急性呼吸道感染患儿鼻咽分泌物中呼吸道合胞病毒亚型的检出分析

Subgroup analysis of respiratory syncytial virus in nasopharyngeal secretion of children with acute respiratory infection

目的探讨急性呼吸道感染患儿呼吸道合胞病毒(RSV)亚型的流行规律。方法应用直接免疫荧光法筛检2006年1月至2012年12月苏州地区42 208份来自急性呼吸道感染住院患儿的鼻咽分泌物标本的RSV病毒抗原;随机抽取不同年份RSV流行季节的RSV阳性标本,采用实时荧光PCR鉴定亚型。结果 RSV流行呈季节性,当年11月至次年3月为高峰期,而当年5至9月为RSV检出低谷期;从2006年至2012年,不同年份间高峰期的RSV阳性检出率差异有统计学意义(χ2=280.09,P<0.01)。在398份不同年份高峰期的RSV抗原阳性标本中,检出A亚型319份(80.15%),B亚型63份(15.83%),未检出16份(4.02%),不同年份高峰期之间RSV亚型分布的差异有统计学意义(P<0.01)。多数年份RSV流行以A亚型为主,在高峰期RSV检出率最低的2008—2009年A、B亚型同时流行,随后的2009—2010年以B亚型为主。结论苏州地区2006年至2012年,前四个流行季RSV检出率呈现周期性隔年增高趋势,之后两个流行季RSV感染呈持续高发趋势,急性呼吸道感染住院患儿RSV以A亚型为主。

Objective To explore the epidemiology of different subgroups of respiratory syncytial virus （RSV） in hospi- talized children with acute respiratory infections in Suzhou. Methods RSV antigen in nasopharyngeal secretions specimens ob- tained from 42 208 hospitalized children with acute respiratory infections from January 2006 to December 2012 were detected using direct immunofluorescence assay. RT-PCR was used to differentiate subgroups A and B of RSV from the positive samples which were randomly selected in the epidemic season of different years. Results RSV infection had a seasonal trend. The peak season of RSV occurred between November and following year＇ s March and the detection rate of RSV was low between May and September. There was difference in RSV positive rates of peak seasons among different years from 2006 to 2012 Of= 280.09, P〈0.01）. In 398 RSV antigen positive samples obtained from peak seasons of different years, 80.15% （319/398） were differentiated as subgroup A and 15.83% （63/398） were subgroup B except 16 samples （4.02%）. There was significant difference in distribution of RSV subgroups in peak seasons among different years （P〈0.01）. Subgroup A of RSV was prevalent in most years. Both subgroup A and B were prevalent in peak season of 2008~2009 with lowest positive rate of RSV. In 2009~2010, subgroup B was prevalent. Conclusions From 2006 to 2012 in Suzhou area, the RSV detection rates in the first four prevalent seasons present an increase trend every other year and then sustain a high prevalence in the following two prevalent seasons. Subgroup A of RSV was the predominant pathogen in hospitalized children with acute respiratory infections.