2018-2019年北京市呼吸道感染病例中肠道病毒D68型临床和流行特征研究  

Clinical and epidemiological characteristics of enterovirus D68 in cases with respiratory infection in Beijing, 2018-2019

作　　者：李爱华[1] 龚成[1] 李茂中[1] 罗明[1] 董梅[1] 王怡婷 王雪 黄芳[1] Li Aihua;Gong Cheng;Li Maozhong;Luo Ming;Dong Mei;Wang Yiting;Wang Xue;Huang Fang(Beijing Center for Disease Control and Prevention,Beijing Academy for Preventive Medicine,Beijing Institute of Tuberculosis Control Research and Prevention,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心,北京市预防医学科学院,北京市结核病控制研究与防治所,北京100013

出　　处：《疾病监测》2022年第6期782-786,共5页Disease Surveillance

基　　金：国家科技重大专项(No.2017ZX10103004)。

摘　　要：目的 分析北京市2018-2019年呼吸道感染病例中肠道病毒D68型(EV-D68)感染者的流行特征。方法 利用北京市呼吸道病原体监测系统,收集2018-2019年全市35家哨点医院就诊的急性呼吸道感染患者的临床标本及流行病学资料,利用实时荧光PCR方法筛查肠道病毒和EV-D68,对EV-D68阳性标本进行VP1区序列的扩增、测序及进化分析。结果 2018-2019年共收集急性呼吸道感染病例15 645例,检出肠道病毒阳性者467例(2.98%)。22例(0.14%)EV-D68阳性病例中,<18岁组11例,18~60岁组7例,>60岁组4例;夏季(6-8月)检出7例,秋季(9-11月)11例,冬季(12月至次年2月)3例,春季(3-5月)1例;8例被诊断为上呼吸道感染,14例为肺炎(其中2例为重症肺炎);主要临床症状为发热(18/22,81.8%)、咳嗽(15/22,68.2%)。14例EV-D68阳性经测序鉴定毒株属于亚型B3和新亚型D3,其中2018年有8例为B3亚型感染、1例为D3亚型感染,2019年5例均为D3亚型。结论 EV-D68引起的呼吸道感染在北京市持续存在,主要在夏秋季流行,B3和新亚型D3为主要流行亚型。Objective To analyze the clinical and epidemiological characteristics of enteroviruse-D68(EV-D68) infection in patients with acute respiratory tract infection in Beijing from 2018 to 2019. Methods The epidemiological data and clinical samples were collected from respiratory infection patients in 35 sentinel hospitals in respiratory pathogen surveillance in Beijing. All the samples were subjected to EV and EV-D68 detections by real-time PCR. The VP1 gene sequences of EV-D68positive samples were analyzed. Results Of 15 645 clinical samples from respiratory infection cases, 467(2.98%) were EV positive and 22(0.14%) were EV-D68 positive. Of the 22 EV-D68 infection cases, 11 were aged <18 years, 7 were aged18-60 years and 4 were aged >60 years. Eight cases were diagnosed with upper respiratory tract infection and 14 cases were diagnosed with pneumonia, including two severe pneumonia cases. The main symptoms for EV-D68 infection cases were fever(18/22, 81.8%) and cough(15/22, 68.2%). Seven cases were detected in summer(June-August), 11 cases in autumn(September-November), 3 cases in winter(December-February) and 1 case in spring(March-May). Fourteen strains of 22 EVD68 belonged to subclade B3 and D3, in which 8 strains belonged to subclade B3 and 1 strain blonged to subclade D3 in 2018,while 5 strains in 2019 belonged to subclade D3. Conclusion Respiratory tract infection caused by EV-D68 persisted in Beijing, mainly in summer and autumn. Subclade B3 and new subcalde D3 were the main pathogen subtypes.

关 键 词：肠道病毒D68 VP1基因 呼吸道感染 

分 类 号：R211[医药卫生—中医学] R373.2