2010年北京住院腹泻患儿腺病毒感染的研究

Investigation of adenovirus infection in hospitalized children with diarrhea during 2010 in Beijing, China

目的研究住院患儿中有腹泻症状者（包括社区获得性和院内获得性）腺病毒感染的情况。方法采用聚合酶链反应（PCR）对2010年北京地区有腹泻症状的住院患儿的粪便标本进行腺病毒的测定。结果519例标本中社区获得性腹泻为289例，院内获得性腹泻为230例。所有标本中腺病毒阳性76例（76／519，14．6％）；其中社区获得性腹泻患儿43例（43／289，14．9％），有20例属于F组腺病毒（20／43，46．5％），均为41型；院内获得性腹泻患儿33例（33／230，14．3％），有13例属于F组腺病毒（13／33，39．4％），其中41型（Ad41）12例，40型1例。系统发育树分析本组检测到的Ad41分属于不同的分支。非F组的腺病毒总例数为43例，型别分别是1型（5例），2型（8例），3型（15例），7型（10例），12型（1例），31型（4例）。结论住院腹泻患儿中腺病毒的感染不容忽视。在本组住院患儿中，社区获得性和院内获得性腹泻中腺病毒感染阳性率相似。2010年度北京住院患儿腹泻中腺病毒的感染以F组腺病毒—肠道腺病毒为主，41型占绝对优势。

Objective children with diarrhea. Method The study was designed to evaluate adenovirus infection in hospitalized Stool specimens were collected from 519 hospitalized children with diarrhea during 2010, including those defined as community-acquired diarrhea （CAD） who developed diarrhea symptoms within 48 hours after admission, and those defined as hospital-acquired diarrhea （HAD） whose symptoms of diarrhea occured beyond 48 hours after admission. PCR was employed to identify adenovirus in fecal samples by using universal primers for adenoviruses of all types, and specific primers for adenovirus group F. PCR products with expected size were sequenced for adenovirus typing. Clinical data for children with adenovirus positive specimens were analyzed. Result A total of 519 hospitalized children, including 289 with CAD and 230 with HAD, were enrolled in the study. Out of 519 stool specimens, 76 showed PCR products with expected 301 bp and identified as adenovirus by sequencing, and the overall positive rate was 14.6%. Out of 289 CAD samples, 43 were positive （positive rate was 14.9% ）. Of them, 20 were identified as enteric adenovirus infection （ adenovirus type 41, Ad41 ）. Thirty-three out of 230 HAD samples were positive （positive rate was 14.3% ）. Of them, 13 were characterized as enteric adenovirus infection （ one was Ad40 and others were Ad41 ）. Ad41 in this study could be divided into two genotypes by phylogenetic tree analysis. Non-enteric adenoviruses were identified in 43 specimens （43/76, 56.6% ） including 5 of serotype 1, 8 of serotype 2, 15 of serotype 3, 10 of serotype 7, 1 of serotype 12, and 4 of serotype 31. In this study, the positive rate of adenovirus between CAD children and HAD children did not differ （X^2 = 0.03, P 〉 0.05 ）, while the positive rate of enteric adenovirus was high in CAD children. Conclusion Adenovirus infection was the main cause of diarrhea in hospitalized children. In this study, the positive rate of adenovirus was similar between children with CAD and with HAD. Enteric adenovirus （adenovirus group F） was the most common adenovirus serotype detected in 2010 in Beijing, and Ad41 was the dominant type.