2021年安徽蚌埠秋冬季肺炎患者鼻病毒检测及基因特征分析

Detection and phylogenetic analysis of human rhinovirus in hospitalized patients with pneumonia in autumn and winter in Bengbu,Anhui province,2021

目的了解人鼻病毒(human rhinovirus,HRV)在成人住院肺炎患者中的检出率及基因特征。方法采集2021年9~12月安徽蚌埠某医院住院肺炎患者咽拭子,以实时荧光定量PCR方法进行14种常见呼吸道病原体检测。巢式PCR法扩增HRV阳性样本的VP4/VP2编码区基因,扩增产物测序。使用MEGA7.0软件构建HRV-VP4/VP2基因序列系统发育树。结果共采集住院肺炎患者咽拭子146份,其中检出阳性样本52份,检出率为35.62%(52/146),HRV、腺病毒、冠状病毒OC43和乙型流感病毒检出率位居前四位。HRV共检出23例,占检出病毒样本的44.23%(23/52),其中HRV混合感染有9例(39.13%,9/23);结合临床数据分析,HRV混合感染组白细胞、中性粒细胞计数、合并高血压、糖尿病、辅助通气比例以及不良预后比例均高于单一感染组(P<0.05)。系统发育树结果显示本研究的HRV感染主要以A组与B组为主。结论HRV是2021年安徽蚌埠秋冬季成人肺炎患者中最常见的病原体,其中HRV-A与HRV-B为优势株。HRV与其他呼吸道病毒混合感染易出现在合并高血压和糖尿病的患者,临床治疗中更需要辅助通气,易出现不良预后。

Objective To investigate genetic characteristics of human rhinovirus(HRV)in adult inpatients with pneumonia in autumn and winter in Bengbu,Anhui province,2021.Methods The pharyngeal swabs of inpatients with pneumonia in Bengbu were collected for the detection of 14 common respiratory pathogens by Real-time PCR during September to December 2021.VP4/VP2 coding regions of HRV positive samples were amplified by nested PCR and phylogenetic tree was constructed using MEGA7.0.Results A total of 146 samples were collected from inpatients with pneumonia;35.62%(52/146)samples were positive with at least one pathogen.The four viruses with high detection rate were HRV,adenovirus,human coronavirus OC43 and influenza B virus.HRV positive samples accounted for 44.23%(23/52)of the positive samples,among which 9 cases(39.13%,9/23)co-infected with HRV.Phylogenetic analysis found that HRV infection were dominated by HRV-A and HRV-B groups.The analysis based on clinical syndrome found that the white blood cells count and the proportion neutrophils of patients with HRV co-infection were higher that of HRV single infection.The proportion of patients with hypertension,diabetes,mechanical ventilation and poor prognosis in the HRV co-infection group were higher than that of HRV single infection group(P<0.05).Conclusions HRV is the predominant pathogen among the adult inpatients with pneumonia in Bengbu.HRV-A and HRV-B groups are common.Patients accompanied by hypertension,diabetes were easily co-infected with HRV.Patients coinfeted with HRV are more likely to be mechanical ventilation and poor prognosis.