上呼吸道感染儿童中肠道病毒流行病学特征分析
Epidemic characteristics of enteroviruses in children with upper respiratory tract infection
王钰 1汤晶晶 2柏桂珍 2丁峥嵘2
作者信息
- 1. 昆明医科大学,云南昆明 650500
- 2. 云南省疾病预防控制中心,云南昆明 650022;云南省肠道病毒研究中心,云南昆明 650022
- 折叠
摘要
目的 了解上呼吸道感染患儿中肠道病毒(enterovirus,EV)流行病学特征,为防控肠道病毒相关呼吸道感染提供依据.方法 2021年1月-2022年9月在昆明市儿童医院门诊采集上呼吸道感染患儿咽拭子标本,提取标本RNA,使用实时荧光定量反转录聚合酶链反应(real-time quantitative reverse transcription PCR,real-time qRT-PCR)检测肠道病毒核酸,阳性标本采用半巢式反转录PCR(semi-nested reverse tran-scription PCR,semi-nested RT-PCR)方法进行VP1编码区扩增、测序和基因定型,用生物信息学软件进行分子流行病学相关分析;采用SPSS20.0统计分析软件进行数据分析.结果 1023例患儿中肠道病毒阳性率为46.82％(479/1 023),对94例(19.62％,94/479)标本成功扩增并测序,鉴定出17种基因型:60例(63.83％,60/94)鉴定为EV-A种中的7种基因型;33例(35.11％,33/94)鉴定为EV-B种中的10种基因型;1例(1.06％,1/94)为EV-C种的脊髓灰质炎病毒工型疫苗株病毒.监测期间除个别月份外,肠道病毒月检出率均≥40.00％.＜1岁、1～＜6岁、6～＜9岁和≥9岁年龄段儿童肠道病毒检出率分别为42.89％(169/394)、48.85％(213/436)、47.17％(75/159)和64.71％(22/34),不同年龄段肠道病毒阳性检出率差异无统计学意义(x2=7.54,P=0.057).发热、咳嗽和疱疹为主要临床症状,临床诊断以疱疹性咽峡炎(20/90,22.22％)和感染性发热(19/90,21.11％)为主.系统进化分析结果显示,同型别本地序列、参考株与原型株汇聚在一大分支内,本地序列具有相对较近亲缘关系,与原型株距离较远;同时间段内,同型别本地序列呈现多条传播链共循环;或在不同时空,同一毒株发生了远距离跨区域传播.结论 肠道病毒是昆明市本地呼吸道感染的重要病原,由多种型别引起,本地肠道病毒形成了独特的进化分支.
Abstract
objective To understand the epidemiological characteristics of enteroviruses(EVs)in children with upper respiratory tract infection and to provide basis for preventing and controlling respiratory tract-related enterovirus infection.Methods Swab samples from children with upper respiratory tract infections were collected in Kunming Children's Hospital from January 2021 to September 2022.Real-time quantitative reverse transcription polymerase chain reaction(real-time qRT-PCR)assay was performed to detect EV RNA,and VP1 region of positive RNAs was forward amplified,sequenced and genetic typed by semi-nested reverse transcription PCR(semi-nested RT-PCR).Molecular epidemiological analysis was conducted using bioinformatics software,and data were analyzed using SPSS 20.0 software.Results A total of 1 023 children were enrolled,and EV was detected in 479 cases(46.82％,479/1 023),and 94(19.62％,94/479)samples were successfully amplified and sequenced.Among 94 positive cases,EV-A,EV-B and EV-C accounted for 63.83％(60 cases,7 serotypes),35.11％(33 cases,10 serotypes),and 1.06％(1 case,1 serotype),respectively.In most months,the positive rate of EV detection was more than 40.00％;The positive rates of EV detection in children aged＜1,1-＜6,6-＜9,and ≥9 years were 42.89％(169/394),48.85％(213/436),47.17％(75/159),and 64.71％(22/34),respectively.There was no statistically significant difference in the positive rate of EV among children of different age groups(x2=7.54,P=0.057).Most cases had symptoms such as fever,cough,and herpes.The most common clinical diagnosis was herpangina(20/90,22.22％)and infectious fever(19/90,21.11％).Phylogenetic analysis showed that each Yunnan strain serotype clustered with its prototype strain or reference strain.The local strains had a close genetic relationship with each other but had a distant genetic relationship with their prototype strains.Co-circulation of different transmission chains of a single serotype and long-distance transmission were observed.Conclusion Enterovirus is essential upper respiratory tract infection pathogen involving multiple serotypes.Kunming's local EVs form distinctive evolutionary lineages.
关键词
呼吸道感染/肠道病毒/测序/基因分型/流行病学特征Key words
Respiratory infection/Enterovirus/Sequencing/Genotyping/Epidemiological characteristic引用本文复制引用
出版年
2024
NETL
NSTL
万方数据