2017-2020年我国儿童急性下呼吸道人腺病毒感染流行病学特征分析

Epidemiological characteristics of acute lower respiratory tract infection with human adenovirus among children in China from 2017 to 2020

目的 了解我国儿童急性下呼吸道人腺病毒(human adenovirus,HAdV)感染的流行病学特征及优势基因型别。方法 收集2017年6月-2020年4月我国南北方6家医院的急性下呼吸道感染(acute lower respiratory tract infection,ALRTI)住院儿童的呼吸道样本,使用多重呼吸道病毒检测试剂对常见呼吸道病毒进行检测。对HAdV阳性样本进行基因分型,并收集患儿的临床信息进行临床特征及流行病学分析。结果 本研究共纳入2 793例ALRTI患儿,其中143例HAdV阳性,检出率为5.12%。南北方检出率分别为6.37%(91/1 429)和3.81%(52/1 364),差异有统计学意义(χ^(2)=9.384,P=0.002),北方3~<6岁年龄组检出率最高,为5.94%;南方1~<3岁年龄组检出率最高,为9.37%。南方2019年春季和北方2019年夏季HAdV检出率最高,分别为10.43%(12/115)和13.70%(10/73)。92例HAdV阳性样本被成功分型,以B种的3型(35例)和7型(33例)居多;北方以B种的3型(19例)、7型(8例)和E种的4型(7例)多见,南方流行的优势型别为B种的3型(16例)和7型(25例)。患儿以肺炎为主要诊断(121例),其中重症肺炎15例,HAdV-7型感染10例。46.15%的患儿合并其他病毒感染,其中呼吸道合胞病毒(18例)为最常见的混合感染病毒。结论 HAdV是2017-2020年我国儿童ALRTI的重要病毒病原之一,感染常年存在;南北方流行的HAdV均以B种为主;HAdV感染重症肺炎以HAdV-7型为主。

Objective To investigate the epidemiological characteristics and predominant genotypes of human adenovirus(HAdV)infection in children with acute lower respiratory tract infection(ALRTI)in China.Methods From June 2017 to April 2020,respiratory samples of hospitalized children with ALRTI from six hospitals in Northern and Southern China were collected.Common respiratory viruses were detected by a multiplex respiratory virus detection kit.HAdV-positive samples were genotyped,and clinical information of the patients was collected for clinical and epidemiological analysis.Results A total of 2793 children with ALRTI were included in this study,of which 143 were HAdV-positive,with a detection rate of 5.12%.The detection rates in Southern and Northern China were 6.37%(91/1429)and 3.81%(52/1364),respectively(χ^(2)=9.384,P=0.002).In Northern China,the incidence of HAdV infection peaked in children aged 3-<6 years(5.94%).While in Southern and Northern China,the incidence of HAdV infection peaked in children aged 1-<3 years(9.37%).In Northern and Southern China,the highest detection rate of HAdV was in the spring and summer of 2019,with 10.43%(12/115)and 13.70%(10/73),respectively.92 HAdV-positive samples were successfully genotyped,of which HAdV-3 and HAdV-7 represented the majority,with 35 cases and 33 cases,respectively.The predominant HAdV genotypes were HAdV-3(19 cases),HAdV-7(8 cases),and HAdV-4(7 cases)in Northern China,while in Southern China,the former two genotypes were more common,accounting for 16 cases and 25 cases,respectively.Pneumonia was the main diagnosis of children(121 cases),including 15 cases of severe pneumonia,accounting for 10.49%of children with HAdV infection,among which 10 cases of HAdV-7 infection.46.15%of the HAdV-positive children were complicated with other viral infections,with respiratory syncytial virus(18 cases)being the most common mixed infection virus.Conclusions HAdV was one of the most important viral pathogens in pediatric ALRTI in China from 2017 to 2020,and the infection existed throughout the year.The HAdV subgroup prevalent in Northern and Southern China was mainly the B subgroup.Severe pneumonia caused by HAdV infection was mainly caused by HAdV-7.