人双埃可病毒致儿童中枢神经系统感染和脓毒症的分子流行病学

Molecular epidemiology of human Parechovirus infections in central nervous system-related disease and sepsis in children

目的检测患儿脑脊液和血浆标本中人双埃可病毒（HPeV），探讨其致儿童中枢神经系统感染和脓毒症的分子流行病学特征。方法收集2009年1月至12月复旦大学附属儿科医院328例14岁以下患儿的脑脊液标本210份和血浆标本149份，肠道病毒检测均阴性。所有患儿均有神经系统症状或脓毒症症状。以反转录套式PCR法直接从标本中检测HPeV，进而通过基于VP3／VP1区的套式PCR扩增片段的测序结果进行基因分型。同时期收集99份健康体检儿童的血浆标本作为健康对照。结果328例患儿中，HPeV阳性者27例，占8．2％，各个年龄段均能检测出HPeV感染，〈3个月龄组66例患儿，阳性12例，检出率最高，为18．2％。HPeV感染流行高峰为12月份，收集的48份标本中，阳性9份，达18．8％。成功分型的20份标本均为HPeV1型。同时期的99份健康对照血浆标本中未检测到HPeV。结论HPeV是致上海地区儿童中枢神经系统感染和脓毒症的病原体，对儿童的危害应引起临床的重视，对HPeV的筛查应纳入常规的病毒检测行列。HPeV1是2009年上海地区的主要致病型。

Objective To obtain the molecular epidemiology of human Parechovirus （HPeV） infections in children with central nervous system （CNS）-related disease and sepsis, as well as understand the pathogenic properties of HPeV infections by detecting HPeV in cerebrospinal fluid （CSF） and blood samples. Methods From January to December in the year of 2009, a total of 359 enterovirus-negative specimens including 210 CSF and 149 blood samples were collected from 328 children （14 years of age who were hospitalized for CNS-related disease and sepsis at Children＇s Hospital, Fudan University, Shanghai, China. HPeV was detected by nested reverse transcription polymerase chain reaction （RT-PCR）, and then directly genotyped by sequencing nested RT-PCR product of VP3/VP1 region. Ninty-nine blood samples from healthy children were collected as controls during the same period. Results Twenty-seven children （8.2%） were HPeV positive in 328 children. HPeV infections were found in all age groups of children and the highest frequency was seen in children 〈3 months old （18.2%, 12/66）. HPeV was detected in several months, with the peak in December （18.8%, 9/48）. Of all the positive samples, 20 were genotyped successfully and identified to be HPeV1. No HPeV infections were found in blood of healthy controls. Conclusions HPeV is the pathogen of CNS infections and sepsis in children virus testing in specimens obtained from children. of 2009 in Shanghai. HPeV screening should be enrolled in the routine HPeV1 is the prevalent type in children in the year of 2009 in Shanghai.