2016—2017年上海秋冬季重症急性呼吸道感染住院儿童中人鼻病毒感染亚型分布特点

Serotypes of human rhinoviruses isolated from hospitalized children with severe acute respiratory in-fection in Shanghai during the autumn and winter of 2016-2017

目的 调查上海重症急性呼吸道感染（SARI）患儿中常见呼吸道病毒感染及鼻病毒（human rhinovirus,HRV）亚型分布特点.方法 收集2016年10月—2017年3月上海重症急性呼吸道感染患儿199份鼻咽抽吸物样本.采用分子检测方法对15种常见呼吸道病毒感染进行分析.用针对5′-UTR区引物筛选鼻病毒,阳性样本再用 VP4-VP2区引物进行扩增与序列分析分型.结果在199份样本中,检出率最高的病毒为 HRV（26.1%）,其次是流感病毒 A 型（6.5%）、腺病毒（6.5%）、呼吸道合胞病毒（6.5%）和博卡病毒（5%）.52份HRV阳性样本,经VP4-VP2序列分析发现：A亚型30例（18种型别,以A21、A12、A38、A78、A88、A96亚型为主）、B亚型7例（5种型别,以B72为主）、C亚型15例（共9种型别,以C27、C40为主）,其中2份样本存在2种亚型共感染,2份样本未能分型,HRV存在型内、型间共感染及与其他呼吸道病毒合并感染情况.HRV-A和HRV-C在不同年龄组SARI患儿中感染率及临床特征无统计学差异.结论 HRV是上海地区儿童重症急性呼吸道感染最主要的病原之一,包括HRV-A,HRV-B和HRV-C型,并呈32种HRV亚型散在分布,主要亚型是A21、A12、A38、A78、A88、A96、B72、C27、C40.

Objective To investigate the etiological characteristics of common viral respiratory tract infections and to analyze the distribution of human rhinovirus（HRV） serotypes in children with severe acute respiratory tract infection （SARI） in Shanghai. Methods Totally 199 nasopharyngeal aspirate speci-mens were collected from children with SARI in Shanghai from October 2016 to March 2017. A nuclear acid test was performed to detect 15 common respiratory viruses in these specimens. HRV strains were screened out using the primer pairs derived from the 5′UTR of HRV and the serotypes of them were identified based on the VP4-VP2 gene sequencing. Results Among the 199 specimens,HRV-positive specimens accounted for 26.1%,followed by those positive for influenza A（6.5%）,adenovirus（6.5%）,respiratory syncytial vi-rus（6.5%） and Boca virus（5%）. Fifty-two HRV-positive specimens were typed by the VP4-VP2 gene se-quencing with 30 belonging to species A（18 serotypes,predominant serotypes：A21,A12,A38,A78,A88 and A96）,seven belonging to species B （five serotypes, predominant serotype： B72） and 15 belonging to species C （nine serotypes,predominant serotypes：C27 and C40）. There were two cases of HRV co-infec-tion. Two HRV-positive specimens could not be typed. HRV mixed serotype infections and co-infections of HRV with other viruses were existed. No significant difference in infection rates of different age groups and clinical characteristics was found between HRV-A and HRV-C infection groups. Conclusion HRV-A and HRV-C were the predominant pathogens causing SARI in children in Shanghai. Thirty-two HRV serotypes were detected and the predominant types were A21,A12,A38,A78,A88,A96,B72,C27 and C40.