2018—2020年河北省某儿童医院呼吸道感染住院患儿中人腺病毒2、3和7型流行特征分析

Epidemiological characteristics of human adenovirus 2,3 and 7 genetypes in hospitalized children with respiratory infection in a hospital of pediatric in Hebei Province from 2018 to 202

目的探讨河北省儿童医院呼吸道感染住院患儿中人腺病毒(HADV)2、3和7型的流行特征。方法回顾性纳入2018年1月至2020年12月因呼吸道感染于河北省儿童医院住院治疗的患儿25686例,采集其深部痰液或鼻咽吸取物,使用多重PCR检测13种临床常见呼吸道病原体,并使用多重实时荧光定量PCR对采用随机数法选取的510份HADV阳性标本进行2、3和7型的分型检测。采用SPSS 21.0软件进行统计学分析,计数资料以例数和百分数表示,组间比较采用χ^(2)检验。结果HADV阳性检出率为7.99%(2052/25686),3~<6岁年龄组的阳性检出率最高(11.44%),2019年HADV的阳性检出率最高(10.64%)。510份HADV阳性样本中,3型构成比最高(31.16%),其次为7型(21.37%)和2型(11.18%)。2019年HADV2型的阳性检出率明显低于2018年和2020年(χ^(2)=8.954和16.354,P=0.003和<0.01),而3型的阳性检出率则明显高于2018年和2020年(χ^(2)=5.248和4.811,P=0.022和0.028)。HADV 2型在冬季的阳性检出率最低;3型在春季的阳性检出率最低,秋、冬季明显升高;7型在秋季的阳性检出率最低,冬季明显升高。HADV与其他呼吸道病原体混合检出率为43.33%(221/510),其中HADV 3型的混合检出率最高(47.32%),且2、3和7型的混合检出率均明显高于其单独检出率(χ^(2)=20.438,P<0.01;χ^(2)=42.105,P<0.01;χ^(2)=27.573,P<0.01)。HADV 7型(15.89%)阳性患儿中重症肺炎的构成比高于非7型(8.23%)阳性患儿(χ^(2)=5.260,P=0.022)。结论HADV是2018—2020年河北省儿童医院住院患儿呼吸道感染的重要病原体之一,易感人群为3~6岁学龄前儿童,易与其他呼吸道病原体混合检出;3型和7型可能是流行的优势基因型别,7型可能是儿童重症肺炎危险因素之一。

Objective To investigate the epidemiological characteristics of human adenovirus(HADV)2,3 and 7 in hospitalized children with respiratory infection.Methods A total of 25686 children with respiratory infection hospitalized at Children′s Hospital of Hebei Province from January 2018 to December 2020 were retrospectively included.Deep sputum or nasopharyngeal aspirates of those children were collected.Then thirteen common respiratory pathogens were detected by multiplex PCR.510 HADV positive specimens were randomly selected via random number and classified for type 2,3 and 7 using a multiplex real-time quantitative PCR.SPSS 21.0 software was used to perform all of the statistical analyses.Enumeration data were expressed by frequency and percentage.χ^(2) test was used for comparison between groups.Results The HADV-positive rate was 7.99%(2052/25686).Children at age 3-<6 years had the highest HADV-positive rate(11.44%).The HADV-positive rate in 2019 was highest(10.64%).Among the 510 HADV-positive specimens,the proportion of type 3 was the highest(31.16%),followed by type 7(21.37%)and type 2(11.18%).The rate of type 2 in 2019 was significantly lower than that in 2018 and 2020(χ^(2)=8.954 and 16.354;P=0.003 and<0.01),while the rate of type 3 was significantly higher than that in 2018 and 2020(χ^(2)=5.248 and 4.811;P=0.022 and 0.028).The rate of type 2,type 3 and type 7 were lowest in winter,spring and autumn,respectively.The rate of type 2 increased significantly in autumn and the rate of type 3 and type 7 increased significantly in winter.The co-detection rate of HADV with other respiratory pathogens was 43.33%(221/510).Among,the co-detection rate of type 3 was highest(47.32%),and the co-detection rate of type 2,3 and 7 was significantly higher than the alone detection rate(χ^(2)=20.438,P<0.01;χ^(2)=42.105,P<0.01;χ^(2)=27.573,P<0.01).The proportion of severe pneumonia in children with type 7 positive(15.89%)was higher than that in children with non-type 7 positive(8.23%)(χ^(2)=5.260,P=0.022).Conclusion HADV is one of the important pathogens of children with respiratory infection in Children′s Hospital of Hebei Province.The susceptible population of HADV is preschool children aged 3 to 6 years.HADV often co-detects with other respiratory pathogens.Type 3 and 7 is likely to be the dominant genotypes in this region,and type 7 may be one of the risk factors of severe pneumonia in children.