儿童急性呼吸道感染病毒感染特点分析

Characteristics of adenovirus infection in children with acute respiratory tract infection

目的分析儿童急性呼吸道感染患儿腺病毒(AdV)感染特点。方法 2009年5月至2009年6月北京儿童医院门诊急性呼吸道感染患儿共492例,入选患儿在就诊当日采集咽拭子标本1份,采用逆转录(RT)-PCR方法进行常见呼吸道病毒核酸检测,包括呼吸道合胞病毒(RSV),鼻病毒(RV),副流感病毒(PIV)1-4型,流感病毒甲型及乙型(IFA、IFB),腺病毒(AdV),肠道病毒(EV),人冠状病毒(HCoV),人偏肺病毒(HMPV)及人博卡病毒(HBoV)。AdV核酸扩增阳性片段进行克隆测序,对序列进行Blast和进化分析以对AdV进行分型。结果 492例急性呼吸道感染患儿的咽拭子标本中,165例检出至少1种病毒,总阳性检出率为33.5%。其中53份检出AdV,检出率为10.8%,在所有检出病毒中阳性率最高。53份AdV阳性标本中共检出3个亚组,7个血清型,以3型(23/53)为主,其次是7(8/53)型和1型(7/53)。结论 2009年春季北京地区AdV有多个血清型流行,以3型为主。AdV仍然是儿童呼吸道感染的重要病原。

Objective To investigate the characteristics of adenovirus infection in children with acute respiratory tract infection. Methods From May to June 2009, 492 out-patients with acute respiratory tract infection were involved in our study. One throat swab specimen was collected from each patient. （RT） PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus （RSV） , rhinovirus （RV）, influzenza virus type A and B （IFA, IFB）, parainfluenza virus （PIV） type 1-4, adenovirus （AdV） , enterovirus （EV）, human coronavirus （HCoV） , human metapneumonia virus （hMPV） and human bocavirus （HBoV）. AdV amplicons were cloned and sequenced to determine the AdV serotypes by using Blast and phylogenetic analysis. Results At least one viral pathogen was detected in 165 out of 492 patients and the overall positive rate was 33.5%. AdV was detected in 53 （10.8%） specimens and it was the most common viral pathogen. Of the 53 AdV postive samples, 3 subgroups and 7 serotypes were found. AdV serotype 3 （23/53） was the major serotype, followed by serotype 7 （8/53） and serotype 1 （7/53）. Conclusion There were several AdV serotypes circulating in the spring of 2009 in Beijing area and serotype 3 was the predominant strain. AdV still playes an important role in acute respiratory tract infection in children.