中国内陆发现HCoV-HKU1感染及N和S蛋白基因序列及进化分析

了解冠状病毒HKU1在我国大陆地区的感染情况及N基因和S基因的编码特征。采用RT-PCR的方法对2005年10月~2006年1月收集的260例急性呼吸道感染的住院儿童鼻咽抽吸物(NPA)进行了冠状病毒HKU1基因检测。将PCR阳性产物测序,并将所测序列在GenBank中进行比较分析。260份样本中共检测到2份冠状病毒HKU1阳性,阳性率为0.77%(2/260),且该2例冠状病毒HKU1阳性患者临床均表现为肺炎症状。扩增其中一株病毒N和S全基因,并进行测序,与GenBank中的冠状病毒HKU1参考株及冠状病毒科其它成员进行序列同源性和进化树分析,并对N和S蛋白的结构与功能进行了初步的预测分析。由此表明我国大陆地区存在冠状病毒HKU1感染,且可能与儿童下呼吸道感染存在相关性。     

从急性腹泻儿童中检出的人博卡病毒2型的研究

为了调查北京地区急性腹泻患儿中人博卡病毒2型（HBoV2）的流行情况并了解这一病毒的基因组特征,本研究收集2010年11月至2011年10月到首都儿科研究所附属儿童医院门诊就诊的急性腹泻患儿的粪便标本553例,采用荧光实时PCR进行HBoV2 DNA的检测。选择2例病毒载量较高的阳性标本进行HBoV2各基因片段的扩增并测序。将所测到的序列进行拼接后得到完整的基因组序列并与GenBank中的相关序列进行比较分析。结果显示,553例粪便标本中共检出HBoV2阳性标本15例,阳性率为2.7%;各年龄组中,3~6月龄患儿中的HBoV2 DNA阳性检出率最高（4.1%）;所检年度中,7月份阳性检出率最高（7.0%）;15例HBoV2检测阳性的患儿年龄均在2岁以下,其中4例患儿同时检出了诺如病毒,3例患儿同时检出了轮状病毒,1例检出了腺病毒。经测序得到两株接近完整的HBoV2基因组序列BJQ19和BJQ390;序列分析表明,这两株序列的同源性为99.2%,与GenBank中的FJ375129同源性最高,分别为99.1%和99.2%,为典型的HBoV2。上述结果表明,北京地区部分儿童的急性腹泻可能与HBoV2感染相关,且HBoV2感染在低年龄组儿童中更为常见。     

人类博卡病毒HBoV1基因组克隆及启动子活性分析

人类博卡病毒 (Human bocavirus,HBoV) 是继细小病毒B19之后,第2个被发现可引起人类疾病的细小病毒。通过PCR扩增方法从患有下呼吸道感染的患儿痰液中鉴定HBoV,以鉴定的阳性样本为模板,利用分子生物学方法构建病毒基因组克隆并进行序列分析。2007年10月?2009年3月从湖北省妇幼保健院共收集941例下呼吸道感染患儿的痰液标本,检测到33份HBoV阳性样品,阳性率为3.51％ (33/941);其中1岁以下婴幼儿患者占阳性样72.7％;构建了含有HBoV中间大片段基因克隆WHL-1,     

2011年甘肃地区急性呼吸道感染儿童患者中鼻病毒感染规律的研究

探讨人鼻病毒(Human rhinovirus,HRV)在甘肃地区急性呼吸道感染儿童患者中的流行特征。2011年1月至12月,从甘肃地区急性呼吸道感染儿童患者中采集咽拭子标本286份,用多重PCR方法对常见呼吸道病毒性病原体进行筛查。多重PCR结果中HRV阳性的标本再用nested-PCR分别扩增HRV的VP1和VP4/VP2结合区基因片段,阳性结果进行序列测定和基因分析。286份咽拭子标本中,27份标本多重PCR检测结果显示为HRV阳性,检出率为9.44%。本研究中,HRV感染病例的平均年龄为3岁,其中,1岁以内儿童感染比例最高,占总阳性数的44.4%(12/27);在27例HRV阳性病例中,男性占16例(16/185,8.64%),女性占11例(11/101,10.89%),两者无显著性差异;HRV感染的高峰出现在5月份(6/27,22.2%);从HRV感染的疾病构成看,普通感冒的比例最高,占12.24%(12/98);其次为肺炎,占8.50%(13/153);剩余2病例均为支气管炎。基因序列特征分析发现:A组HRV是甘肃地区2011年的优势流行基因型,占阳性病例的84.62%(22/26),其次为C组HRV,占11.54%(3/26),B组HRV仅发现1例。HRV感染在2011年甘肃地区全年均可发生,主要感染以1岁以内儿童。A组HRV是该地区2011年急性呼吸道感染儿童患者中的主要流行基因型,并存在多个基因型和多个HRV血清型共同流行的特点。     

南京地区2010～2011年度呼吸道感染患儿腺病毒的流行病学研究

本研究为了解南京地区儿童腺病毒(ADV)感染的流行特点及型别,收集2010年8月至2011年7月南京医科大学附属南京儿童医院住院及门诊呼吸道感染患儿的鼻咽抽吸物(NPA)及咽拭子(NPS)共644例,采用巢氏聚合酶链反应法(Nested-PCR)检测ADV hexon基因,将阳性PCR扩增产物进行测序、同源性和进化分析。同时对12种其他呼吸道相关病毒进行PCR检测,包括人博卡病毒(HBoV),呼吸道合胞病毒(RSV),人鼻病毒(HRV),副流感病毒1～4型(PIV1-4),流感病毒A和B(IFVA/B),人偏肺病毒(HMPV),冠状病毒NL63和HKU1(HCoV-NL63和HCoV-HKU1)。结果显示:644例标本中共检出ADV阳性扩增产物171份,检出率为26.55%,3型120例(70.18%,120/171),7型16例(9.36%,16/171),1型12例(7.02%,12/171),2型10例(5.85%,10/171),5型6例(3.51%,6/171),6型3例(1.75%,3/171),57型3例(1.75%,3/171),41型1例(0.58%,1/171)。ADV感染呈全年散发,其发病高峰主要在4～7月。以7岁以下儿童多见(96.49%)。171例ADV感染患儿中有99例(57.89%)存在混合感染,其中以呼吸道合胞病毒(RSV)、人鼻病毒(HRV)多见。ADV阳性患儿诊断以下呼吸道感染为主(63.16%),肺炎占30.41%。结论:ADV是2010年8月到2011年7月南京地区儿童呼吸道感染的重要病原之一,其优势流行株为3型,长期监测其流行型别具有重要意义。     

冬季急性下呼吸道感染住院儿童病原学分析及临床流行病学特点

目的了解冬季儿童急性下呼吸道感染病原谱及临床流行病学特征,为临床抗感染及病原检测提供依据。方法对我院2006年12月～2007年2月急性下呼吸道感染住院患儿采用一次性无菌吸痰管经鼻腔插入7～8cm,达到咽部以下负压吸取1～2ml深部鼻咽分泌液送细菌培养,并对呼吸道合胞病毒(RSV),腺病毒(ADV),A、B型流感病毒(IFV),1、2及3型副流感病毒(PIV)等7种常见呼吸道病毒抗原进行检测及运用荧光定量聚合酶链反应(PCR)技术检测标本中支原体和衣原体DNA。结果①381份下呼吸道感染儿童痰标本中细菌培养阳性81份,病毒检测阳性133份,支原体和衣原体阳性分别12份与6份,混合感染标本44份,总标本病原学检出率为50.66%(193/381)。②RSV阳性标本112份,为最重要的感染病原,连续3个月RSV检出率均在30%左右,6月龄以下儿童占61.61%,2岁以下儿童占86.61%,阳性标本中78.57%的患儿有喘息表现。③大肠埃希菌(16株)、肺炎链球菌(14株)、肺炎克雷伯菌及金黄色葡萄球菌(各10株)、卡他莫拉菌布兰汉亚种(8株)、流感嗜血杆菌和副流感嗜血杆菌(各6株)表现为主要的致病菌。结论RSV感然仍为儿童冬季急性下呼吸道感染最主要的病原,尤其在2岁以下儿童,且易表现为喘息发作。仍有40%以上感染病原未明,儿童急性下呼吸道感染病原谱需进一步完善。     

呼吸道感染住院患儿Merkel细胞多瘤病毒检测及临床研究

目的:了解北京地区Merkel细胞多瘤病毒(MCPyV)在呼吸道感染住院儿童中的流行情况和临床特点。方法:采集北京友谊医院儿科呼吸道感染住院患儿的鼻咽抽吸物样本200份,并收集相应的患儿临床资料,采用TaqMan real-time PCR方法检测MCPyV LTAg基因,并经测序确认;MCPyV阳性样本同时检测常见的人呼吸道病毒混合感染情况。结果:200份标本中共检出MCPyV阳性6例,检出率3%;感染儿童年龄从6月到5岁,其中年龄≤3岁的占83.3%(5/6)。诊断包括支气管肺炎和急性支气管炎,临床表现包括发热、咳嗽、喘息。6例阳性样本均与其他呼吸道病毒混合感染,A型流感病毒和呼吸道合胞病毒混合感染最常见,6例阳性样本MCPyV载量均低于10拷贝/μL。结论:real-time PCR方法检测呼吸道感染住院患儿中MCPyV的感染率为3%,6例MCPyV阳性样本均与其他呼吸道病毒混合感染且MCPyV载量较低,不能认为MCPyV是儿童呼吸道感染的病因。     

北京地区急性呼吸道感染儿童中人鼻病毒感染状况研究

为了解北京地区急性呼吸道感染儿童中人鼻病毒(HRV)-A、B、C型(尤其是HRV-C)的感染状况及分子生物学特征,本研究收集了2011年1月至12月急性呼吸道感染患儿呼吸道标本703例,采用半巢式PCR方法同时进行HRV-A、B、C检测,并对HRV阳性标本进行VP4/VP2衣壳蛋白编码区基因序列测定及进化树分析。结果显示703例标本中共有54例HRV检测阳性,总阳性检出率为7.7%(54/703);HRV感染的儿童中年龄在5岁以下的占94.4%(51/54);HRV检出率在毛细支气管炎患儿中最高(23.1%),其次是哮喘(20.0%)、肺炎(11.0%)、急性支气管炎(4.3%)、急性上呼吸道感染(4.1%)患儿;序列分析表明54例HRV检测阳性标本中25例为HRV-A(46.3%,25/54),8例为HRV-B(14.8%,8/54),21例为HRV-C(38.9%,21/54);HRV同一基因型内各核苷酸序列同源性为70.0%～100.0%,不同基因型间核苷酸序列同源性为55.5%～65.8%。上述结果提示,HRV是引起北京地区儿童急性呼吸道感染(尤其是下呼吸道感染)重要的病毒病原之一;HRV-C阳性检出率与HRV-A相近,较HRV-B高;HRV各个基因型间具有较高变异性。     

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。     

采用半巢式RT-PCR检测兰州地区住院肺炎患儿下呼吸道分泌物中的RSV

从人呼吸道合胞病毒(hRSV)基因序列中高度保守的N基因处,设计了特异性半巢式引物,以反转录-聚合酶链式反应(RT-PCR)方法随机检测了46份兰州地区2007年春季住院肺炎患儿下呼吸道分泌物样本。结果46份样本中有19份扩增出了预期目的片段,对所有扩增产物进行基因序列测定。结果表明19份样本均有RSV感染,其检出率为41%,而且序列分析结果显示,所有RSV阳性样本均与RSVA亚型的同源性高于B亚型。     

The human bocavirus role in acute respiratory tract infections of pediatric patients as defined by viral load quantification

The major objective of this study was to investigate the pathogenic role of human bocavirus (hBoV) in patients hospitalized with acute respiratory tract infection (ARTI). Overall, 685 respiratory samples from 426 patients were examined by PCR for human bocavirus, as well as for other known human respiratory viruses. HBoV was quantified by PCR. Forty/283 (14.1%) pediatric patients, and 2/143 (1.4%) adult patients were found to harbor hBoV for a total of 45 episodes (16 detected as single infection, and 29 as coinfection) of hBoV-associated respiratory infection. HBoV DNA quantification revealed the presence of an NPA viral load > 1.0 x 10(5) DNA copies/ml in respiratory secretions from 17/40 (42.5%) children and 0/2 adults. Below this cut-off, hBoV appeared to be an innocent bystander or a persistent virus. Although hBoV may be frequently detected in children with upper or lower ARTI, in less than 50% young patients it appears to be potentially pathogenic.     

High viral load of human bocavirus correlates with duration of wheezing in children with severe lower respiratory tract infection

Background

Human bocavirus (HBoV) is a newly discovered parvovirus and increasing evidences are available to support its role as an etiologic agent in lower respiratory tract infection (LRTI). The objective of this study is to assess the impact of HBoV viral load on clinical characteristics in children who were HBoV positive and suffered severe LRTI.

Methods

Lower respiratory tract aspirates from 186 hospitalized children with severe LRTI were obtained by bronchoscopy. HBoVs were detected by real-time PCR and other 10 infectious agents were examined using PCR and/or direct fluorescent assay.

Results

Thirty-one patients (24.6%) were tested positive for HBoV in the respiratory tract aspirates. Fifteen samples had a high viral load (>10⁴ copies/mL) and the other sixteen samples had a low viral load (<10⁴ copies/mL). The duration of presented wheezing and hospitalization was longer in children with high viral load of HBoV than that in children with low viral load. The days of wheezing showed a correlation with viral load of HBoV.

Conclusion

We confirmed that HBoV was frequently detected in patients with severe LRTI. Wheezing was one of the most common symptoms presented by patients with positive HBoV. A high HBoV viral load could be an etiologic agent for LRTI, which led to more severe lower respiratory tract symptom, longer duration of wheezing and hospitalization.     

Surveillance and Genome Analysis of Human Bocavirus in Patients with Respiratory Infection in Guangzhou, China

Human bocavirus (HBoV) is a novel parvovirus associated with respiratory tract diseases and gastrointestinal illness in adult and pediatric patients throughout the world. To investigate the epidemiological and genetic variation of HBoV in Guangzhou, South China, we screened 3460 throat swab samples from 1686 children and 1774 adults with acute respiratory infection symptoms for HBoV between March 2010 and February 2011, and analyzed the complete genome sequence of 2 HBoV strains. Specimens were screened for HBoV by real-time PCR and other 6 common respiratory viruses by RT-PCR or PCR. HBoV was detected in 58 (1.68%) out of 3460 samples, mostly from pediatric patients (52/58) and inpatient children (47/58). Six adult patients were detected as HBoV positive and 5 were emergency cases. Of these HBoV positive cases, 19 (32.76%) had co-pathogens including influenza virus (n = 5), RSV (n = 5), parainfluenza (n = 4), adenovirus (n = 1), coronavirus (n = 7). The complete genome sequences of 2 HBoVs strains (Genbank no. {"type":"entrez-nucleotide","attrs":{"text":"JN794565","term_id":"361064618","term_text":"JN794565"}}JN794565 and {"type":"entrez-nucleotide","attrs":{"text":"JN794566","term_id":"361064623","term_text":"JN794566"}}JN794566) were analyzed. Phylogenetic analysis showed that the 2 HBoV strains were HBoV1, and were most genetically close to ST2 (GenBank accession number DQ0000496). Recombination analysis confirmed that HBoV strain GZ9081 was an intra–genotype recombinant strain among HBoV1 variants.     

High Human Bocavirus Viral Load Is Associated with Disease Severity in Children under Five Years of Age

Human bocavirus (HBoV) is a parvovirus and detected worldwide in lower respiratory tract infections (LRTIs), but its pathogenic role in respiratory illness is still debatable due to high incidence of co-infection with other respiratory viruses. To determine the prevalence of HBoV infection in patients with LRTI in Shanghai and its correlation with disease severity, we performed a 3-year prospective study of HBoV in healthy controls, outpatients and inpatients under five years of age with X-ray diagnosed LRTIs. Nasopharyngeal aspirates were tested by PCR for common respiratory viruses and by real time PCR for HBoV subtypes 1–4. Nasopharyngeal swabs from healthy controls and serum samples and stools from inpatients were also tested for HBoV1-4 by real time PCR. Viral loads were determined by quantitative real time PCR in all HBoV positive samples. HBoV1 was detected in 7.0% of inpatients, with annual rates of 5.1%, 8.0% and 4.8% in 2010, 2011 and 2012, respectively. Respiratory syncytial virus (RSV) subtype A was the most frequent co-infection detected; HBoV1 and RSVA appeared to co-circulate with similar seasonal variations. High HBoV viral loads (>10⁶ copies/ml) were significantly more frequent in inpatients and outpatients than in healthy controls. There was a direct correlation of high viral load with increasing disease severity in patients co-infected with HBoV1 and at least one other respiratory virus. In summary, our data suggest that HBoV1 can cause LRTIs, but symptomatic HBoV infection is only observed in the context of high viral load.     

Characteristic systemic cytokine responses in children with human bocavirus‐positive lower respiratory tract infection

To investigate systemic cytokine responses in human bocavirus (HBoV)‐associated lower respiratory tract infection, serum cytokine profiles were analyzed in HBoV positive‐children (n = 14) using multiplex immunoassay. Concentrations of TNF‐α, IL‐2, IL‐5 and IL‐8 on admission were significantly different from those of respiratory syncytial virus‐positive children (n = 28). This unique cytokine response might partly explain some characteristic clinical features of HBoV‐associated respiratory infection.     

Detection and quantitative analysis of human bocavirus associated with respiratory tract infection in Osaka City,Japan

HBoV was initially identified in patients with RTI in 2005. Since its discovery, there have been continual reports concerning HBoV detection and its prevalence. In this study of clinical specimens from young children, real‐time PCR was undertaken to examine whether HBoV infection is associated with RTI and to support quantitative analysis of HBoV in these patients. In all, 376 specimens were collected from patients with RTI during April 2006–October 2008. Analyses revealed HBoV in 59 specimens (15.7%). Of HBoV‐positive patients, children under the age of 3 years comprised 94.9%. Of the HBoV‐positive samples, 47.5% were codetected with other respiratory viruses (dual infection, 27; triple infection, 1). During the study period, the numbers and rate of detection of HBoV were high mainly around May. Statistical analyses showed that the detection rate of HBoV during April–June was higher than during other months. Moreover, the viral load was greater in subjects with infection with HBoV alone than in subjects with mixed respiratory viral infections. Considering these results together, HBoV is probably associated with RTI in young children. However, the pathogenesis of this infection and the importance of the high rate of co‐infection remain uncertain. Additional epidemiologic information and further analyses are necessary to clarify the virological characteristics and the linkage of HBoV to disease.     

Detection of human bocavirus mRNA in respiratory secretions correlates with high viral load and concurrent diarrhea

Human bocavirus (HBoV) is a parvovirus recently identified in association with acute respiratory infections (ARI). Despite its worldwide occurrence, little is known on the pathogenesis of HBoV infections. In addition, few systematic studies of HBoV in ARI have been conducted in Latin America. Therefore, in order to test whether active viral replication of human bocavirus is associated with respiratory diseases and to understand the clinical impact of this virus in patients with these diseases, we performed a 3-year retrospective hospital-based study of HBoV in outpatients and inpatients with symptoms of Acute Respiratory Infections (ARI) in Brazil. Nasopharyngeal aspirates (NPAs) from 1015 patients with respiratory symptoms were tested for HBoV DNA by PCR. All samples positive for HBoV were tested by PCR for all other respiratory viruses, had HBoV viral loads determined by quantitative real time PCR and, when possible, were tested by RT-PCR for HBoV VP1 mRNA, as evidence of active viral replication. HBoV was detected in 4.8% of patients, with annual rates of 10.0%, 3.0% and 3.0% in 2005, 2006 and 2007, respectively. The range of respiratory symptoms was similar between HBoV-positive and HBoV-negative ARI patients. However, a higher rate of diarrhea was observed in HBoV-positive patients. High HBoV viral loads (>10⁸ copies/mL) and diarrhea were significantly more frequent in patients with exclusive infection by HBoV and in patients with detection of HBoV VP1 mRNA than in patients with viral co-infection, detected in 72.9% of patients with HBoV. In summary, our data demonstrated that active HBoV replication was detected in a small percentage of patients with ARI and was correlated with concurrent diarrhea and lack of other viral co-infections.     

北京地区住院患儿WU多瘤病毒感染的流行病学研究

自2007年Gaynor A M等人通过高通量测序在肺炎患儿呼吸道样本中发现了WU多瘤病毒(Washington University polyomavirus,WUPyV)以来,WUPyV在世界各地被广泛检出。为了解北京地区急性呼吸道感染住院儿童中WUPyV感染情况及其临床特征,收集北京地区2017年4月至2018年3月共1 276份呼吸道感染住院患儿的鼻咽抽吸物样本,使用real time PCR方法对样本进行WUPyV检测,同时对WUPyV阳性样本进行17种常见呼吸道病毒筛查。共检出WUPyV阳性样本76份(5.96%,76/1 276),4岁以下儿童居多(92.11%,70/76);WUPyV感染全年可见,无显著季节性;多伴随其他呼吸道病毒混合感染(60.53%,46/76),最常见混合感染为鼻病毒和A型流感病毒;WUPyV单一感染者与混合感染者病毒载量无显著性差异,临床诊断和表现基本一致;WUPyV感染患儿的常见诊断为支气管炎(68.42%,52/76)和肺炎(30.26%,23/76);临床症状主要表现为高热、咳嗽、咳痰。研究结果提示WUPyV是北京地区急性呼吸道感染住院患儿呼吸道样本中常见病毒之一,多见于4岁以下儿童。