2019—2022年长春市某哨点医院儿童急性呼吸道感染病例中肠道病毒流行病学与基因特征分析  

Epidemiological and genetic analysis of enterovirus in cases of acute respiratory infections in a sentinel hospital of Changchun city from 2019 to 2022

作　　者：张瑶 田玉玲[3] 王慧玲[2] 王娜[2] 王利武 谢智博 李汶霞 王雅各 宋金华 夏百成[2] 孙馨 张燕 纪龙[1] ZHANG Yao;TIAN Yuling;WANG Huiling;WANG Na;WANG Liwu;XIE Zhibo;LI Wenxia;WANG Yage;SONG Jinhua;XIA Baicheng;SUN Xin;ZHANG Yan;JI Long(School of Public Health,Shandong First Medical University&Shandong Academy of Medical Sciences,Jinan,Shandong 250117,China;National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases(NITFID),NHC Key Laboratory of Medical Virology and Viral Diseases,National Institute for Viral Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;不详)

机构地区：[1]山东第一医科大学(山东省医学科学院),山东济南250117 [2]中国疾病预防控制中心病毒病预防控制所、国家卫生健康委医学病毒和病毒病重点实验室、传染病溯源预警与智能决策全国重点实验室,北京102206 [3]长春市儿童医院,吉林长春130061

出　　处：《中国病毒病杂志》2024年第2期145-151,共7页Chinese Journal of Viral Diseases

基　　金：国家“十三五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2018ZX10713002)。

摘　　要：目的了解2019—2022年吉林省长春市某哨点医院儿童急性呼吸道感染(acute respiratory infections,ARIs)病例中肠道病毒的流行情况及型别组成。方法采集2019年6月—2022年12月长春市儿童医院ARIs患儿的咽拭子样本,并收集患儿临床信息,用描述性分析方法对肠道病毒感染病例的性别、年龄和季节分布情况进行分析。采用实时荧光反转录聚合酶链反应(real-time quantitative reverse transcription PCR,real-time qRT-PCR)技术检测肠道病毒,使用反转录聚合酶链反应(reverse transcription PCR,RT-PCR)技术扩增肠道病毒VP1全长并进行系统进化分析。结果共采集2707例ARIs病例的咽拭子样本,检出肠道病毒阳性样本65例,检出率为2.40%。65份阳性样本中,32.31%(21/65)为混合感染,以肠道病毒和鼻病毒的双重混合感染最为常见,占肠道病毒阳性病例的10.77%(7/65)。2019—2022年春季、夏季、秋季和冬季肠道病毒的检出率分别为0、6.91%(40/579)、2.90%(21/725)和0.45%(4/894),不同季节肠道病毒检出率差异有统计学意义(χ^(2)=78.036,P<0.01),夏季检出率最高,秋季次之。本研究共鉴定出10种型别肠道病毒,分别为CVA2、CVA4、CVA5、CVA6、CVA10、CVA16、CVB3、E11、E18和EV-D68,其中CVA4检出最多,占比为44.82%(26/58),其余型别检出占比为1.72%~12.07%。结论2019—2022年长春市儿童ARIs病例中肠道病毒夏秋季检出率较高,肠道病毒感染以EV-A组为主。Objective To understand the prevalence of enterovirus infections in cases of acute respiratory infections(ARIs)among children in a sentinel hospital of Changchun city,Jilin province from 2019 to 2022,and to analyze the epidemiology and genotype composition of enteroviruses in pediatric ARIs cases.Methods Respiratory samples were collected from children with ARIs in Changchun Children's Hospital from June 2019 to December 2022,and relevant clinical information was collected to describe the gender,age,and seasonal distribution of enterovirus infection cases.Real-time quantitative reverse transcription polymerase chain reaction(real-time qRT-PCR)was used to detect enterovirus,and the full length of VP1 of enterovirus-positive(EV-positive)samples was amplified and phylogenetically analyzed using reverse transcription polymerase chain reaction(RT-PCR).Results A total of 2707 ARIs case samples were collected and 65 EV-positive samples were detected,with a detection rate of 2.40%.Among 65 EV-positive samples,32.31%(21/65)were co-infections,with enterovirus and rhinovirus co-infections being the most common,accounting for 10.77%(7/65)of the number of EV-positive cases.The detection rates of enteroviruses in spring,summer,autumn,and winter from 2019 to 2022 were 0(0),6.91%(40/579),2.90%(21/725),and 0.45%(4/894),respectively.The differences in enterovirus detection rates among seasons were statistically significant(χ^(2)=78.036,P<0.01),with the highest detection rate in summer,followed by fall.A total of 10 enterovirus types were identified in this study,namely CVA2,CVA4,CVA5,CVA6,CVA10,CVA16,CVB3,E11,E18,and EV-D68,among which CVA4 was detected most frequently,accounting for 44.82%(26/58),and that of the rest types ranged from 1.72% to 12.07%.Conclusion The detection rates of enteroviruses are higher in summer and fall among pediatric ARIs cases in Changchun city,Jilin province from 2019 to 2022,with enterovirus group A being the predominant enterovirus infection.

关 键 词：急性呼吸道感染 肠道病毒 基因分型 流行病学 住院病例 

分 类 号：R373.2[医药卫生—病原生物学]