: Nanjing Medical University, 2019.
[8]	史云菊, 柳璐, 李肖静, 等. 呼吸道感染肺炎支原体调查与季节因素的相关性研究[J]. 中华医院感染学杂志, 2016, 26(14): 3216-32188. DOI: 10.11816/cn.ni.2016-153765. Shi YJ, Liu L, Li XJ, et al. Respi ratory tract infection pneumonia mycoplasma survey and its correlation with seasonal factor[J]. Chin J Nosocomiology, 2016, 26(14): 3216-3218. DOI: 10.11816/cn.ni.2016-153765.
[9]	王军华, 范承武, 刘胜, 等. 桂林市儿童肺炎支原体感染流行特点及与气候因素相关性研究[J]. 临床儿科杂志, 2013, 31(11): 1038-1041. DOI: 10.3969j.issn.1000-3606.2013.11.009. Wang JH, Fan CW, Liu S, et al. Epidemiological characteristics and meteorological factors in childhood Mycoplasma pneumoniae infection in Guilin[J]. J Clin Pediatr, 2013, 31(11): 1038-1041. DOI: 10.3969/j.issn.1000-3606.2013.11.009.
[10]	Li ZJ, Zhang HY, Ren LL, et al. Etiological and epidemiological features of acute respiratory infections in China[J]. Nat Commun, 2021, 12(1): 5026. DOI: 10.1038/s41467-021-25120-6.
[11]	Yan C, Xue GH, Zhao HQ, et al. Current status of Mycoplasma pneumoniae infection in China[J]. World J Pediatr 2024, 20(1): 1-4. DOI: 10.1007/s12519-023-00783-x.
[12]	朱祥. 肺炎支原体感染的研究进展[J]. 实用心脑肺血管病杂志, 2020, 28(2): 107-112. DOI: 10.3969/j.issn.1008-5971.2020.01.y05. Zhu X. Research progress on Mycoplasma pneumoniae infection[J]. Pract J Card Cereb Pneumal Vasc Dis, 2020, 28(2): 107-112. DOI: 10.3969/j.issn.1008-5971.2020.01.y05.
[13]	Li H, Li SK, Yang HJ, et al. Resurgence of Mycoplasma pneumonia by macrolide-resistant epidemic clones in China[J]. Lancet Microbe, 2024, 5(6): e515. DOI: 10.1016/S2666-5247(23)00405-6.
[14]	刘馨玉, 李萌, 陈明伟, 等. 成人社区获得性肺炎住院患者的病原学分析[J]. 临床医学研究与实践, 2019, 4(29): 20-21. DOI: 10.19347/j.cnki.2096-1413.201929010. Liu XY, Li M, Chen MW, et al. Etiological analysis of adult inpatients with community-acquired pneumonia[J]. Clin Res Pract, 2019, 4(29): 20-21. DOI: 10.19347/j.cnki.2096-1413.201929010.
[15]	Larcher C, Jeller V, Fischer H, et al. Prevalence of respiratory viruses, including newly identified viruses, in hospitalised children in Austria[J]. Eur J Clin Microbiol Infect Dis, 2006, 25(11): 681-686. DOI: 10.1007/s10096-006-0214-z.
[16]	Kim D, Quinn J, Pinsky B, et al. Rates of co-infection between SARS-CoV-2 and other respiratory pathogens[J]. JAMA, 2020, 323(20): 2085-2086. DOI: 10.1001/jama.2020.6266.
[17]	Opatowski L, Baguelin M, Eggo RM. Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: a key role for mathematical modelling[J]. PLoS Pathog, 2018, 14(2): e1006770. DOI: 10.1371/journal.ppat.1006770.
[18]	Jacoby P, Watson K, Bowman J, et al. Modelling the co-occurrence of Streptococcus pneumoniae with other bacterial and viral pathogens in the upper respiratory tract[J]. Vaccine, 2007, 25(13): 2458-2464. DOI: 10.1016/j.vaccine.2006.09.020.

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2015—2023年上海市成人急性呼吸道感染病例中肺炎支原体感染特征

doi: 10.16462/j.cnki.zhjbkz.2025.03.009

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陈健，E-mail: chenjian@scdc.sh.cn

郑雅旭，E-mail: zhengyaxu@scdc.sh.cn

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Characteristics of mycoplasma pneumoniae infection in acute respiratory tract infection adult cases in Shanghai, 2015-2023

Corresponding author: ZHENG Yaxu, E-mail: zhengyaxu@scdc.sh.cn; CHEN Jian, E-mail: chenjian@scdc.sh.cn

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2015—2023年上海市成人急性呼吸道感染病例中肺炎支原体感染特征

doi: 10.16462/j.cnki.zhjbkz.2025.03.009

通讯作者: 陈健，E-mail: chenjian@scdc.sh.cn 郑雅旭，E-mail: zhengyaxu@scdc.sh.cn

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Characteristics of mycoplasma pneumoniae infection in acute respiratory tract infection adult cases in Shanghai, 2015-2023

Corresponding author: ZHENG Yaxu, E-mail: zhengyaxu@scdc.sh.cn; CHEN Jian, E-mail: chenjian@scdc.sh.cn

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陈健，E-mail: chenjian@scdc.sh.cn

郑雅旭，E-mail: zhengyaxu@scdc.sh.cn