昆明地区5岁以下儿童博卡病毒和偏肺病毒感染的临床流行病学调查

Clinical Epidemiology of Human Bocavirus and Metapneumovirus Infection among Children under 5 years in Kunming

目的了解昆明地区5岁以下急性呼吸道感染患儿中人类博卡病毒(HBoV)和人类偏肺病毒(hMPV)的流行状况、混合感染情况以及主要的临床表现特点.方法按照病例纳入标准,采集2009年9月至2010年9月在昆明地区6所不同区域医院就诊患儿的鼻咽拭子标本550份,应用多重PCR技术,检测HBoV和hMPV及其它常见引起儿童呼吸道感染的21种病原体.同时收集所有患儿的临床资料以供分析研究.采用Epidata软件创建数据库和管理数据,利用SPSS软件进行数据分析.结果 550份呼吸道感染患儿的鼻咽拭子标本检出HBoV阳性标本18份,检出率为3.3%;检出hMPV阳性标本29份,检出率为5.3%.在18例HBoV阳性的标本中,与其它病原体混合感染的有17例,占阳性标本的94.4%;29例hMPV阳性标本中与其它病原体混合感染率为58.6%;与HBoV和hMPV混合感染的常见病原体依次有呼吸道合胞病毒、鼻病毒、甲型流感病毒和流感嗜血杆菌;HBoV及hMPV感染无性别差异;HBoV以0～1岁患儿感染率最高;hMPV感染没有明显的年龄组差异.HBoV和hMPV的检出率高峰均为秋冬季.2种病毒感染的主要临床表现均为咳嗽、发热和喘息.结论HBoV和hMPV是昆明地区儿童急性呼吸道感染的重要病原;在昆明地区的流行季节主要为秋冬季;临床上以咳嗽、喘息和发热为主要表现.

Objective To investigate the prevalence,epidemiology and clinical features of Human Bocavirus（HBoV）and Human Metapneumovirus（hMPV）infection in children with respiratory tract infection in Kunming.Methods From October 2009 to December 2010,550 nasal swab samples were collected from children under 5 years with respiratory tract infection.Multiplex polymerase chain reaction was used to detect 21 common pathogens including HBoV and hMPV.At the same time,the baseline characteristics of children and clinical manifestation were recorded by researchers through structure questionnaire.SPSS software was used to analyze data.Results Out of 550 nasopharyngeal swab specimens,18 specimens were detected with HBoV infection and 29 samples were detected with hMPV infection.The positive rate of HBoV and hMPV was 3.3% and 5.3%,respectively.Among 18 HBoV positive samples,there were 17 samples mixed other pathogen infection.The mixed infection rate of HBoV accounted for 94.4%.Meanwhile,among 29 hMPV positive specimens,the co-infection rate was 58.6%.The most common pathogens of mixed infection with HBoV and hMPV were respiratory syncytial virus,rhinovirus,influenza A virus and Haemophilus influenza.Infant got higher HBoV infection.There was no significant difference between different age groups of hMPV infection.The peak of positive infection rate of HBoV and hMPV were both in autumn and winter.Fever,cough and wheezing were the major clinical manifestation of children with HBoV and hMPV infection.Conclusions HBoV and hMPV are important pathogens of acute respiratory tract infection in children in Kunming.The prevalent seasons are autumn and winter for the two virus infection.