中枢神经系统感染和脓毒症患儿人副肠孤病毒和非脊髓灰质炎肠道病毒感染的特征

Characteristics of human parechovirus and non-polio enteroviruses infections in children suspected central nervous system infections or sepsis in 2014 of Beijing

目的 通过检测患儿脑脊液和血清标本中的HPeV和NPEV,结合临床探讨其在儿童中的感染特征.方法 收集2014年1月至12月首都儿科研究所附属儿童医院来自600例16岁以下怀疑中枢神经系统感染或脓毒症患儿的脑脊液标本543份和血清标本173份,其中116例患儿同时收集到脑脊液和血清标本.通过实时荧光RT-PCR和巢式RT-PCR的方法对HPeV和NPEV进行筛查及分型.结果 在最终诊断为CNS感染的136例患儿中,HPeV阳性率为1.5％,NPEV阳性率为16.9％;诊断为脓毒症的51例患儿中,HPeV阳性率为5.9％,NPEV阳性率为3.9％;其他诊断的413例患儿中,HPeV阳性率为3.4％,NPEV阳性率为2.9％.HPeV感染患儿以0月～＜3月年龄组最多,而NPEV则以3岁～＜7岁组最多.NPEV感染的高峰为7月～9月,而HPeV感染的高峰为11月和12月.结论 HPeV感染患儿年龄低于NPEV感染患儿,HPeV和NPEV可在儿童中引起脓毒症或CNS感染等严重疾病.

Objective To better understand the characteristics of HPeV and NPEV infections by detecting HPeV and NPEV in cerebrospinal fluids （CSF） and blood samples.Methods A total of 543 CSF and 173 blood samples were collected from 600 children younger than 16 years old who were suspected as viral CNS infection or sepsis from January to December in 2014 in Beijing,in which CSF and blood samples were collected simultaneously from 116 children.Real-time RT-PCR and transcription-nested PCR （RT-nPCR） were performed to detect HPeV and NPEV.Results HPeV and NPEV were detected in 1.5% and 16.9% in 136 children diagnosed as CNS infectious diseases,5.9% and 3.9% in 51 children diagnosed as sepsis,and 3.4% and 2.9% in 413 children with other diagnosis.HPeVs were mainly detected in children under 3 months of age,while NPEVs were frequently detected in children aged 3 ～ 〈 7 years.The majority of NPEV infections occurred in the period from July to September,while most of HPeV infections happened in November and December.Conclusions The data indicated that children with HPeV infections were younger than those with NPEV infections and that both HPeV and NPEV may cause CNS infections and sepsis in children.