2017-2020年我国儿童急性下呼吸道人腺病毒感染流行病学特征分析  

Epidemiological characteristics of acute lower respiratory tract infection with human adenovirus among children in China from 2017 to 2020

作　　者：王金津 段亚丽 艾军红[1] 朱云[1] 王然 陈祥鹏[1] 卢根 孙云 李昌崇[4] 靳蓉[5] 尚云晓[6] 徐保平[7] 谢正德[1] WANG Jinjin;DUAN Yali;AI Junhong;ZHU Yun;WANG Ran;CHEN Xiangpeng;LU Gen;SUN Yun;LI Changchong;JIN Rong;SHANG Yunxiao;XU Baoping;XIE Zhengde(National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,National Clinical Research Center for Respiratory Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,2019RU016,Beijing 100045,China;不详)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院、北京市儿科研究所感染与病毒研究室、中国医学科学院儿童危重感染诊治创新单元、国家呼吸系统疾病临床医学研究中心、儿科重大疾病研究教育部重点实验室、儿童呼吸道感染性疾病研究北京市重点实验室,北京100045 [2]广州市妇女儿童医疗中心呼吸科 [3]银川市妇女儿童保健院普儿科 [4]温州医科大学附属第二医院/育英儿童医院呼吸科 [5]贵阳市妇幼保健院呼吸科 [6]中国医科大学附属盛京医院小儿呼吸内科 [7]国家儿童医学中心、首都医科大学附属北京儿童医院呼吸科、国家呼吸系统疾病临床医学研究中心

出　　处：《中国预防医学杂志》2024年第3期283-288,共6页Chinese Preventive Medicine

基　　金：国家自然科学基金项目(82072266);国家科技重大专项(2017ZX10103004-004);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-026);国家重点研发计划(2023YFC2306000)。

摘　　要：目的 了解我国儿童急性下呼吸道人腺病毒(human adenovirus,HAdV)感染的流行病学特征及优势基因型别。方法 收集2017年6月-2020年4月我国南北方6家医院的急性下呼吸道感染(acute lower respiratory tract infection,ALRTI)住院儿童的呼吸道样本,使用多重呼吸道病毒检测试剂对常见呼吸道病毒进行检测。对HAdV阳性样本进行基因分型,并收集患儿的临床信息进行临床特征及流行病学分析。结果 本研究共纳入2 793例ALRTI患儿,其中143例HAdV阳性,检出率为5.12%。南北方检出率分别为6.37%(91/1 429)和3.81%(52/1 364),差异有统计学意义(χ^(2)=9.384,P=0.002),北方3~<6岁年龄组检出率最高,为5.94%;南方1~<3岁年龄组检出率最高,为9.37%。南方2019年春季和北方2019年夏季HAdV检出率最高,分别为10.43%(12/115)和13.70%(10/73)。92例HAdV阳性样本被成功分型,以B种的3型(35例)和7型(33例)居多;北方以B种的3型(19例)、7型(8例)和E种的4型(7例)多见,南方流行的优势型别为B种的3型(16例)和7型(25例)。患儿以肺炎为主要诊断(121例),其中重症肺炎15例,HAdV-7型感染10例。46.15%的患儿合并其他病毒感染,其中呼吸道合胞病毒(18例)为最常见的混合感染病毒。结论 HAdV是2017-2020年我国儿童ALRTI的重要病毒病原之一,感染常年存在;南北方流行的HAdV均以B种为主;HAdV感染重症肺炎以HAdV-7型为主。Objective To investigate the epidemiological characteristics and predominant genotypes of human adenovirus(HAdV)infection in children with acute lower respiratory tract infection(ALRTI)in China.Methods From June 2017 to April 2020,respiratory samples of hospitalized children with ALRTI from six hospitals in Northern and Southern China were collected.Common respiratory viruses were detected by a multiplex respiratory virus detection kit.HAdV-positive samples were genotyped,and clinical information of the patients was collected for clinical and epidemiological analysis.Results A total of 2793 children with ALRTI were included in this study,of which 143 were HAdV-positive,with a detection rate of 5.12%.The detection rates in Southern and Northern China were 6.37%(91/1429)and 3.81%(52/1364),respectively(χ^(2)=9.384,P=0.002).In Northern China,the incidence of HAdV infection peaked in children aged 3-<6 years(5.94%).While in Southern and Northern China,the incidence of HAdV infection peaked in children aged 1-<3 years(9.37%).In Northern and Southern China,the highest detection rate of HAdV was in the spring and summer of 2019,with 10.43%(12/115)and 13.70%(10/73),respectively.92 HAdV-positive samples were successfully genotyped,of which HAdV-3 and HAdV-7 represented the majority,with 35 cases and 33 cases,respectively.The predominant HAdV genotypes were HAdV-3(19 cases),HAdV-7(8 cases),and HAdV-4(7 cases)in Northern China,while in Southern China,the former two genotypes were more common,accounting for 16 cases and 25 cases,respectively.Pneumonia was the main diagnosis of children(121 cases),including 15 cases of severe pneumonia,accounting for 10.49%of children with HAdV infection,among which 10 cases of HAdV-7 infection.46.15%of the HAdV-positive children were complicated with other viral infections,with respiratory syncytial virus(18 cases)being the most common mixed infection virus.Conclusions HAdV was one of the most important viral pathogens in pediatric ALRTI in China from 2017 to 2020,and the infection existed t

关 键 词：人腺病毒 急性下呼吸道感染 流行特征 基因型 儿童 

分 类 号：R725.6[医药卫生—儿科]