2016-2020年乐山市某院急性呼吸道腺病毒感染儿童的分子流行特征

Molecular epidemiological characteristics of children with acute respiratory adenovirus infection in Leshan from 2016 to 2020

目的分析2016-2020年乐山市某院急性呼吸道腺病毒(HAdV)感染儿童的分子流行特征。方法研究对象为乐山市人民医院儿科自2016年1月-2020年1月收治的748例急性呼吸道感染患儿,采集患儿鼻炎抽吸物(NPAs)行腺病毒核酸检测及病毒核型分析,比较不同性别、年龄、就诊季节、疾病类型、病情腺病毒血清学分布情况及混合感染患儿腺病毒血清学分布情况。结果748例急性呼吸道感染患儿中HAdV阳性率19.25%,48个月-59个月患儿中HAdV阳性率最高,<12个月患儿检出率最低,夏季检出率最高;成功分离的HAdV阳性标本有106例,其中B、C亚组分别占48.11%,以B亚组HAdV-7型检出率最高,其次为C亚组HAdV-2型;HAdV-7型春季检出率高于秋冬两季,HAdV-3型夏季检出率高于春、秋、冬三季;重症肺炎、急性支气管炎均以HAdV-7型、HAdV-3型检出为主,普通肺炎以HAdV-7型检出为主,毛细支气管炎以HAdV-2型检出为主;混合感染发生率为71.70%(76/106),以甲型流感病毒、冠状病毒为主;不同混合感染类型的患儿腺病毒血清型分布差异均无统计学意义。结论急性呼吸道疾病儿童中存在一定比例的腺病毒感染比例,且以B亚组HAdV-7型、C亚组HAdV-2型相对常见,且腺病毒血清分型与就诊季节、疾病类型等存在一定关联。

OBJECTIVE To study the molecular epidemiological characteristics of children with acute respiratory adenovirus infection in Leshan from 2016 to 2020.METHODS Totally 748 children with acute respiratory infection admitted to the department of pediatrics at Leshan People′s Hospital were recruited as the research subjects between Jan 2016 and Jan 2020.Their nasopharyngeal aspirates(NPAs)were collected for adenovirus nucleic acid test and virus karyotype analysis.Serological distribution of adenovirus in children of different age and gender,in different seasons,in children with different diseases and conditions and in children with mixed infections were compared.RESULTS In this study,the HAdV positive rate detected in 748 patients was 19.25%.The HAdV positive rate was the highest in children aged between 48 and 59 months,and the lowest in children under 12 months old.The detection rate was the highest in summer.A total of 106 HAdV positive specimens were successfully isolated,of which subgroup B and subgroup C accounted for 48.11%,respectively.The detection rate of HADV-7 was the highest in subgroup B,followed by HAdV-2 in subgroup C.The detection rate of HADV-7 in spring was higher than that in autumn and winter,and HAdV-3 in summer was higher than that in spring,autumn and winter.HAdV-7 and HAdV-3 were predominant in severe pneumonia and acute bronchitis,HAdV-7 was predominant in common pneumonia,and HAdV-2 was predominant in bronchiolitis.The incidence of mixed infection was 71.70%(76/106),and the proportions of influenza A virus and coronavirus were the highest.There was no significant difference in adenovirus serotype distribution among children with different mixed infection types.CONCLUSION Children with acute respiratory diseases are prone to adenovirus infection,and the subgroup B HAdV-7 type and subgroup C HAdV-2 type are relatively common,and adenovirus serotype is related to season and disease type.