西安市流感样病例中人腺病毒感染特点分析

Characteristics of the human adenovirus infections from influenza-like illness samples in Xi＇an

目的 分析2013-2015年西安市流感样病例中非流感患者腺病毒（HAdV）感染的流行病学特点和病毒分型特征.方法 收集2013年1月到2015年12月西安市两所国家级流感监测哨点医院的流感样病例样本,经荧光PCR筛检流感病毒阴性而腺病毒阳性的标本,进行病毒分离后对HAdV六邻体（Hexon）基因扩增、测序及分型鉴定,与HAdV 1-7型的参考序列构建基因进化树.结果 2 367份标本中检测出88例腺病毒阳性,阳性率为3.72％.共检出7种亚型的HAdV,其中HAdV-1型占9.09％,HAdV-2型占22.73％,HAdV-3型占23.86％,HAdV-4型占5.68％,HAdV-5型占7.95％,HAdV-6型占3.41％,HAdV-7型占1.14％.在腺病毒阳性病例中,男性检出率高于女性,但差异不具有统计学意义（P＞0.05）;按年龄分6个组,1岁以下3例阳性,1～3岁36例阳性,4～6岁26例阳性,7 ～18岁16例阳性,19 ～59岁5例阳性,60以上2例阳性.7岁以下儿童高发,年龄组间差异具有统计学意义（Х^2=0.10,P ＜0.05）.结论 2013-2015年西安市上呼吸道感染中HAdV的主要的流行型别为3型和2型,7岁以下儿童高发;HAdV的感染全年散发,无明显季节性.

Objective To analyze the epidemiological characteristics and the molecular types of human adenovirus （HAdV） from influenza-like illness （ILI） samples with negative influenza virus in Xi＇an from January 2013 to December 2015.Methods Samples from patients with ILI were collected from two national influenza sentinel surveillance hospitals during 2013-2015 in Xi＇an.HAdV was detected by real-time PCR,and then the positive samples were inoculated into Hep-2 cells to isolate the viruses.The amplified products were purified and sequenced of hexon gene,and the sequences were compared with the Genebank data and phylogenetic trees were constructed.Results In 2367 samples,88 samples were positive for HAdV,the positive rate was 3.72%.There were 7 subtypes detected,and the rates of each subtype are as follows：HAdV-1 was 9.09%,HAdV-2 was 22.73%,HAdV-3 was 23.86%,HAdV-4 was 5.68%,HAdV-5 was 7.95%,HAdV-6 was 3.41% and HAdV-7 was 1.14%.Males had higher infection rate than females,but there was no significant difference.The patients were divided into 6 groups according to age.There were 3 positive samples among those under 1 year of age,36 positive samples among those 1 to 3 years old,26 positive samples among those 4 to 6 years old,16 positive samples in those 7 to 18 years old,5 positive samples in 19 to 59 years old and 2 positive samples in those older than sixty years of age.HAdV infection was primarily confined to children under 7 years of age.Conclusions HAdV-3 and HAdV-2 were the dominant epidemic strains during 2013-2015 in Xi＇an.Children younger than 7 years were the main susceptible population.HAdV infections circulate all year-round and there was no considerable seasonal variation.