流感高发季节150例流感病毒核酸阴性的流感样病例鼻咽分泌物呼吸道病毒检测分析

Respiratory virus detection in influenza virus-negative nasopharyngeal swabs of 150 influenza-like illness cases during flu epidemic season

目的分析流感高发季节150例流感病毒核酸阴性的流感样病例(ILI)鼻咽分泌物呼吸道病毒的病毒病原谱。方法 150例ILI患者,流感病毒核酸检测均呈阴性,留取鼻咽分泌物标本,采用荧光定量PCR法检测鼻咽分泌物呼吸道合胞病毒、腺病毒、鼻病毒、冠状病毒等多种呼吸道病毒。结果 150例标本中,病毒阳性检出率29.33%(44/150)。44例中呼吸道合胞病毒22例(14.67%),其中A型3例(2.00%)、B型19例(12.67%);腺病毒9例(6.00%);鼻病毒5例(3.33%);冠状病毒5例(3.33%),其中COV-229E 1例(0.67%)、COV-NL63 1例(0.67%)、COV-OC43 3例(2.00%);混合感染3例(2.00%),分别为呼吸道合胞病毒B型合并COV-OC43、腺病毒和鼻病毒。病原谱构成分析显示,呼吸道合胞病毒A型占总体阳性标本的6.81%,B型占43.18%,腺病毒占20.45%,鼻病毒占11.36%,冠状病毒占11.36%,混合感染占6.81%。44份病毒阳性标本中,男、女性病毒阳性检出率分别为32.10%(26/81)、26.09%(18/69),二者比较,P>0.05。≤4岁、4~18岁、19~59岁、≥60岁者病毒阳性检出率分别为41.07%(23/56)、36.37%(8/22)、16.98%(9/53)、21.05%(4/19),组间比较,P均<0.05。≤4岁者多发呼吸道合胞病毒、腺病毒和鼻病毒感染,≥60岁者未检测到鼻病毒感染。结论流感高发季节血清流感病毒核酸阴性的ILI患者存在呼吸道合胞病毒、腺病毒、鼻病毒和冠状病毒等病毒感染。≤4岁ILI者多发呼吸道合胞病毒、腺病毒和鼻病毒感染。

Objective To analyze the pathogen spectrum of influenza virus-negative nasopharyngeal swabs from 150 influenza-like illness（ILI） cases during flu epidemic season. Methods Totally 150 influenza virus-negative nasopharyngeal swabs specimens were selected randomly for the respiratory syncytial virus（RSV）,adenovirus（Ad V）,human rhinovirus（HRV） and coronavirus（Co V） detection by using real-time PCR. Results Of 150 influenza-like cases,44 cases were virus positive with the positive rate of 29. 33%（44/150）,including 22 cases of RSV infection（14. 67%）,9 cases of Ad V infection（6. 00%）,5 cases of HRV infection（3. 33%） and 5 cases of Co V infection（3. 33%） including 1 case of COV-229 E（0. 67%）,1 case of COV-NL63（0. 67%） and 3 cases of COV-OC43（2. 00%）. There were 3 cases of coinfection（2. 00%）,which were RSVB co-infected with COV-OC43,Ad V and HRV,respectively. The pathogen spectrum analysis showed that RSVA accounted for 6. 81% of the total positive samples,RSVB accounted for 43. 18%,Ad V accounted for 20. 45%,HRV accounted for 11. 36%,Co V accounted for 11. 36%,and co-infection accounted for 6. 81%. In addition,the positive rate was 32. 10%（26/81） in males and 26. 09%（18/69） in females,and no significant difference was found between males and females（P〈0. 05）. The positive rate was 41. 07%（23/56） in the children under four years old,36. 37%（8/22） in the age of 4-18,16. 98%（9/53） in the age of 19-59,and 21. 05%（4/19） in the old people above 60 years old,with significant difference（all P〈0. 05）. RSV,Ad V and HRV were the main viruses infected in the children under 4 years old,and no HRV was detected in the old people above 60 years old. Conclusion RSV,Ad V,HRV,and Co V could be detected in the influenza-like cases,and the children under 4 years old,are more mainly infected with RSV,Ad V,and HRV.