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。

The Epidemiological Study of Adenovirus in Children with Respiratory Tract Infections in Nanjing Area from 2010 to 2011

To investigate the epidemiological features and types of human adenoviruses(ADV) in children with acute respiratory tract infection in Nanjing area,China.Nasopharyngeal aspirates and nasopharyngeal swabs were collected from 644 outpatients or hospitalized pediatric patients with ARTI at the Children Hospital of Nanjing,Jiangsu Province,China,between August 2010 and July 2011.Adenoviruses were identified and typed from the collected clinical specimens by nested-PCR based on the partial region of the hexon gene.Other 12 respiratory viruses including human bocavirus(HBoV),respiratory syncytial virus(RSV),human rhinovirus(HRV),parainfluenza viruses 1-4(PIV1-4),influenza virus A/B(IFVA/B),human metapneumovirus(HMPV),human coronavirus NL63 and HKU1(HCoV-HKU1 and HCoV-NL63) were also identified by PCR method.All PCR positive products were sequenced and phylogenetic analysis was conducted.It was showed that adenoviruses were detected in 171 patients out of 644(26.55%) children,120(70.18%,120/171)for ADV3,16(9.36%,16/171)for ADV7,12(7.02%,12/171)for ADV1,10(5.85%,10/171)for ADV2,6(3.51%,6/171)for ADV5,3(1.75%,3/171)for ADV6,3(1.75%,3/171)for ADV57,and 1(0.58%,1/171)for ADV41.ADV infection could occur in any season.There was a higher possibility of ADV infection from April to July in 2011.Most cases(96.49%) were younger than 7 years old.A total of 99 of the 171 ADV-positive children(57.89%) were co-infected with other respiratory viruses.Respiratory syncytial virus(RSV) and human rhinovirus(HRV) were the most common additional respiratory viruses.Lower respiratory tract infections were the most frequent diagnoses made in the hospital,in which there were 52 pneumonia(30.4%) cases.Conclusion: ADV is one of the most important pathogens of acute respiratory tract infection in children in Nanjing area,and adenovirus type 3 was the most prevalent serotype.It is important to develop long-term surveillance.