2000年秋冬至2002年夏北京地区急性呼吸道感染病毒病原学研究

Study on viral etiology of acute respiratory tract infections in infants and young children in beijing area

为了解北京地区婴幼儿急性呼吸道感染的病毒病原 ,对2000年秋冬至2002年夏收集的1402份临床标本进行了病原分析。所有标本接种Hep_2和MDCK细胞进行病毒分离 ;鼻咽洗液脱落细胞涂片后经间接免疫荧光检测7种呼吸道病毒 ;RT_PCR鉴定RSV亚型 ;血凝及血凝抑制试验鉴定流感病毒型别 ;nested_PCR检测肠道病毒。1402份标本中672份咽拭子标本取自门诊患儿 ,730份鼻咽洗液标本取自住院患儿。结果 :共有614份标本为病毒阳性 ,阳性率为43.8 %。病毒阳性标本中呼吸道合胞病毒 (RSV)占66.1 % ,并以A亚型为主 ;RSV阳性标本中91.4 %来自诊断为毛细支气管炎或肺炎的住院患儿。2001～2002年冬春季RSV感染比2000～2001年同期高25.1 %。流感病毒阳性标本占总阳性标本的24.4% ,其中89.3 %来自门诊患儿 ;2000～2001年以乙型流感病毒为主 ,2001～2002年以甲3型为主。在冬春季还可检测到腺病毒和副流感病毒 ,夏季检测不到以上几种呼吸道病毒。利用nested_PCR方法检测2002年夏季收集的标本 ,发现7月份肠道病毒感染率相当高。提示RSV是北京地区冬春季婴幼儿急性下呼吸道感染首要病毒病原 ,流感病毒是婴幼儿急性上呼吸道感染首要病毒病原 ,肠道病毒是夏季婴幼儿呼吸道感染主要病毒病原。病毒分离、免疫荧光和PCR等方法的并用提高了?

to understand the viral etiology of acute respiratory infections(aRi)in infants and young children in beiˉjing area,1402specimens from the caseS in outpatient department(672cases,via throat swab)and those admitted to the wards(730cases,via nasopharyngeal aspirate)were protocally examined here for the detection of viral pathogens of the patients with ari from dec.2000to oct.2002.a series of laboratory assessments,including inoculating cell culture with MDck and hep_2cell lines,indirect immunofluorescence assay(iifa)for the identiFication of nearly7different viruses,reˉverse transcription_pcr assay,haemoagGlutination/haemoagglutination inhibition tests and nested_pcr technique were seParately applied to detect the viral viruses,such as respiratory syncytial viruS(rsv),influenza virus,para_influenza virus,entero_virus as well as the typIng of rsv and influenza virus.as the first of the results obtained,out of thesE1402speciˉmens,614copies(43.8%)showed positive in viral etiology,mainly inCluding406specimens(66.1%)of rsv and150(24.4%)of influenza virus.most of rsv infection(91.4%)were discovered in the hospitalized cases clinically diagnoseD as bronchiˉolitis and pneumonia.subsequently,sub_group a of rsv pathogen was found to be dominant when identified by means of rt_pcr assay.moreover,there wAs a higher peak of rsv infection during prevalent seasons of the years2001～2002in comparison with that in the years2000～2001.secondly,most of influenza viruS were detected as the main viral pathogen in outpatients(89.3%).meanwhile,inFluenza virus b was the principal type in the prevalent seasons during the years2000～2001,whileas influenza virus a3as the major one during the years2001～2002differently.the next,para_influenza virus and adenovirus were detected out espEcially in winter and spring seasons,while none of these2viruses mentioned abovE could be found in summer season.finally,interestingly,when nested_pcr assay WAs used to detect enteroviruses in the specimens collected in summer of the year2002,there was a high positive rate(95%)of this kind of viral pathogen predomInantly in july.therefore,all these data described here epidemiologically indicAted that rsv and influenza viruses were the major viral pathogens of ari in infAnts and young children in beijing area during winter and spring seasons of2000～2002,and enˉteroviruses were the most common agents in the summer in2002.