婴幼儿疑似甲型H1N1重症病例及门诊流感样病例中鼻病毒的检测分析

Detection and analysis on rhinovirus in children with severe influenza A(H1N1/2009)-like infection and influenza-like illness

目的了解鼻病毒在婴幼儿疑似甲型H1N1重症病例及门诊流感样病例中的分布、分子进化特征及与其他呼吸道病毒的合并感染情况。方法样本有两种来源:疑似甲流重症病例样本246份为样本1组,门诊流感样病例样本68份为样本2组。扩增鼻病毒5′非编码区及VP2-VP4区,测序比对,构建进化树。对鼻病毒阳性样本检测其他常见呼吸道病毒。结果样本1组中鼻病毒阳性率为8.54%(21/246)。样本2组中鼻病毒阳性率为16.2%(11/68)。样本1组和样本2组鼻病毒与其他呼吸道病毒的合并感染率分别为71.4%、9.09%,两者具有显著性差异(P<0.05)。对其中14份样本成功进行了测序,HRV-A、HRV-B、HRV-C基因型所占比例分别为64.3%、7.1%和28.6%。多序列比对分析表明鼻病毒3个基因型间的核苷酸序列一致性为55%～65%。结论 HRV在疑似甲型H1N1流感重症病例中主要是以合并感染为主。杭州地区婴幼儿疑似甲型H1N1流感重症病例及门诊流感样病例中鼻病毒感染主要是以HRV-A,HRV-C基因型为主,HRV各型别之间核苷酸变异较大。

The aim of the present research was to study the infection,prevalence and evolution of human rhinovirus in children with severe influenza A（H1N1/2009）-like infection and influenza-like illness,and to study the coinfection for HRV with the other respiratory viruses.Throat swab/endotracheal aspirates specimens were collected from 246 children with severe influenza A（H1N1/2009）-like infection（group 1）,and throat swab specimens were collected from 68 children with influenza-like illness（group 2）.Molecular tests were used to detect its 5＇ noncoding region and VP2-VP4 of human rhinovirus.Nucleic acid sequence for VP2-VP4 was used for phylogenetic reconstruction.The co-infection for HRV with the other respiratory viruses was analysed.Results showed that in the 246 specimens of group 1,21 specimens were HRV positive（8.54%）.In the 68 specimens of group 2,11 specimens were HRV positive（16.2%）.The rate of co-infection for HRV with another viruses was 71.4% and 9.09% in group 1 and group 2,respectively,which had significant difference（P0.05）.Among the 14 specimens which were sequenced successfully,the rate for 3 HRV species,HRV-A,HRV-B,and the novel species of HRV-C,was 64.3%,7.1%,and 28.6%,respectively.There were only 55% to 65% nucleotide acid identity among the 3 HRV genotypes.In conclusion,the main infection is coinfection of HRV in severe influenza A（H1N1/2009）-like illness.The main genotypes of human rhinovirus in children with severe influenza A（H1N1/2009）-like infection and with influenza-like illness are HRV-A and HRV-C in Hangzhou.The nucleotide acid of HRVs are quite variable.