1起家庭聚集性肺炎病原学检测及基因特征分析

目的 分离鉴定引起家庭聚集性肺炎的病原体，并进行基因特征分析。方法 采集该家庭每个成员的血清、咽拭子和肺炎患者的肺泡灌洗液，通过PCR方法、病毒分离、hexon测序、BLAST比对和血清IgG酶联免疫方法检测病原，并对hexon序列进行进化树分析。对阳性病毒分离物进行全基因组扩增。结果 父母咽拭子2份、孩子肺泡灌洗液2份经PCR检测均为腺病毒（AdV）阳性，肺泡灌洗液病毒分离阳性，4份标本hexon区域PCR扩增测序，核苷酸同源性为99.5%～100.0%，病毒全序扩增拼接分析，BLAST比对与腺病毒7型核苷酸同源性97.0%，基因进化树分析显示hexon基因分型与腺病毒7d位于同一分支。ELISA方法检测一家4口均出现恢复期与急性期血清腺病毒IgG4倍增高现象。结论 腺病毒7型是该起家庭聚集性肺炎的病因。

Objective To isolate and identify the pathogen leading to a family gathered pneumonia and analyze its gene characteristics. Methods Collect everyone’s serum （acute and recovery stage）, throat swab and bronchoalveolar lavage fluid of the family. The etiology was identified by PCR, virus isolation, hexon gene sequenced, BLAST and ELISA. The whole genome of the virus were further amplified and sequenced. Results 2 virus were obtained by Hep2 cell from 2 bronchoalveolar lavage fluids. Adenovirus was detected positive by PCR in parent 2 throat swabs and 2 children bronchoalveolar lavage fluids and 2 isolates. The nucleotide acid homologies of the 4 samples hexon genes were 99.5%-100%. The virus was finally identified as adenovirus 7 by 97.0% homology of nucleotide through BLSAT in the genebank. It was localized into the same cluster with AdV7d stains based on hexon gene using Mega 4.0. The level of adenovirus IgG in the recovery stage serum was 4 times higher than in the acute stage serum through ELISA in the 4 persons. Conclusion Adenovirus serotype 7 was the primary pathogen induced the family gathered pheunomia.