人肠道病毒D68型在儿童急性呼吸道感染中的临床特征与分子生物学特征分析

The clinical and molecular characterizations of enterovirus D68 among children with acute respiratory infection

目的了解人肠病毒D68(EV-D68)在儿童急性呼吸道感染(acute respiratory tract infection,ARTI)中的临床特征及分子流行病学特征。方法采集2014年3月至2016年3月年深圳市妇幼保健院住院及门诊年龄1月至14岁符合急性呼吸道感染(ARTI)患儿共13 472份咽拭子分泌物,使用EV通用核酸试剂盒进行肠道病毒检测,EV病毒通用核酸阳性标本通过RT-PCR扩增并测序分型。结果在13 472份鼻咽部拭子标本中,EV阳性病例1 222例,阳性率为9.10%,EV-D68感染患儿7例,阳性率0.05%,其VP1扩增序列分离的5株D68均与进化簇1病毒序列具有高同源性,2例与进化簇2有高同源性。结论 EV-D68可能是急性呼吸道感染的一种新的主要病原体,感染高峰季节可能在秋冬季节,以急性下呼吸道感染(acute lower respiratory tract infections,ALRTI)为主要表现。

Objective To explore the clinical and molecular epidemiological characteristics of children with enterovirus D68 in acute respiratory tract infection(ARTI). Methods 13 472 cases which were diagnosed with acute respiratory tract infection in the outpatient and ward from March 2014 to March 2016 were screened for enterovirus(EV). The EV positive cases of enterovirus were collected to identify the types of enterovirus by RT-PCR and sequencing. Results 1 222 EV positive cases were found in 13 472 nasopharyngeal swab specimens, the positive rate was 9.10%; and 7 EV-D68 infection were detected, the positive rate was 0.05%. Compared to the Fermon prototype strain of the VP1 sequence, 5 strains of EV-D68 have higher homology with group 1 virus sequence, while 2 with group 2 virus sequence. Conclusions EVD68 may be a new predominant pathogen in acute lower respiratory tract infection(ARTI). The infection peak season may be in autumn and winter season. ALRTI may be a clinical feature of EV-D68 infection.