2009—2011年南京地区儿童急性呼吸道感染人冠状病毒HKU1和NL63临床与流行病学特征

Clinical and epidemiological characteristics of Human Coronavirus HKU1 and NL63 in children with acute respiratory tract infection during 2009-2011 in Nanjing

目的研究南京地区急性呼吸道感染患儿冠状病毒HKU1(Human CoV-HKU1)和NL63(Human CoV-NL63)的感染状况,分析其临床和流行病学特征。方法2009年8月至2011年7月收集了因急性呼吸道感染于南京医科大学儿童医院就诊和住院患儿呼吸道分泌物标本1286份,采用逆转录聚合酶链反应(RT-PCR)法检测HCoV-HKU1和NL63基因,同时对阳性标本进行常见呼吸道病毒筛查。采用分子生物学实验方法对阳性扩增产物进行克隆、测序、同源和进化分析。结果HCoV-HKU1检出率1.1%(14/1286),核苷酸同源性98.2%~100%,混合感染率92.9%,主要临床诊断为支气管炎、支气管肺炎、毛细支气管炎,临床表现为咳嗽、发热、喘息。HCoV-NL63检出率1.5%(19/1286),核苷酸同源性95.6%~100%,混合感染率为63.2%,主要临床诊断为急性上呼吸道感染、支气管炎、支气管肺炎,临床表现为发热、咳嗽、咳痰。HCoV-HKU1和NL63感染均无死亡病例。结论HCoV-HKU1感染主要为下呼吸道感染,在冬春季流行,受感染人群以1岁以下婴幼儿为主;HCoV-NL63感染包括上呼吸道和下呼吸道感染,在夏季和秋季流行,受感染人群以1岁~3岁幼儿为主。冠状病毒HKU1与NL63感染的临床特点比较无明显差异。

Objective To investigate the clinical and epidemiological characteristics of Coronavirus HKU1 (Human CoV-HKU1) and NL63 (Human CoV-NL63) in children with acute respiratory tract infection in Nanjing. Methods From August 2009 to July 2011, 1 286 respiratory samples were collected from the outpatient and hospitalized children in the Children′s Hospital of Nanjing Medical University. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect HCoV-HKU1 and NL63 genes, besides, positive samples were used for common respiratory virus screening. The positive amplification products were cloned, sequenced, homologous and phylogenetic analysis was conducted by molecular biological method . Results The detection rate of HCoV-HKU1 was 1.1% (14/1 286), the positive sequences shared a 98.2%-100% nucleotide identity with the HCoV-HKU1 strains and mixed infection rate was 92.9%. The main clinical diagnoses were bronchitis, bronchopneumonia and bronchiolitis. The clinical manifestations were cough, fever, wheezing. The detection rate of HCoV-NL63 was 1.5% (19/1 286), the positive sequences shared a 95.6%-100% nucleotide identity with the HCoV-NL63 strains and mixed infection rate were 63.2%. The main clinical diagnosis were acute upper respiratory tract infection, bronchitis, bronchopneumonia. The clinical manifestations were fever, cough, expectoration. No deaths were found in both HCoV-HKU1 and NL63 infections. Conclusions From August 2009 to July 2011, HCoV-HKU1 and NL63 were detected in children with respiratory tract infection in Nanjing area. HCoV-HKU1 infected cases were lower respiratory tract infection, epidemic in winter and spring, infected cases were mainly under 1 years of age, HCoV-NL63 infected cases including upper respiratory and lower respiratory tract infection, epidemic in the season of summer and autumn. The infected cases were mainly at the age rank from 1 year to 3 years. The clinical manifestations of children infected with coronavirus HKU1 and NL63 are not specificity.