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中华微生物学和免疫学杂志
北京生物制品研究所
中华微生物学和免疫学杂志

北京生物制品研究所

沈心亮

月刊

0254-5101

cjmia@163.com

010-52245168

100024

北京市朝阳区三间房南里4号

中华微生物学和免疫学杂志/Journal Chinese Journal of Microbiology and ImmunologyCSCD北大核心CSTPCD
查看更多>>中华医学会主办。本刊以医学微生物学和免疫学的基础和应用研究及其新理论、新技术以及国内外研究进展为报道内容。设有细菌学、病毒学、分子微生物学、临床微生物学、感染免疫、疫苗学、基础免疫学、临床免疫学、分子免疫学、免疫遗传、肿瘤免疫、中药免疫、免疫治疗、免疫学技术、检测技术、述评、综述、学术会议评述、人物述林、医药信息、新书介绍等栏目。读者为本专业科研人员、教师和高、中级卫生防疫、检验工作者及大学以上学生。本刊是中国生物科学和基础医学两学科核心期刊；被CA、BA、EM、Medline等国内外多种著名检索系统收录。杂志曾获国家优秀科技期刊奖并多次获省部级优秀科技期刊奖。2001年进入国家新闻出版署建设的“中国期刊方阵”。2008年获得中国科学技术信息研究所“中国精品科技期刊”称号。
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    呼吸道合胞病毒

    89页
    查看更多>>摘要：近期我国急性呼吸道疾病持续上升与多种呼吸道病原体感染有关。其中呼吸道合胞病毒(respiratory syncytial virus，RSV)感染是导致1岁以下婴幼儿肺内感染住院的第一原因。在RSV流行高发季节，80%以上婴幼儿的急性下呼吸道感染由RSV感染引起。世界卫生组织数据表明，RSV感染是5岁以下儿童因病毒感染而住院甚至死亡的第一大因素。
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    致敬经典：回顾我国儿童中呼吸道合胞病毒感染的早期开拓性研究

    钱渊
    90-92页
    查看更多>>摘要：呼吸道合胞病毒(respiratory syncytial virus, RSV)是世界各地婴幼儿下呼吸道感染最重要的病原。我国儿童中RSV感染的研究始于20世纪70年代初。回顾这段历史，可以看到科研紧密结合儿科临床需求，严格按照经典的病毒病原学方法，得到了翔实可靠的结果，为我国的RSV研究奠定了基础。 Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in infants and young children worldwide. The study on RSV infection in children dates back to the early 1970s. Looking back at the history, we can see a close association between scientific research and pediatric clinical needs, and how solid data are obtained by strictly following the classic methodology for viral etiological study. The original studies on respiratory syncytial virus infection in children lay the foundation for RSV research in China.

    呼吸道合胞病毒回顾性研究

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    表达呼吸道合胞病毒G蛋白胞外区的重组H1N1流感病毒单剂滴鼻免疫可在小鼠诱导强免疫应答与保护

    韩瑞雯王东红王瑭琪程雪婷...
    93-100页
    查看更多>>摘要：目的 基于重组流感病毒载体的呼吸道合胞病毒(RSV)疫苗的构建及在小鼠体内的免疫保护效果评价。 方法 构建并拯救表达RSV A2型G蛋白胞外结构域(Gecto)的重组甲型流感病毒，将其命名为PR8NAGecto/WSN。体外验证重组病毒G蛋白表达与病毒生长动力学后，单剂滴鼻免疫BALB/c小鼠，并评价体液免疫、黏膜免疫与细胞免疫。免疫4周后，分别用RSV A2与RSV B9320进行攻毒，通过小鼠体重变化、肺组织病毒滴度及病理评价免疫保护效果。 结果 单剂滴鼻免疫PR8NAGecto/WSN能在小鼠体内产生较强的体液免疫、黏膜免疫及细胞免疫。与对照组比较，免疫组小鼠经RSV A2或B9320两个亚型病毒攻毒后肺病毒载量与肺组织病理均明显改善。 结论 单剂滴鼻免疫重组PR8NAGecto/WSN疫苗可在小鼠体内诱导较强的RSV特异免疫应答与攻毒保护。本研究为新型RSV黏膜疫苗的研发提供新的思路与实验资料。 Objective To construct a novel respiratory syncytial virus (RSV) vaccine based on a recombinant influenza virus vector and evaluate its immune protective effects in mice. Methods A recombinant H1N1 influenza A virus (IAV) expressing the extracellular domain (Gecto) of RSV A2 G protein was constructed and rescued, named as PR8NAGecto/WSN. After in vitro verification of the Gecto expression and PR8NAGecto/WSN growth kinetics, a single dose of PR8NAGecto/WSN was used to immunize BALB/c mice through intranasal administration to evaluate the efficacy of PR8NAGecto/WSN by assessing humoral (IgG, neutralizing antibody), mucosal (IgA) and cellular immunity (IFN-γ ELISPOT). Four weeks after immunization, the mice were challenged with RSV A2 or RSV B9320 to evaluate the protective effects of PR8NAGecto/WSN by analyzing mouse body weight changes, lung tissue virus titers and pathological changes. Results A single-dose intranasal immunization with PR8NAGecto/WSN induced robust humoral, mucosal and cellular immunity in mice. Moreover, the mice in the immunized group had lower lung virus loads and mild lung pathological damages following the challenge with RSV A or RSV B subtype as compared with the control group. Conclusions A single-dose intranasal immunization with PR8NAGecto/WSN induces robust immunity and provide protection against RSV A and B challenges in mice. This study provides new ideas and reference for the development of novel mucosal vaccines against RSV.

    呼吸道合胞病毒流感病毒病毒载体G蛋白

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    两种呼吸道合胞病毒PreF三聚体重组蛋白疫苗的制备和免疫原性评价

    张恒肖红剑李海巍杨耀云...
    101-109页
    查看更多>>摘要：目的 通过基因序列设计及优化，构建质粒并表达纯化出4种呼吸道合胞病毒(RSV) PreF蛋白，对其免疫原性进行评价。 方法 分别用Human和CHO密码子优化Coronin-1A和T4三聚体蛋白基因序列，并添加到RSV F蛋白序列后，将上述质粒转染Expi293F细胞进行蛋白质表达，收获上清经镍柱纯化后，制备出4种三聚体蛋白，并进行SDS-PAGE分析及Western blot鉴定。于0周和3周免疫动物，采血后进行结合抗体和中和抗体活性检测。 结果 SDS-PAGE分析及Western blot鉴定结果表明，制备及表达的4种蛋白质具有稳定的三聚体结构；抗原抗体亲和力试验表明，4种三聚体蛋白与RSV特异性单抗8897、D25、Motavizumab、AM14和Palivizumab的亲和力均很强；免疫血清的结合抗体效价和中和抗体效价结果表明，初次免疫后，两种T4三聚体蛋白诱导的抗体水平更高，再次免疫后，Human密码子优化的三聚体蛋白抗体增长幅度较高。 结论 两种不同的异源三聚体基序添加均可产生有效的三聚体PreF蛋白，并能在小鼠体内诱导出有效的结合抗体和中和抗体。 Objective To construct and purify four respiratory syncytial virus (RSV) PreF proteins through gene sequence design and optimization and evaluate their immunogenicity. Methods Coronin-1A and T4 trimer protein gene sequences were optimized with Human and CHO codons, and then added to RSV F protein sequence. The above plasmids were transfected into Expi293F cells for protein expression. After purification by nickel column, four trimer proteins were prepared. SDS-PAGE and Western blot were performed for protein identification. BALB/c mice were immunized at week 0 and week 3, and blood samples were collected to measure the activities of binding and neutralizing antibodies in serum. Results SDS-PAGE and Western blot showed that the four proteins had stable trimer structure. Antigen-antibody affinity test showed that the four trimer proteins had strong affinity with RSV-specific monoclonal antibodies 8897, D25, Motavizumab, AM14 and Palivizumab. The titers of antibodies induced by the two T4 trimers were higher after the initial immunization, while there was a substantial increase in the titers of antibodies induced by Human codon-optimized trimer protein after the second immunization. Conclusions PreF trimer protein can be prepared by adding any of the two different heterotrimer motifs, and induce effective binding and neutralizing antibodies in mice.

    呼吸道合胞病毒PreF三聚体蛋白抗体效价

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    呼吸道合胞病毒PreF和PostF重组蛋白疫苗的免疫原性评价

    陈佳敏肖红剑杨耀云张恒...
    110-119页
    查看更多>>摘要：目的 对比呼吸道合胞病毒(RSV)融合前F蛋白(PreF)和融合后F蛋白(PostF)的免疫原性差异。 方法 通过SDS-PAGE及Western blot鉴定PreF和PostF的表达，使用Octet仪器检测F蛋白与特异性抗体的亲和力，用PreF和PostF免疫小鼠，检测免疫血清的结合抗体与中和抗体差异。 结果 PreF经改造后以稳定的三聚体形式存在，与单抗D25、8897、AM14、Palivizumab以及Motavizumab均具有很高的亲和力，但PostF缺乏表位Ø构象，并呈现单体构象，与D25、8897、AM14并无明显结合。PreF和PostF免疫小鼠的研究发现，AS01佐剂比铝佐剂更能诱导出高滴度结合抗体和针对RSV Long株的中和抗体。PreF与PostF免疫后诱导的结合抗体与PreF的结合能力相当，PostF免疫后诱导的结合抗体与PostF的结合水平显著高于PreF。 结论 PreF拥有更多的抗体结合表位，改造后稳定的PreF三聚体重组蛋白能够诱导更强的中和抗体。同时，AS01佐剂免疫效果优于铝佐剂。因此，基于PreF稳定的三聚体结构改造及佐剂的研发对于RSV疫苗的发展至关重要。 Objective To compare the immunogenicity of the prefusion (PreF) and postfusion (PostF) conformations of the respiratory syncytial virus (RSV) F protein. Methods The expression of PreF and PostF recombinant proteins was analyzed by SDS-PAGE and Western blot. The binding affinity between F protein and its specific antibodies was detected by Octet. The binding antibodies and neutralizing antibodies in immune serum were detected after immunizing mice with PreF or PostF recombinant protein. Results PreF protein was stable in the form of a trimer after modification with higher binding affinity with monoclonal antibodies such as D25, 8897, AM14, Palivizumab and Motavizumab. PostF protein lacked the antigenic site Ø and showed a monomer conformation. Besides, it was unable to bind to D25, 8897 and AM14 antibodies. Animal experiments showed that AS01 adjuvant was better than aluminum adjuvant in inducing binding antibodies and neutralizing antibodies against RSV Long strains. The binding antibodies induced by PreF and PostF recombinant proteins had similar binding ability to PreF protein, while the binding antibodies induced by PostF recombinant protein showed stronger binding ability to PostF than to PreF. Conclusions PreF has more epitopes and the trimer form of PreF recombinant protein after modification is more stable and can induce stronger neutralizing antibodies. Moreover, the immunopotentiating effect of AS01 adjuvant is better than that of aluminum adjuvant. Therefore, stabilization-based trimer structure modification of PreF and the development of adjuvants are crucial for the development of RSV vaccines.

    呼吸道合胞病毒重组F蛋白融合前构象佐剂免疫评价

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    呼吸道合胞病毒黏附糖蛋白基因新变异形式的发现及其感染患儿临床特征分析

    江明礼王凤杰韩振志徐炎鹏...
    120-127页
    查看更多>>摘要：目的 分析北京地区呼吸道合胞病毒(respiratory syncytial virus, RSV)流行特征，监测黏附糖蛋白(G)基因序列变异及感染患儿临床特征。 方法 收集2023年1月1日—2023年12月31日首都儿科研究所附属儿童医院急性呼吸道感染患儿呼吸道标本，对经呼吸道病原体多重核酸检测确定为RSV阳性的样本，进一步通过PCR方法扩增得到RSV G蛋白基因全长，测序后建立系统发育进化树确定RSV分型及G蛋白序列变异，通过电子病历系统获得临床资料，分析北京地区RSV感染患儿临床特征。 结果 共收集5 489份急性呼吸道感染患儿呼吸道标本，其中男3 046例，女2 443例，平均年龄4.36岁。核酸检测确定为RSV阳性的589例(10.7%，589/5 489)，其中男349例，女240例，平均年龄(2.51±2.78)岁，中位年龄0.48岁。2023年3月开始RSV呈现持续流行趋势，存在两个流行高峰，分别为5月(24.6%，122/496)和12月(18.2%，126/693)。2023年7月前以A亚型为优势亚型，8—10月为两个亚型博弈阶段，11月转变为B亚型。通过序列分析发现一种长度为954 bp的RSV B亚型新序列(RSV-B-BA9-954bp)，在进化树中独立成一簇。存在新变异的RSV B亚型感染患儿收入重症监护病房(ICU)的比例(44.1%，15/34)高于未变异的RSV B亚型感染患儿(25.2%，31/123)(χ2＝4.600，P＝0.032)，但白细胞计数和C-反应蛋白低于未变异的RSV B亚型感染患儿(P<0.05)。 结论 2023年北京地区儿童中RSV自3月份开始持续流行，出现两个流行高峰，优势流行亚型由A转换为B，监测到一种新的RSV B亚型G蛋白基因变异(RSV-B-BA9-954bp)。 Objective To analyze the epidemiological features of respiratory syncytial virus (RSV) infection in Beijing, and monitor the sequence variations in RSV glycoprotein (G) gene and clinical features of infected children. Methods Respiratory tract specimens were collected from children with acute respiratory infection in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 1, 2023 to December 31, 2023. RSV-positive specimens screened by multiple nucleic acid testing were subjected to PCR to amplify the full-length RSV G gene. A phylogenetic tree was constructed after gene sequencing to analyze RSV subtypes and trace G gene variants. Clinical data were retrieved from the medical record system to analyze the clinical features of children with RSV infection in Beijing. Results A total of 5 489 respiratory specimens were collected from 3 046 male patients and 2 443 female patients. The average age of the patients was 4.36 years. A total of 589 RSV-positive specimens (10.7%, 589/5 489) were detected with 349 from male patients and 240 from female patients. The average age of children with RSV infection was (2.51±2.78) years and the median age was 0.48 years. RSV had been circulating among children in Beijing since March 2023 with two epidemic peaks in May (24.6%, 122/496) and December (18.2%, 126/693). The predominant subtype of RSV in the first half of 2023 was subtype A, but it was replaced by subtype B from November 2023. Phylogenetic analysis revealed a novel G gene of RSV subtype B (RSV-B-BA9-954bp) with a length of 954 bp, which belonged to a new cluster in the phylogenetic tree. The percentage of patients admitted to the Intensive Care Unit (ICU) was higher in children with new variant of RSV subtype B infection than in those with common RSV subtype B infection [44.1% (15/34) vs 25.2% (31/123), χ 2=4.600, P=0.032], while the counts of white blood cells and the levels of C-reactive protein were lower in the children with new variant infection (P<0.05). Conclusions RSV has been prevalent among children in Beijing since March 2023 with two epidemic peaks. The predominant A subtype is gradually replaced by to B subtype. A new variant of RSV B G gene (RSV-B-BA9-954bp) is detected among the children.

    呼吸道合胞病毒G蛋白新突变临床特征

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    人呼吸道合胞病毒北京地区A亚型ON1基因型地方株感染A549细胞转录组学分析

    王凤杰江明礼郭琪李晓芸...
    128-133页
    查看更多>>摘要：目的 应用转录组测序方法，分析北京地区人呼吸道合胞病毒(respiratory syncytial virus, RSV)A亚型优势流行基因型ON1地方株感染A549细胞后差异表达基因，为RSV防治提供潜在靶点。 方法 选用已经过全基因组测序确定为RSV A亚型ON1基因型的地方株(61397-ON1)感染A549细胞，提取总mRNA，通过转录组测序筛选出与未感染的A549细胞为对照的差异表达基因，对其进行GO分析、KEGG通路分析，同时随机选择6个差异表达倍数大于2倍的基因进行qRT-PCR验证。 结果 以未感染的A549细胞为对照，筛选出1 632个差异表达基因，其中807个基因表达上调，825个基因表达下调。差异基因主要参与细胞因子反应以及MAPK级联反应正向调控等免疫应答相关生物过程，并在MAPK信号通路、NOD样受体信号通路、p53信号通路、TNF信号通路、IL-17信号通路及NF-κB信号通路发生了富集。选择的6个差异表达基因qRT-PCR验证结果与转录组数据趋势一致。 结论 RSV A亚型ON1基因型毒株感染A549细胞后的差异表达基因主要参与细胞因子应答及免疫相关信号通路，为RSV致病的分子机制及防治策略研究提供基础资料。 Objective To analyze the differentially expressed genes of human respiratory syncytial virus (RSV) subtype A genotype ON1, a predominant genotype in Beijing, after infecting A549 cells using transcriptomic sequencing, and provide potential targets for RSV prevention and treatment. Methods A local strain (61397-ON1) identified by whole-genome sequencing as ON1 genotype of RSV subtype A was selected to infect A549 cells. Total mRNA was extracted, and the differentially expressed genes in infected and uninfected A549 cells were screened by transcriptomic sequencing. GO analysis and KEGG pathway analysis were performed. Besides, six genes with differential expression ratio greater than two times were randomly selected for qRT-PCR verification. Results There were 1 632 differentially expressed genes between infected and uninfected A549 cells, of which 807 genes were up-regulated and 825 genes were down-regulated. The differentially expressed genes were mainly involved in immune response-related biological processes such as cytokine response and positive regulation of MAPK cascades, and were enriched in MAPK signaling pathway, NOD-like receptor signaling pathway, p53 signaling pathway, TNF signaling pathway, IL-17 signaling pathway and NF-κB signaling pathway. The results of qRT-PCR for six differentially expressed genes were consistent with the trend of transcriptome data. Conclusions The differentially expressed genes of RSV A subtype ON1 genotype after infecting A549 cells are mainly involved in cytokine response and immune-related signaling pathways. This study provides basic data for further study of the molecular mechanism of RSV infection and the development of prevention and treatment strategies.

    呼吸道合胞病毒地方株ON1基因型转录组学分析差异表达基因

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    急性呼吸道感染住院患儿呼吸道合胞病毒分子流行特征分析

    于方圆潘芬蔡沁张天栋...
    134-141页
    查看更多>>摘要：目的 了解2020年4月至2021年12月COVID-19疫情暴发后至逐渐常态化管理期间，呼吸道合胞病毒(RSV)的流行特征、基因分型及基因进化特征。 方法 收集2020年4月至2021年12月上海市儿童医院符合要求的急性呼吸道感染(ARTI)住院患儿鼻咽分泌物或鼻咽吸出物。通过PCR-毛细电泳法及RT-PCR方法对RSV进行鉴定及黏附糖蛋白(G)第二高变区基因片段扩增。生物信息学软件对RSV基因序列进行同源性及基因进化分析。采用χ2检验对阳性率进行比较。 结果 共采集标本6 211份，RSV的阳性检出率为13.62%(846/6 211)。男女患儿感染RSV的阳性率分别为14.07%(503/3 574)和13.01%(343/2 637)，差异无统计学意义(χ2＝1.467，P＝0.226)。≤6月龄儿童感染RSV阳性率最高，随着年龄的增长，儿童感染RSV的阳性检出率逐渐降低，且各年龄组之间阳性率的差异有统计学意义(χ2＝352.942，P<0.001)。2020年4月至2020年8月未检出RSV阳性标本，之后RSV阳性检出率逐渐升高，两个流行高峰分别出现于2020年12月至2021年2月及2021年8月至10月。2020年以RSV B亚型流行为主导，2021年前9个月以RSV B亚型为主，后3个月RSV A亚型逐渐成为主要的流行亚型。本研究所获得的176株RSV A亚型均为ON1基因型，上海流行株的核苷酸同源性为90.20%～99.50%；250株RSV B亚型均为BA9基因型，上海流行株的核苷酸同源性为90.10%～100.00%。 结论 2020年4月至2021年12月，随着COVID-19防控措施的实施，RSV的流行季节有所变化。RSV A和B亚型的流行基因型分别为ON1和BA9，且RSV A亚型逐渐替代B亚型成为主要流行亚型。 Objective To investigate the epidemiological characteristics, genotypes and genetic evolution of respiratory syncytial virus (RSV) isolated in Shanghai from April 2020 to December 2021, which was a period from the COVID-19 outbreak to the phase of regular epidemic prevention and control. Methods This retrospective study collected the nasopharyngeal secretions or nasopharyngeal aspirates of children with acute respiratory tract infection (ARTI) admitted to the Shanghai Children′s Hospital from April 2020 to December 2021. PCR-capillary electrophoresis and RT-PCR were used for virus identification and the amplification of the gene fragment of the second hypervariable region of RSV G protein. Homology analysis and phylogenetic analysis were conducted using bioinformatics software. Chi-square test was used to compare the detection rates of RSV. Results A total of 6 211 samples were collected and 13.62% (846/6 211) of them were positive for RSV. The positive rates of RSV in male and female patients were 14.07% (503/3 574) and 13.01% (343/2 637), respectively, with no significant gender difference (χ2=1.467, P=0.226). The highest detection rate of RSV was found in children ≤6 months of age, and the rate of RSV infection decreased gradually with age (χ2=352.942, P<0.001). No RSV-positive specimens were detected from April 2020 to August 2020, after which the detection rate of RSV gradually increased with two epidemic peaks occurring from December 2020 to February 2021 and from August to October 2021. The predominant epidemic subtype was RSV subtype B in 2020 and the first 9 months of 2021, which was gradually replaced by RSV subtype A in the last 3 months of 2021. The 176 strains of RSV subtype A obtained in this study were all ON1 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.20%-99.50%. All of the 250 strains of RSV subtype B were BA9 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.10%-100.00%. Conclusions From April 2020 to December 2021, with the regular prevention and control of COVID-19, there is a change in the epidemic season of RSV. The prevalent genotypes of RSV subtypes A and B are ON1 and BA9, respectively, and the subtype A gradually replaces subtype B as the most prevalent subtype.

    呼吸道合胞病毒呼吸道感染儿童基因特征监测

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    2019—2023年河北地区儿童呼吸道合胞病毒流行特征分析

    曹贝贝翟宇段素霞李梅...
    142-148页
    查看更多>>摘要：目的 了解2019—2023年河北地区儿童呼吸道合胞病毒(RSV)的流行特征。 方法 收集2019—2023年在河北省儿童医院住院治疗患儿的下呼吸道标本46 576例，采用多重RT-PCR和毛细电泳法检测13种常见呼吸道病原体，并对数据进行统计学分析。 结果 RSV总体阳性检出率为18.76%(8 739/46 576)，男性患儿和女性患儿RSV总体阳性率分别为18.84%(51 74/27 462)和18.65%(3 565/19 114)，性别比较差异无统计学意义(χ2＝0.916，P＝0.339)；RSV检出率与年龄增长存在线性关系(P<0.01)；各年份RSV检出率之间差异有统计学意义(χ2＝723.71，P<0.01)；2019—2021年的阳性检出率高峰期在12月至次年2月；2019年和2020年5—10月阳性检出率极低；2021年全年阳性检出率均在10%以上，且5月和8月出现了反季节流行的小高峰；2022年全年阳性检出率较低，无明显季节变化；2023年阳性检出率高峰出现在4—6月。各年龄组阳性检出率在疫情前、疫情期间和疫情后差异有统计学意义(P<0.01)。RSV与其他呼吸道病原体的混合检出率为29.20%(2 522/8 739)，与鼻病毒(52.29%, 1 342/2 552)混合检出最常见。 结论 RSV是河北地区儿童呼吸道感染的常见病原体，易感人群主要为3岁以下儿童，COVID-19疫情后出现了反季节流行。随着RSV流行特征的改变，有必要对RSV开展持续监测，为相关疾病的防控提供科学数据。 Objective To analyze the epidemiological characteristics of respiratory syncytial virus (RSV) among children in Hebei from 2019 to 2023. Methods A total of 46 576 lower respiratory tract specimens were collected from hospitalized children in the Children′s Hospital of Hebei Province from 2019 to 2023. Multiple RT-PCR and capillary electrophoresis were used to detect 13 common respiratory pathogens in the specimens, and the results were statistically analyzed. Results The overall positive rate of RSV was 18.76%(8 739/46 576). The overall positive rates of RSV in male and female children were 18.84%(5 174/27 462) and 18.65%(3 565/19 114), respectively, showing no statistically significant difference between genders (χ2=0.916, P=0.339). A linear relationship was found between the positive rate of RSV and age (P<0.01). There was a significant difference in the positive rates of RSV in different years (χ2=723.71, P<0.01). The positive rate of RSV peaked in the period from December to February from 2019 to 2021. In 2019 and 2020, the positive rates of RSV were very low from May to October, while the positive rate of RSV was above 10% throughout the whole year of 2021 and small off-season epidemics occurred in May and August. The positive rate of RSV was low in 2022, and no significant seasonal change was observed. The rate of RSV infections peaked from April to June in 2023. There were significant differences in the rates of RSV infections before, during and after the COVID-19 epidemic in each age group (P<0.01). The rate of mixed infections was 29.20%(2 522/8 739), and the most common other respiratory pathogen was human rhinovirus (52.29%, 1 342/2 552 ). Conclusions RSV is a common pathogen causing respiratory tract infections in children in Hebei, especially in children under 3 years old. After the COVID-19 epidemic, there are off-season RSV epidemics. Given the variations in the epidemiological features of RSV, it is necessary to carry out continuous monitoring of RSV to provide scientific data for the prevention and control of related diseases.

    呼吸道合胞病毒儿童流行特征新型冠状病毒

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    天津单中心呼吸道合胞病毒感染儿童的流行病学特征研究

    吕玉洋徐婧玥张贺平
    149-154页
    查看更多>>摘要：目的 分析天津地区呼吸道合胞病毒(RSV)感染儿童的流行病学特征，为预防和诊治儿童RSV感染提供参考。 方法 收集2022年1月至2024年1月于天津市第五中心医院治疗的2 743例急性呼吸道感染患儿的临床资料，采用多重荧光PCR技术检测患儿咽拭子中肺炎支原体、人鼻病毒、腺病毒、甲型流感病毒、乙型流感病毒、RSV共6种病原体的核酸片段，对RSV-RNA阳性病例的流行病学和临床资料进行回顾性分析。 结果 2 743例患儿的RSV-RNA阳性率为15.09%(414/2 743)。2022年患儿RSV-RNA阳性率为9.29%(73/786)，2023年患儿RSV-RNA阳性率为16.53%(302/1 827)，两年间阳性率的差异有统计学意义(χ2＝23.45，P<0.05)。冬春季RSV感染率与夏秋季差异有统计学意义(χ2＝19.46，P<0.05)，冬季感染率最高(19.32%，193/999)，秋季感染率最低(9.43%, 45/477)。各年龄组之间，RSV感染率有显著差异(χ2＝71.38，P<0.05)，0～2岁组感染率最高(21.18%, 230/1 086)，6～8岁组感染率最低(6.29%，27/429)。414例RSV患儿中，单纯感染359例(86.71%)，混合感染55例(13.29%)，其中合并1种其他病原体感染52例，合并感染病原体多为人鼻病毒(4.83%, 20/414)和肺炎支原体(6.04%, 25/414)。 结论 天津市2022年1月至2024年1月急性呼吸道感染患儿中RSV感染率为15.09%，冬季感染率最高，秋季感染率最低。各年龄段儿童均可发生RSV感染，0～2岁感染率最高，6～8岁感染率最低。RSV感染同时还伴有其他呼吸道病原体感染，最常见的病原体是人鼻病毒和肺炎支原体。 Objective To analyze the epidemiological characteristics of respiratory syncytial virus (RSV) infection in children in Tianjin, and provide reference for the prevention and treatment of RSV infection in children. Methods Clinical data of 2 743 children with acute respiratory infections treated at the Tianjin Fifth Central Hospital from January 2022 to January 2024 were collected. Multiplex fluorescent PCR was used to detect the nucleic acid fragments of six respiratory pathogens including Mycoplasma pneumoniae, human rhinovirus, adenovirus, influenza A virus, influenza B virus and RSV in the throat swabs of the patients. A retrospective analysis was performed on the epidemiological and clinical data of RSV-RNA positive cases. Results The positive rate of RSV-RNA in the 2 743 children was 15.09% (414/2 743). The positive rate of RSV-RNA was 9.29% (73/786) in 2022 and 16.53% (302/1 827) in 2023, with a statistically significant difference between the two years (χ2=23.45, P<0.05). The incidence of RSV infection in winter and spring was significantly different from that in summer and autumn (χ2=19.46, P<0.05). The highest and the lowest infection rates of RSV were found in winter (19.32%, 193/999) and autumn (9.43%, 45/477), respectively. There was a significant difference in RSV infection rate among different age groups (χ2=71.38, P<0.05), with the highest infection rate in the age group of 0-2 years (21.18%, 230/1 086), and the lowest infection rate in the age group of 6-8 years (6.29%, 27/429). Among the 414 children with RSV infection, 359 cases (84.97%) were infected with RSV alone, while the other 55 cases (13.29%) were infected with mixed pathogens. Fifty-two cases had co-infection of RSV and one other pathogen. The most common pathogens in co-infection cases were human rhinovirus (4.83%, 20/414) andMycoplasma pneumoniae (6.04%, 25/414). Conclusions The RSV infection rate among children with acute respiratory tract infection in Tianjin from 2022 to 2024 was 15.09%, with the highest infection rate in spring and the lowest infection rate in autumn. RSV infection can occur in children of all ages, with the highest infection rate in children aged 0-2 years and the lowest infection rate in children aged 6-8 years. RSV infection is often complicated by other respiratory pathogens, and the most common pathogens are human rhinovirus and Mycoplasma pneumoniae.

    急性呼吸道感染呼吸道合胞病毒感染率儿童

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