上海地区2009年至2010年婴儿呼吸道感染病毒谱系的特征

Study on the etiology profiles of respiratory viral infections in infants in Shanghai during 2009 to 2010

目的使用Seeplex RV15 ACE检测试剂盒检测上海地区婴儿呼吸道感染病毒的病原谱系。方法征集新华医院儿科呼吸道发热门诊O～1岁组患儿62例，以咽拭子对呼吸道分泌物采样，提取样本中病毒核酸，反转录合成cDNA，使用Seeplex RV15 ACE检测试剂盒扩增15种呼吸道病毒的目的基因，以琼脂糖凝胶电泳检测特异性产物条带，判定感染病毒。并以检出病毒与检出季节和临床特征进行比较。数据采用Fisher’s精确检验和卡方检验。结果62例呼吸道感染患儿从咽拭子中检出病毒阳性36例，占58．1％，其中呼吸道合胞病毒B型（RSV—B）、鼻病毒、腺病毒、肠道病毒（hEV）、冠状病毒229E—NL63、A型流感病毒、副流感病毒1型和3型、博卡病毒、偏肺病毒、B型流感病毒的检出率分别为12．9％、11．3％、11．3％、8．0％、6．5％、6．5％、4．8％、4．8％、1．6％、1．6％和1．6％。检出双重感染6例，三重感染1例，多重感染占阳性病例的19．4％（7／36）。冬季RSVB检出率，高于其他三季（Fisher’s精确检验，P=0．001），夏季检出hEV高于其他三季（Fisher’s精确检验，P=0．01）。结论RSVB、鼻病毒和腺病毒是上海地区婴儿呼吸道感染的前三位病毒病原体，多重病毒感染常见。

Objective To investigate the etiology spectrum of respiratory viral infection in the infants in Shanghai by using Seeplex~ RV15 ACE Detection kit. Methods Sixty-two throat swab samples were collected from the infant patients under one year age, who were admitted to pediatric clinic in Xinhua Hospital during June, 2009 to June, 2010. Among these samples, 15 species of respiratory virus were amplified by using Seeplex RV15 ACE Detection kit. Identified viruses were analyzed for their seasonal distribution pattern and clinical infectious symptoms. The data were analyzed by Fisher＇s exact test and chi square test. Results Viruses were successfully detected from 36 swab samples （58. 1%）. Among them, respiratory syncytial virus-B （RSV B）, human rhinovirus （hRV） and adenovirus （ADV） accounted for 12. 9%, 11. 3% and 11. 3% of the infections, respectively. Other detected viruses included human enterovirus （hEV） （8.0%）, influenza virus A （FluA） and eoronavirus 229E-NL63 （each 6. 5%）, parainfluenzavirus （PIV）-I and PIV-3 （each 4.8% ）, human Boca virus （HBoV）, human metapneunovirus （hMPV） and influenza virus B （FluB） （each i. 6%）. Dual infections were identified in six cases and triple infections in one case, which as a whole accounted for 19. 4% of positive cases （7/36）. RSV B infection in winter was significantly higher than the other three seasons. Of the detection rate （Fisher＇s exact test, P= 0. 001）, hEV infection in summer was significantly higher than the other three quarters （Fisher＇s exact test, P= 0.01）. Conclusions RSV-B, hRV, and ADV are the three most common etiologies in respiratory viral infection in the infants under one-year age in Shanghai area. Multiple infections are also common.