急性呼吸道感染住院儿童人类博卡病毒感染的临床特征

Clinical characteristics of human Bocavirus in children hospitalized for acute respiratory tract infections

目的了解西安地区以急性呼吸道感染住院患儿的人类博卡病毒(HBoV)感染的临床特征。方法将2008年1月-12月以急性呼吸道感染住院患儿的咽拭及痰液标本252例分成2份,1份应用直接免疫荧光法检测RSV,甲、乙型流感病毒,Ⅰ、Ⅱ、Ⅲ型副流感病毒和腺病毒常见的7种呼吸道病毒;另1份用于提取HBoV DNA,分析HBoV感染的临床特点及流行病学特征。随机抽取1份HBoV DNA阳性扩增产物进行序列测定,并通过Clustal W软件与GenBank中其他HBoV序列进行多序列比对分析。结果252份标本共检测到15份(6.0%)HBoV PCR阳性扩增产物。HBoV感染全年均有发生,冬春季多发;73.3%HBoV感染患儿的年龄为6个月至3岁;53.3%的患儿诊断为支气管肺炎(包括毛细支气管炎);53.3%患儿合并有其他呼吸道病毒的感染,HBoV单独感染与合并其他呼吸道病毒感染在临床特征方面无明显差别。HBoVNS1测序的291bp与GenBank中2个原型株HBoV Stockholm 1(st1,No.DQ00495)、HBoV Stockholm2(st2,No.DQ00496)和北京的2株(No.DQ988934.2及No.DQ988933.1)的同源性为99.0%。结论HBoV在15例以急性呼吸道感染住院患儿的咽拭及痰液标本中检出,HBoV感染以下呼吸道感染为著,与其他呼吸道病毒有较高的合并感染,HBoV单独感染与合并其他呼吸道病毒感染在临床特征方面无明显差别。

Objective To study the epidemiology and clinical characteristics of human Bocavirus （HBoV） infection in pediatric patients with acute respiratory tract infections （ARTI） in Xi＇an area. Methods Sputum and throat swabs were collected from 252 children admitted in the Department of Pediatrics, Xijing Hospital for ARTI between January 2008 and December 2008, Each sample was divided into two： one used for HBoV DNA extraction, and another used for detection of common respiratory viruses （including respiratory syncytial virus （RSV）, influenza virus A and B, parainfluenzae virus 1, 2 and 3, and human adenoviruses）. One of PCR products with expected molecular mass was selected randomly for DNA sequencing and was compared with the sequences of HBoV in the GenBank though ClustalW method. Results Fifteen of the 252 samples （6.0%） were found to be HBoV. HBoV infection was found to be yearround, although most occurred in the winter and spring months. 73.3% of the patients with HBoV infection aged from 6 months to 3 years. Most common diagnoses were bronchopneumonia. （including bronehiolitis）（53.3% ）. eight of the HBoV- positive children （53.3%） were co-infected with other respiratory viruses. No significant differences were found in the clinical characteristics between single and dual infections. The product （291 bp） shared high nucleotide sequence homology （99.0%） with two prototype strains-Stockholml （stl, No.DQ00495） and Stockholm 2 （st2, No.DQ00496） and two Beijing strains （No.DQ988934.2 and No.DQ988933.1 ）. Conclusions HBoV was found in the sputum and throat swabs of 15 patients hospitalized for ARTI, and it was associated with acute lower respiratory tract infection. Co-infections were frequent and clinically similar to HBoV infection alone.