Analysis Of Influenza Surveillance Results And Clinical Characteristics In A Sentinel Hospital Of Taiyuan City From 2017 To 2019

Objective:A retrospective analysis of the influenza virus surveillance results in the fever clinic of the First Hospital of Shanxi Medical University from January 2017 to December 2019.Compare the prevalence trends of various types of influenza virus and the clinical characteristics of hospitalized patients in order to provide a reference for the prevention and treatment of influenza.Methods:The influenza virus surveillance results in the fever clinic of the First Hospital of Shanxi Medical University from January 2017 to December 2019 were collected,and the positive patients were divided into four groups according to the etiological characteristics(A H1N1 group,seasonal H3 group,B Victoria Group and B Yamagata group).The distribution of patients in each group and the general situation,clinical characteristics and treatment outcome of inpatients in each group were compared and analyzed.Results:Part one Analysis of influenza surveillance results in the fever clinic of the First Hospital of Shanxi Medical University from 2017 to 20191.A total of 2200 influenza like cases were collected from the first hospital of Shanxi Medical University from January 2017 to December 2019,and 301 cases were detected positive by PCR,with a positive rate of 13.68%.Among them,129 cases(42.86%)were H1N1,120 cases(39.87%)were H3,17 cases(5.65%)were Victoria and 35 cases(11.63%)were Yamagata.In 2017(a total of 140 positive cases),41 cases(29.29%)of a H1N1,84 cases(60%)of seasonal H3,0 case of B Victoria and 15 cases(10.71%)of B Yamagata were detected.In 2018(a total of 84 positive cases),56 cases(66.67%)of a H1N1,5 cases(5.95%)of seasonal H3,4 cases(4.76%)of B Victoria and 19 cases(22.62%)of B Yamagata were detected.In 2019(a total of 77 positive cases),a H1N1 was detected 32 cases(41.56%),31 cases(40.26%)of seasonal H3,13 cases(16.88%)of type B Victoria and 1 case(1.30%)of type B Yamagata.2.Among the 301 positive patients,there were significant differences in outpatient rate,hospitalization rate and severe+critical disease rate among the groups(P<0.05).Part two Analysis of clinical characteristics of 36 inpatients with influenza36 cases of influenza inpatients were actually collected,including 25 cases(69.44%)in the A/H1N1 group,4 cases(11.11%)in seasonal H3 group,1 case(2.78%)in BV Group and 6 case(16.67%)in the BY group.1.General information.The positive rate in the A/H1N1 group is higher in"severe+critical illness(100%),total hospitalization cost≥10,000 RMB(72%),etc.";the positive rate in the seasonal H3 group is higher in"comorbidities(75%)";in the BV group,the positive rate is higher in"complications and group occupations(both 100%)";in the BY group,the positive rate of"severe+critical illness(83.33%),hospitalization days≥14 days,and total hospitalization expenses≥10,000 RMB(both 66.67%),etc."is higher.Among the four groups of hospitalized patients,the fatality rates of A/H1N1 group and BY group were28%(7/25)and 16.67%(1/6),respectively,and the other two groups were 0.2.Clinical characteristics."Fever"(the positive rate is 100%)is common in the four groups.These positive rate in the A/H1N1 group are high,based on"symptoms[cough(92%),sputum(84%),etc.],physical signs[pulmonary rales positive(92%),fever days>7d(64%),etc.],auxiliary examination[Chest CT lesions involving both lungs(88%),Lac>2mmol/L(68%),and other pathogens positive(64%),etc.]and complications[(pneumonia(96%),respiratory failure(72%),liver damage(64%)and ARDS(60%)]".In the seasonal H3 group,it is higher in"symptoms[chill(50%)]and auxiliary examination[PLT<100×10~9/L(50%)]"."Symptoms[cough]and auxiliary examinations[LYMPH%<10%](both 100%)"is higher in the type BV group.In the BY group,it is higher in"symptoms[cough(100%),sputum(83.33%),chills(66.67%),etc.],physical signs[pulmonary rales positive(83.33%),Fever days>7 days(66.67%),etc.],auxiliary examination[LYMPH%<10%(83.33%),PCT>2ng/ml(83.33%),other pathogens were positive Patients(83.33%),and chest CT involving both lungs(66.67%),etc.]and complications[(pneumonia(83.33%)),respiratory failure(83.33%),ARDS(66.67%)and heart damage(50%)]”.3.Treatment outcome.The four groups were mainly"good prognosis(72%,100%,100%,83.33%)".In addition,the positive rate in the A-H1N1 group is higher with"anti-influenza virus treatment(60%)and the use of ventilator(52%)",and in the type BY group it is higher with"anti-influenza virus treatment(66.67%)and the use of ventilator Ventilators(50%),the number of antibacterial drugs>5(50%)and antifungal therapy(50%)".Conclusion:Part one1.From 2017 to 2019,influenza viruses infecting human beings are A/H1N1,A/H3,BV and BY.2.The dominant strains of influenza virus are different in different years,so the real-time monitoring of influenza virus is of great significance.3.Except for the influence of the B Victoria group,the seasonal H3 group is based on outpatient diagnosis and treatment,while the type A H1N1 group and the type B Yamagata group focus on hospitalization and have a higher rate of severe+critical illness.Part two1.The general information,clinical features and treatment outcome of four different types of influenza inpatients have both commonness and characteristics,which is helpful for the identification of different types.2.The four groups of hospitalized patients with influenza often have a good prognosis.Most of the hospitalized influenza patients in the A/H1N1 group and BY group were severely ill,and a few had a poor prognosis or even died,while the inpatients in the seasonal H3 group and the BV group were mostly mildly ill.