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.
Molecular epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute respiratory tract infection in Shanghai
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.
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