河北省石家庄地区某哨点医院2018-2020年住院儿童肺炎患者鼻病毒流行病学及基因特征分析

Epidemiological and genetic characteristics of human rhinovirus in hospitalized children with pneumonia in a sentinel hospital in Shijiazhuang,Hebei province of China in 2018 to 2020

目的了解河北省石家庄地区某哨点医院2018-2020年住院肺炎儿童中鼻病毒(human rhinovirus)感染及遗传变异规律。方法收集2018-2020年河北省儿童医院住院肺炎患儿的支气管肺泡灌洗液标本444例,采用多重聚合酶链反应方法对常见呼吸道病原体进行筛查,鼻病毒阳性的标本再扩增其VP4/VP2基因并进行分析。结果444份标本中鼻病毒检出率为10.59%(47/444),鼻病毒感染主要集中在3岁以下儿童,占65.96%(31/47);其中婴儿组检出率最高,为27.27%(12/44),幼儿组检出率为4.32%(19/128),学龄前组检出率为14.84%(6/139),学龄期组检出率为7.52%(10/133),不同年龄组间检出率差异有统计学意义(χ^(2)=20.418,P=0.000),鼻病毒检出无明显的季节性(2020年1—3月无检出)。支气管肺炎中鼻病毒检出率(16.96%,19/112)高于肺炎中的检出率(7.95%,26/327)(χ^(2)=7.367,P=0.007)。混合感染36例,检出高峰为夏季,婴儿组检出率最高,与肺炎链球菌、肺炎支原体混合感染最常见。获得的11条VP4/VP2序列全部为鼻病毒A基因型(human rhtnovirus A,HRV-A),共检出6个血清型。结论河北省石家庄地区某哨点医院2018-2020年住院儿童肺炎病例鼻病毒的感染率高,感染以3岁以下儿童为主,支气管肺炎鼻病毒检出率高于肺炎,获得的序列全部为HRV-A型。

Objective To understand the epidemiology of human rhinovirus infection and genetic variation in hospitalized children with pneumonia in a sentinel hospital in Shijiazhuang,Hebei province,China.Methods The bronchoalveolar lavage fluid specimens were collected from 444 cases who were hospitalized in a children′s hospital of Hebei province.Common respiratory pathogens were detected by multiplex RT-PCR,and the VP4/VP2 gene was amplified and analyzed from human rhinovirus positive samples.Results Among 444 cases of pneumonia,47 cases were positive(10.59%)and most positive cases(65.96%,31/47)were younger than 3 years old.The detection rate was 27.27%(12/44)in the infant group,4.32%(19/128)in the child group,14.84%(6/139)in the preschool group,and 7.52%(10/133)in the school-age group.There was significant difference in the detection rate among different age groups.HRV infection did not show obvious seasonality.The detection rate of HRV(16.96%,19/112)in bronchopneumonia was much higher than that in pneumonia(7.95%,26/327).Among 36 cases of mixed infections,the detection peak was in summer,and the highest detection rate was in infant group.The most common infection was mixed with Streptococcus pneumoniae and Mycoplasma pneumoniae.The 11 VP4/VP2 sequences were all HRV-A and 6 serotypes were detected.Conclusions The infection rate of HRV is high in hospitalized children with pneumonia in a sentinel hospital in Shijiazhuang of Hebei province in China.The most susceptible population is the under 3 years old group.The detection rate of HRV in bronchopneumonia is higher than that in pneumonia.All sequences are HRV-A genotype.