2015~2017年上海市急性结膜炎患者中人腺病毒感染的型别分布及其流行病学特征

Molecular Typing and Epidemiology Characteristics of Acute Conjunctivitis in Shanghai,China,from 2015 to 2017

为了解上海市2015-2017年急性结膜炎患者中腺病毒感染的型别分布及流行病学特征,本研究收集上海市2015-2017年间各区监测点医院符合病例定义的患者眼结膜拭子所有的标本,使用荧光PCR方法筛查腺病毒核酸。所有腺病毒核酸阳性标本接种HEp-2细胞,获得毒株后使用测序引物扩增腺病毒hexon、fiber和penton base基因高变区片段,使用生物信息学软件对测序后序列信息进行腺病毒基因特征分析。结果显示,2015-2017年共收集急性结膜炎患者的眼结膜拭子标本2 594例,其中腺病毒核酸阳性652例(阳性检出率为25.13%),占急性结膜炎监测总阳性检出率的95.18%(652/685)。经细胞培养后获得腺病毒阳性毒株138株,分离率为79.90%,其基因型别主要为人腺病毒D37亚型、B3亚型,分别占52.17%、28.99%。本研究提示,人腺病毒是引起上海市2015-2017年急性结膜炎感染的主要病原体,其中D37亚型和B3亚型为优势基因型且进化高度保守,需要进一步加强监测。

To explore the molecular typing and epidemiology characteristics of acute conjunctivitis(AC) in Shanghai,China,from 2015 to 2017,conjunctival swabs were collected from outpatients with AC from 2015 to 2017 at a surveillance hospital in Shanghai,China. Specimens were tested for variants of universal enterovirus,enterovirus subtype-70,adenovirus,and coxsackievirus A24 by real-time polymerase chain reaction(PCR)or reverse transcription-polymerase chain reaction(RT-PCR). PCRs were carried out for amplification of hexons,fibers,and DNA polymerase genes of partial adenoviruses. Evolution of the amplified genes of selected adenoviruses was analyzed by Lasergene? and MEGA?. Results showed that,of 2,594 AC samples,652/685(95.18%)were adenovirus-positive. Also,138 of HEp-2 cell cultures with sample inoculation were amplified as positive for adenovirus DNA by PCR,and the adenovirus was 52.17% of the Ad37 type and 28.99% of the Ad3 type. The present study suggested that AC was caused mainly by adenoviruses,especially the Ad37 and Ad3 types.