用套式RT-PCR检测兰州地区肺炎患儿下呼吸道分泌物中的RSV和HPIV-3

为了调查兰州地区肺炎患儿中RSV和HPIV-3的感染状况,分别在RSV的G蛋白基因的保守序列和HPIV-3的HN基因的保守序列处,设计了套式引物,采用套式RT-PCR的方法检测了60份兰州地区肺炎患儿下呼吸道分泌物样本,结果显示,60份样本中RSV阳性为14例(23%),HPIV-3阳性为12例(20%)。并分别随机对其中的5份样本的扩增产物进行了基因序列测定,结果5份RSV阳性样本与参考株序列的同源性均大于97%,5份HPIV-3阳性样本与参考株序列的同源性大于97%。表明兰州地区下呼吸道感染患儿中,RSV和HPIV-3是常见的感染病原体。     

急性下呼吸道感染患儿中RSV的分离鉴定及分析

目的对2015年兰州单中心急性下呼吸道感染患儿中呼吸道合胞病毒(respiratory syncytial virus,RSV)进行分离鉴定及分析。方法收集临床急性下呼吸道感染患儿痰分泌物226份,在HEP-2细胞中连续盲传培养3代,收获的培养物用半巢式RT-PCR进行检测,选取强阳性样品进行测序以确定其型别,并对其流行病学特征进行分析。结果 226份样品中RSV阳性样本为76份(阳性率为34%)。RSV阳性患儿中,男女性别比为3∶1;年龄分布6月龄患儿占45%,6月龄~2岁占35%,2~5岁的占20%。冬季为发病高峰。76例RSV阳性患儿中,临床诊断依次为毛细支气管炎31例(40.79%)、喘息性支气管炎21例(27.36%)、支气管肺炎20例(26.32%)和支气管哮喘4例(5.26%)。40份强阳性RSV样品经测序确定为B亚型。结论 RSV是引起婴幼儿急性下呼吸道感染的重要病原之一,2015年RSV的流行株主要为B亚型。     

西藏地区儿童急性呼吸道感染中呼吸道合胞病毒的初步研究

本研究为了解西藏地区儿童急性呼吸道感染中呼吸道合胞病毒(Respiratory syncytial virus,RSV)及基因型别。首先采用直接免疫荧光法检测2011年4～7月西藏自治区人民医院儿科病房因急性呼吸道感染住院患儿的鼻咽分泌物标本中7种常见的呼吸道病毒及人类偏肺病毒(Human metapneumovirus,hMPV)的抗原。然后对RSV抗原阳性的标本分别提取RNA,用逆转录-巢式聚合酶链反应法(Nest-PCR)确定RSV型别,同时用实时荧光PCR(Real-Time PCR)方法进行验证。再通过对G蛋白基因PCR扩增产物序列测定确定RSV的基因型。通过与GenBank中不同地区RSV分离株的G蛋白基因序列比对,了解西藏地区RSV G蛋白的结构特点及变异情况。结果表明,从167例标本中检测出呼吸道病毒抗原阳性的为65例,总阳性率为38.9%(65/167),其中RSV 45例,占阳性标本的69.2%(45/65),对其中42例RSV阳性标本进行了PCR分型,其中40例为A亚型,2例为B亚型。对7株A亚型RSV G蛋白基因PCR产物测序结果显示,全部为GA2基因型。西藏RSV与RSV原型株A2株核苷酸的同源性为90.7%～91.8%,氨基酸的同源性只有86.5%～87.2%。氨基酸的变异主要集中在胞外区一个高度保守序列的两端。7株西藏A亚型RSV G蛋白的核苷酸序列与GenBank中不同的RSV分离株相比同源性为90.7%～91.8%。西藏地区2011年春季小儿急性呼吸道感染的病毒病原主要为呼吸道合胞病毒,A亚型是2011年西藏地区的流行优势型别,其G蛋白胞外区基因具有较高的变异性。     

浙江地区呼吸道合胞病毒G基因分子特征分析

收集2004年冬季浙江省儿童医院呼吸道感染患儿的鼻咽吸引物,进行呼吸道合胞病毒(RSV)分离,对分离株用特异性RT-PCR鉴定;对鉴定阳性的RSV毒株进行G蛋白全基因序列测定,并与RSV国际标准株及各地参考株的G蛋白基因序列进行同源性比较并构建基因进化树。结果表明,在4株RSV浙江分离株中,3株G蛋白基因ORF全长897bp,另1株为894bp;各分离株之间的核苷酸与氨基酸同源性分别为98.05%、97.06%;与A型RSV标准株的核酸同源性为95.69%,与B型RSV标准株的同源性为78.79%;其3’端基因高变区核苷酸序列与RSVGA2亚型的同源性最高。提示2004年冬季浙江省RSV流行株属于RSVGA2亚型。     

浙江地区呼吸道合胞病毒G基因分子特征分析

收集2004年冬季浙江省儿童医院呼吸道感染患儿的鼻咽吸引物,进行呼吸道合胞病毒(RSV)分离,对分离株用特异性RT-PCR鉴定;对鉴定阳性的RSV毒株进行G蛋白全基因序列测定,并与RSV国际标准株及各地参考株的G蛋白基因序列进行同源性比较并构建基因进化树.结果表明,在4株RSV浙江分离株中,3株G蛋白基因ORF全长897bp,另1株为894bp;各分离株之间的核苷酸与氨基酸同源性分别为98.05%、97.06%;与A型RSV标准株的核酸同源性为95.69%,与B型RSV标准株的同源性为78.79%;其3'端基因高变区核苷酸序列与RSV GA2亚型的同源性最高.提示2004年冬季浙江省RSV流行株属于RSV GA2亚型.     

人呼吸道合胞病毒M蛋白非复制型重组腺病毒的构建和鉴定

人呼吸道合胞病毒（human respiratory syncytial virus, RSV)基质蛋白（matrix protein,M）在RSV形态发生上具有重要作用,因含有CTL抗原表位,在疫苗研究上具有一定意义。为此,应用RT-PCR 方法从感染RSV的HEp-2 细胞中扩增获得M蛋白基因,构建了含M基因的非复制型重组腺病毒并进行表达和鉴定。基因序列分析显示RSV M基因仅有一处碱基发生错义突变。非复制型重组腺病毒DNA分子FGAd/RSVM转染293细胞,观察到细胞出现CPE,RT-PCR发现M基因有转录,Western blotting及间接免疫荧光分析检测到M蛋白。成功克隆A亚型RSV Long株M基因,并获得一株可表达A亚型RSV M蛋白的非复制型重组腺病毒FGAd/RSVM,可用于体内研究观察其免疫效果及免疫保护作用。     

上海复旦大学附属儿科医院急性下呼吸道感染患儿常见病毒的检测及临床研究

目的 建立套式反转录-聚合酶链反应(nested-RT-PCR)检测临床样本鼻病毒(human rhinovirus,HRV)基因的方法和直接免疫荧光(DFA)的方法对常见呼吸道病毒病原进行检测,了解上海儿科医院小儿急性下呼吸道感染(ALRTI)中病毒感染的现状.方法 收集住院确诊为ALRTI患儿的深部鼻咽分泌物(NPS)标本.用套式RT-PCR的方法检测NPS中的HRV基因,并进一步对扩增产物进行序列分析;用DFA的方法检测NPS中的呼吸道合胞病毒(RSV)、流感病毒(IFV)、副流感病毒(PIV)、腺病毒(ADV)抗原.并分析各种病毒所致ALRTI的临床特点及流行特征.结果 342例患儿除细菌感染外共130例病毒抗原阳性,其中检测出RSV 64例(18.70%),1岁以下婴儿的RSV检出数为71.8%.RSV 8月份起检出率逐渐升高,到12月份达到最高;HRV阳性患儿46例(13.45%),3岁以下婴幼儿检出例数有38例,占HRV检出数的82.6%.HRV致ALRTI全年可见,在3到5月为最高峰;ADV感染9例(2.63%);PIV感染8例(2.3%);IFV感染7例(2.0%);病毒合并感染共有4例.46例HRV阳性标本中选取15份用另1对引物扩增并测序,测得的核苷酸序列经过blast比较,与GenBank中已知HRV序列的同源性在83%～97%,样本间的序列比较提示变异性较大.130例病毒性ALRTI患儿绝大部分诊断为支气管肺炎.以中等度发热为主,末梢血白细胞＜10×109/L 93例(71.5%),CRP＜8 mg/L 99例(76.2%),符合病毒性肺炎的特点,并发症较少,均治愈出院.结论 本地区小儿病毒性ALRTI中,以RSV及HRV占为主要地位,ADV、PIV及IFV相对少见.较少有混合性病毒感染.HRV所致小儿ALRTI以婴幼儿居多,集中于春、秋两季.套式RT-PCR检测HRV基因快速、操作简便、特异性较强,HRV基因组具有高度变异的特点.     

呼吸道合胞病毒TaqMan探针实时定量RT-PCR检测方法的建立及应用

目的:建立呼吸道合胞病毒(RSV)核酸特异、快速、敏感的TaqMan探针实时荧光定量PCR检测方法,并对临床样本进行检测。方法:比对编码RSV非编码蛋白的基因序列,选取其保守片段设计引物和探针,建立实时荧光定量RT-PCR检测方法,并与传统RT-PCR方法进行比较,分别对两者的灵敏性、特异性、重复性及临床样本检验的适用性进行评价。结果:所建立的实时荧光定量RT-PCR检测方法可用于RSV的特异性检测。相对于传统RT-PCR方法100拷贝/反应的检测灵敏度,实时荧光定量RT-PCR的检测灵敏度达到10拷贝/反应,检测范围为1010~101拷贝/反应,且具有良好的特异性和重复性。从169份临床呼吸道标本中检出RSV阳性40例,高于普通PCR方法(31/169)。结论:建立了RSV的TaqMan探针实时定量PCR检测方法,并可用于临床鼻咽拭子样本的检测,在临床上具有较好的应用前景。     

H6亚型禽流感病毒RT-LAMP检测方法的建立

建立一种快速、敏感、特异的检测H6亚型禽流感病毒(AIV)逆转录环介导等温扩增(RT-LAMP)检测方法.根据H6亚型AIV血凝素(HA)基因序列的保守区8个位点设计了6条特异性LAMP引物,以H6亚型AIV阳性样品RNA为模板进行一步法扩增,对反应条件和反应体系进行优化.结果表明该方法的特异性良好,对其他呼吸道病原体均无扩增反应.该方法灵敏度高,最低可检测到H6亚型AIV RNA为0.01 pg,该方法无需特殊仪器,只需在水浴锅中进行,是一种适于基层的简便、灵敏、快速的H6亚型AIV检测方法.     

Clinical characteristics and molecular epidemiology of human metapneumovirus in children with acute lower respiratory tract infections in China, 2017 to 2019: A multicentre prospective observational study

Human metapneumovirus (HMPV) infection is one of the leading causes of hospitalization in young children with acute respiratory illness. In this study, we prospectively collected respiratory tract samples from children who were hospitalized with acute lower respiratory tract infection in six hospitals in China from 2017 to 2019. HMPV was detected in 145 out of 2733 samples (5.3%) from the hospitalized children. The majority of HMPV-positive children were under the age of two (67.6%), with a median age of one year. HMPV can independently cause acute lower respiratory tract infection in young children, while all patients showed mild clinical symptoms. Of all the co-infected patients, HMPV was most commonly detected with enterovirus (EV) or rhinovirus (RhV) (38.0%, followed by respiratory syncytial virus (RSV) (32.0%). The highest detection rate occurred from March to May in both northern and southern China. Out of 145 HMPV positive samples, 48 were successfully typed, of which 36 strains were subgrouped into subtypes A2c (75%), eight strains were included in subtype B1 (16.7%), and four strains were included in subtype B2 (8.3%). Moreover, 16 A2c strains contained 111-nucleotide duplications in the G gene. Twenty-seven complete HMPV genomes were successfully obtained, and 25 (92.6%) strains belonged to subtype A2c, whereas one strain was included in subgroup B1 and another was included in subgroup B2. A total of 277 mutations were observed in the complete genomes of 25 A2c strains. All results presented here improve our understanding of clinical characteristics and molecular epidemiology of HMPV infection in children.     

569例呼吸道感染住院儿童7种常见呼吸道病毒病原学分析

目的了解呼吸道感染住院患儿呼吸道病毒的分布情况。方法选取2015年7月至2016年6月呼吸道感染的住院患儿病例,抽取鼻咽分泌物,采用直接免疫荧光法检测常见的7种病毒,即呼吸道合胞病毒(RSV)、甲型流感病毒(IVA)、乙型流感病毒(IVB)、副流感病毒1型(PIV1)、副流感病毒2型(PIV2)、副流感病毒3型(PIV3)、腺病毒(IVD)。结果共有569例样本送检,193例病毒检测阳性(33.92%),其中有3例为2种病毒的混合感染。男性共369例,女性共200例。其中RSV、PIV3、ADV的感染率居前三位。呼吸道病毒的感染率随着患儿年龄的增长逐渐下降,除新生儿外,6个月内的婴幼儿呼吸道病毒检出率最高。RSV检测阳性率自11月开始呈增高趋势,12月最高,达55.86%。PIV3的检出高峰出现在7月,达13.64%。结论 RSV是本地区儿童呼吸道感染最常见的病毒。呼吸道病毒的检出率与年龄、季节等因素有关。     

Novel Respiratory Syncytial Virus (RSV) Genotype ON1 Predominates in Germany during Winter Season 2012–13

Respiratory syncytial virus (RSV) is the leading cause of hospitalization especially in young children with respiratory tract infections (RTI). Patterns of circulating RSV genotypes can provide a better understanding of the molecular epidemiology of RSV infection. We retrospectively analyzed the genetic diversity of RSV infection in hospitalized children with acute RTI admitted to University Hospital Heidelberg/Germany between October 2012 and April 2013. Nasopharyngeal aspirates (NPA) were routinely obtained in 240 children younger than 2 years of age who presented with clinical symptoms of upper or lower RTI. We analyzed NPAs via PCR and sequence analysis of the second variable region of the RSV G gene coding for the attachment glycoprotein. We obtained medical records reviewing routine clinical data. RSV was detected in 134/240 children. In RSV-positive patients the most common diagnosis was bronchitis/bronchiolitis (75.4%). The mean duration of hospitalization was longer in RSV-positive compared to RSV-negative patients (3.5 vs. 5.1 days; p<0.01). RSV-A was detected in 82.1%, RSV-B in 17.9% of all samples. Phylogenetic analysis of 112 isolates revealed that the majority of RSV-A strains (65%) belonged to the novel ON1 genotype containing a 72-nucleotide duplication. However, genotype ON1 was not associated with a more severe course of illness when taking basic clinical/laboratory parameters into account. Molecular characterization of RSV confirms the co-circulation of multiple genotypes of subtype RSV-A and RSV-B. The duplication in the G gene of genotype ON1 might have an effect on the rapid spread of this emerging RSV strain.     

Respiratory syncytial virus infections during an epidemic period in Salvador, Brazil. Viral antigenic group analysis and description of clinical and epidemiological aspects

Acute respiratory infections (ARI) caused by respiratory syncytial virus (RSV) were studied in 482 children from Salvador, BA, Brazil, over a period of 12 months. The epidemic period of RSV infections in Salvador occurred from February (summer) to August (winter), with peaks in May, June, and July. The grouping characteristics of 84 RSV present in nasopharyngeal secretions of children seen at a reference university hospital were analyzed. RSV represented 17.4% of all cases and 54.5% of the positive samples. Sixty-four RSV strains were assigned to group A and 14 to group B. Both groups circulated in the five months of the epidemic period studied. Infections by both groups of RSV were more frequent in children up to one year of age. The incidence of RSV ARI was slightly more frequent in males, although group B had more infected females.     

Infections caused by RSV among children and adults during two epidemic seasons

Respiratory Syncytial Virus (RSV) is one of the most common causes of lower respiratory tract infections in young children, immunocompromised patients (children and adults), patients with chronic respiratory diseases and elderly people. Reinfections occur throughout the life, but the severity of disease decreased with subsequent infection. The aim of this study was to analyze the frequency of RSV infections in two selected subpopulations: young children (below 5 y.) and adults with chronic respiratory diseases (25-87 y.). Nasopharyngeal swabs (334) collected from October 2008 to March 2010 were examined. The presence of RSV genome was determined by RT-PCR and the presence of RSV antigen by quick immunochromatographic test. Positive results of RT-PCR were found in 45.2% of all swabs: 48.6% samples in 2008; 41.5% in 2009; 50.8% in 2010. The highest frequency of RSV-positive samples was in fall-winter months, but differences in RSV epidemic seasons were found. In the first season (2008-2009) an increased number of RSV infections was observed from November 2008, but in the second season--from January 2010. Generally, the frequency of RSV-positive RT-PCR among children was 53%, among adults 25%. The highest difference was observed in the first three-month period of 2010. RT-PCR positive samples were found in 68.5% of children and 5.9% of adults. However, the RSV antigen was found in 44.4% of samples collected from adults in this period. Our results indicate that the contribution of RSV infections during epidemic season of respiratory tract infections in Poland was really high among children and adults.     

Isolation of respiratory syncytial virus from nasopharyngeal aspirates stored at 20 degrees C from one to fifteen months after collection

Cell culture isolation is used for recovering respiratory syncytial virus (RSV) from respiratory specimens. As RSV is a thermolabile virus, specimens destined for inoculation into cell culture require special transport, handling, and storage. The isolation rate of RSV from nasopharyngeal aspirates (NPA) stored at 20 20 degrees C for one to 15 months after collection was investigated. A total of 126 samples considered positive for RSV by indirect fluorescence-antibody were tested by virus isolation in HEp-2 cell culture. RSV was isolated from 47/126 specimens (37.3%). These results show that RSV may be recovered from NPA stored at 20 20 degrees C by cell culture.     

First detection of human metapneumovirus in children with respiratory infections in Romania

The human metapneumovirus (hMPV) was first isolated in 2001 in the Netherlands (Van der Hoogen and collaborators) from a nasopharyngeal aspirate sampled from an infant. Based on the morphological, biochemical and genetic characteristics, the hMPV was initially classified in the genus Metapneumovirus with the avian metapneumovirus (APV), the agent causing the respiratory infections of the upper tract in turkeys and other birds. Subsequently, together with the respiratory syncytial virus (RSV), it was classified in the Pneumovirus genus which is a part of the Pneumovirinae subfamily, the Paramyxoviridae family. The aim of the present study was to optimize hMPV molecular detection and to detect the virus in samples form children with respiratory infections in Romania. Two types of RTPCR commercial kits were evaluated for the detection of hMPV. Tests were performed on 28 pharyngeal exudates from children aged from 9 months to 6 years, which were negative for influenza viruses and for Respiratory Syncytial Virus (RSV). Among the tested samples 7 (25%) have been positive for hMPV by RT-PCR. These results document for the first time that hMPV is circulating in Romania and causes respiratory infections, especially in newborns and children under 6 years old.     

Respiratory viruses in children younger than five years old with acute respiratory disease from 2001 to 2004 in Uberlândia, MG, Brazil

The main viruses involved in acute respiratory diseases among children are: respiratory syncytial virus (RSV), influenzavirus (FLU), parainfluenzavirus (PIV), adenovirus (AdV), human rhinovirus (HRV), and the human metapneumovirus (hMPV). The purpose of the present study was to identify respiratory viruses that affected children younger than five years old in Uberlandia, Midwestern Brazil. Nasopharyngeal aspirates from 379 children attended at Hospital de Clínicas (HC/UFU), from 2001 to 2004, with acute respiratory disease, were collected and tested by immunofluorescence assay (IFA) to detect RSV, FLU A and B, PIV 1, 2, and 3 and AdV, and RT-PCR to detect HRV. RSV was detected in 26.4% (100/379) of samples, FLU A and B in 9.5% (36/379), PIV 1, 2 and 3 in 6.3% (24/379) and AdV in 3.7% (14/379). HRV were detected in 29.6% (112/379) of the negative and indeterminate samples tested by IFI. RSV, particularly among children less than six months of life, and HRV cases showed highest incidence. Negative samples by both IFA and RT-PCR might reflect the presence of other pathogens, such as hMPV, coronavirus, and bacteria. Laboratorial diagnosis constituted an essential instrument to determine the incidence of the most common viruses in respiratory infections among children in this region.