乌鲁木齐地区RT-PCR法检测儿童急性呼吸道病毒的临床研究

目的利用多重荧光逆转录聚合酶链反应(RT-PCR)分析急性下呼吸道感染患儿4种病毒:人腺病毒(HADV)、人博卡病毒(HBoV)、人偏肺病毒(HMPV)、人呼吸道合胞病毒(HRSV)的感染情况。方法收集1045例急性呼吸道感染的住院患儿鼻咽深部分泌物标本,采用多重荧光RT-PCR进行呼吸道病毒4项指标检测,就病毒分布情况、季节因素等方面进行临床流行病学特点分析。结果1045例患儿中有281例4种呼吸道病毒阳性,总阳性率为26.89%;其中单一病毒感染194例(69.04%)、混合病毒感染87例(30.96%),HMPV感染最多,为120例(42.70%)、其次为HRSV感染119例(42.35%);在各年龄组中≤3岁组阳性229例(36.06%),4~7岁组阳性114例(42.22%),≥8岁组阳性63例(45.00%)。从季节分布来看,春、夏、秋、冬四季的检出率分别为25.68%、28.24%、49.34%、65.57%。结论多重荧光RT-PCR法能快速检测乌鲁木齐地区儿童急性呼吸道病毒,呼吸道病毒感染主要为HMPV和HRSV感染;呼吸道病毒患儿感染率最高年龄段为≥8岁;以秋季和冬季为呼吸道病毒感染高发期。     

郑州地区11299例急性呼吸道感染儿童病原体检查结果分析

目的了解郑州地区急性呼吸道感染儿童病原体流行情况。方法取11299名急性呼吸道感染住院患儿的咽分泌物、痰液或肺泡灌洗液,采用基于毛细管电泳的多重PCR法检测12种呼吸道病原体。结果11299例样本中,检测结果为阳性的8742例,阳性率为77.37%,其中,单纯感染6943例(79.42%),混合感染1799例(20.58%)。阳性标本中鼻病毒(HRV)阳性标本最多,2859例,阳性率25.3%;其次为肺炎支原体(MP),2047例,阳性率18.12%。不同性别患儿中,HRV和MP的阳性检出率有统计学意义。结论HRV是郑州地区急性呼吸道感染儿童的最常见病原体。12种呼吸道病原体的阳性率随月份变化呈现不同的特点;甲型流感病毒H1N1型和肺炎衣原体(Ch)的阳性率与患儿年龄无关,其他病原体阳性率与患儿年龄相关。     

2108例儿童呼吸道病原体感染的流行病学特征

目的 探讨呼吸道病原体感染住院儿童的病原谱特征,为相关感染性疾病的诊治和预防控制提供依据。方法 收集2022年6月至2023年3月深圳市龙岗区妇幼保健院采集住院儿童呼吸道病原体样本2108份,采用多重聚合酶链反应技术对样本进行甲型流行性感冒病毒(influenza A virus,FluA)、乙型流行性感冒病毒(influenza B virus,FluB)、呼吸道合胞病毒(respiratory syncytial virus,RSV)、腺病毒(respiratory adenovirus,ADV)、鼻病毒(respiratory rhinovirus,HRV)、肺炎支原体(mycoplasma pneumoniae,MP)6种病原体检测,分析总体检出情况,并对不同年龄、性别、疾病、月份、时间段的病原体分布特点进行比较。结果 病原体的阳性总检出率为50.05%,单一感染中HRV(333例,15.80%)、RSV(237例,11.24%)、FluA(194例,9.20%)占比较高,混合感染中以HRV与RSV组合频次最高;住院患儿不同年龄组病原体单一感染、混合感染(3种病原体混合感染除外...     

沈阳地区儿童急性呼吸道感染常见病毒流行病学特征分析

目的 分析沈阳地区急性呼吸道感染患儿常见病毒流行特点。方法 选取2019-2022年本院接诊的782例急性呼吸道感染患儿为本次研究对象。在患儿未进行抗病毒药物治疗前采集患儿咽拭子标本。采用多重实时荧光PCR方法检测呼吸道合胞病毒(RSV)、副流感病毒(PIV)、人鼻病毒(HRV)、乙型流感病毒(IFVB)、甲型流感病毒(IFVA)、人腺病毒(HADV)、肠道病毒(EV)、冠状病毒(COV)、人偏肺病毒(HMPV)、人博卡病毒(HBOV)10种呼吸道感染常见病毒抗原。结果 782例急性呼吸道感染患儿中,281例患儿病毒核酸检测阳性,阳性率35.93%。234例患儿为单一病毒感染,阳性率29.92%,主要为RSV、PIV感染。47例患儿为混合病毒感染,阳性率6.01%,主要为RSV+PIV混合感染。对比单一病毒阳性患儿组与病毒阴性组患儿的临床症状,单一病毒阳性患儿组发生发热、咳嗽发生率高于病毒阴性组患儿,差异有统计学意义(P<0.05)。两组患儿咳痰、咽喉疼痛、呼吸困难、呕吐、腹泻的发生率对比差异无统计学意义。感染IFVB、IFVA、HADV、EV、COV、HBOV患儿均出现发热症状...     

人类偏肺病毒与呼吸道合胞病毒呼吸道感染的临床研究

目的 了解福州地区人类偏肺病毒(HMPV)感染情况,比较HMPV与呼吸道合胞病毒(RSV)引起呼吸道感染的临床特征及流行特点.方法 采集2005年至2007年连续两个冬春季节153份福建省立医院就诊呼吸道感染患者痰标本或咽拭子标本,RT-PCR和套式RT-PCR分别检测RSV和HMPV,部分阳性PCR产物测序,DNAMAN软件分析;结合临床资料,比较两种病毒所引起的呼吸道感染临床症状、体征和流行特点.结果 153份鼻咽分泌物标本中,32份HMPV阳性,阳性率为20.9%;26份RSV阳性,阳性率为17.0%,8份HMPV和RSV均阳性.随机抽取3份标本,HMPV核苷酸序列一致,登载NCBI基因库(序列号DQ887758),基因进化树分析为单一基因型,属A基因型,但发生部分变异.2005年至2006年冬春HMPV阳性26份,阳性率为26.7%,2006年至2007年冬春HMPV阳性6份,阳性率为10.7%,而RSV检出情况与HMPV相反.儿童RSV感染平均年龄为(2.65±2.65)岁,HMPV为(4.58±3.35)岁.两种病毒引起呼吸道感染症状均以咳嗽、咽痛,发热为主.结论 HMPV与RSV均是福州地区冬春季节呼吸道病毒感染的主要病原体,两者可合并感染;HMPV主要感染年龄较大儿童,HMPV与RSV的临床特征相似.本研究期间福州地区发现的HMPV为单一基因型.     

老年人群呼吸道感染病原体IgM检测结果

目的了解本院老年人群呼吸道感染病原体的流行病学特点,为指导临床诊断和治疗、制定预防措施提供依据。方法借助呼吸道感染病原体Ig M试剂,采用间接免疫荧光技术同时检测呼吸道感染患者9种病原体:肺炎支原体(MP)、乙型流感病毒(INFB)、副流感病毒(PIVs)、嗜肺军团菌(LP)、呼吸道合胞病毒(RSV)、甲型流感病毒(INFA)、肺炎衣原体(CP)、腺病毒(ADV)以及Q热立克次体(COX)观察其季节性变化。结果 1 063例老年人群中共检出阳性259例,阳性率为24.34%。老年人群呼吸道感染的主要病原体为MP、INFB、PIVs、LP与RSV。MP的感染率最高,为15.90%;而INFB感染存在季节性差异(P0.05)。3.5%的阳性患者发生了混合感染,主要混合感染类型为MP与INFB。结论 MP为老年人群呼吸道感染的主要病原体。老年人群呼吸道感染应重点关注MP的诊断与防治,并在INFB高发季节注意混合感染。     

苏州地区人副流感病毒3感染住院患儿临床特征

目的探讨苏州地区因急性呼吸道感染住院患儿中副流感病毒3型(HPIV3)感染临床特征。方法收集2013年1月~2013年12月因急性呼吸道感染住院2298例患儿的痰标本,应用直接免疫荧光法测呼吸道合胞病毒、流感病毒(A、B)、人副流感病毒(1~3)和腺病毒,采用实时PCR检测人博卡病毒DNA,逆转录PCR检测人偏肺病毒及鼻病毒RNA。分析人副流感病毒3型感染患儿的临床特点及流行病学特征,并与呼吸道合胞病毒(RSV)感染进行比较。结果 2298例痰标本中病毒检测阳性者983例(42.78%),HPIV3阳性98例(4.26%),次于RSV阳性233例(10.14%);HPIV3常年均可感染,以春、夏季为发病高峰,夏季发病率高达45.92%;发病年龄均为6岁以下儿童,1岁以下检出率高,占62.30%;98例阳性标本中,HPIV3单独感染61例,主要引起支气管肺炎(80.33%)、急性毛细支气管炎(13.11%),以咳嗽(96.72%)、喘息(44.26%)、发热(47.54%)为主要临床症状;与RSV比较,HPIV3住院患儿喘息发生率低,主要引起支气管肺炎,差异有统计学意义(P0.05)。结论 HPIV3是苏州地区住院患儿呼吸道感染的重要病原之一,其有单独的致病性,与RSV相比,在季节分布、临床表现等方面有一定差异。     

永康市1个月~12岁下呼吸道感染患儿的病毒病原现状及不同年龄、季节、病种的病毒检出情况比较

目的了解浙江永康市小儿下呼吸道感染患儿的病毒病原现状及不同年龄、季节、病种的病毒检出情况。方法采用多重PCR方法,持续监测永康地区2013年9月~2015年9月下呼吸道感染患儿的10种病毒病原现状及年龄、季节、病种的病毒分布情况。结果 (1)507例下呼吸道感染住院患儿中,下呼吸道相关病毒的检出率为89.7%(455/507),依次为RSV检出率最高为31.9%,其次为HPIVs、HRV、IFVB、HMPV、IFVA、HBOV、ADV、NL63、HKU1及其他。(2)455例病毒阳性患儿血常规结果表明:中性粒细胞总数下降者占73.4%,白细胞总数多为正常占66.2%,淋巴细胞总数上升者占72.1%,各血常规项目内差异有统计学意义(P0.05)。(3)其中,1个月~3岁的儿童阳性检出率为93.9%,此年龄段病毒检出率明显高于其他年龄段,呼吸道合胞病毒RSV、副流感病毒HPIVs、鼻病毒HRV、甲/乙型型流感病毒IFVA/IFVB、人类偏肺病毒HMPV、人博卡病毒HBOV在年龄上分布上的差异有统计学意义(P0.05)。(4)本研究全年病毒检出率均在70%以上,秋冬季检出率最高,秋季占96.7%,冬季占89.0%,各季节阳性检出结果间差异有统计学意义(P0.05)。(5)507例下呼吸道患儿中,诊断为肺炎、急性支气管炎、慢性阻塞性肺疾病、支气管扩张的患儿分别占69.8%、9.7%、5.3%和4.9%,每个病种检出的病毒感染情况差异有统计学意义(P0.05)。结论永康地区病毒引起的呼吸道感染仍是该地区患儿患病的主要原因,其临床资料和病毒学的积累研究对呼吸道疾病的治疗和预防有着重要的意义。     

武汉地区儿童急性呼吸道感染病原学研究

目的:了解武汉地区儿童急性呼吸道感染不同病原体的感染情况及流行病学特征。方法:对13 850例于2014-01-2014-12就诊被诊断为呼吸道感染的儿童,用间接免疫荧光法检测9种呼吸道病原体IgM抗体。结果:病原体总阳性检出率为31.00%,各病原体检出率由高到低依次为:肺炎支原体(MP,16.92%)、乙型流感病毒(IFNB,6.01%)、腺病毒(ADV,4.42%)、呼吸道合胞病毒(RSV,1.55%)、副流感病毒(PIV,1.29%)、肺炎军团菌血清I型(CP,0.45%)、甲型流感病毒(IFNA,0.25%)、肺炎衣原体(CP,0.07%)、Q热立克次体(RB,0.04%)。其中2种以上病原体混合感染率为20.12%,MP和IFNB混合感染率为29.98%。MP在2014年全年都维持较高的流行水平,并在6月和9月出现2次流行高峰;IFNB在冬春出现2个发病高峰期,其中以1月份发病率最高;ADV在春季出现了流行高峰,然后呈逐渐下降趋势,其中以3月份发病率最高。结论:2014年武汉地区急性呼吸道感染病原体以MP、IFNB和ADV为主,并且混合感染情况严重,了解本地区急性呼吸道感染患儿的流行病学特征对呼吸道疾病的防治有重要意义。     

重庆市渝东片区人群隐孢子虫病流行病学调查

目的探讨重庆市渝东片区人群隐孢子虫病感染现状,为防治隐孢子虫病流行提供依据。方法 2011年对渝东片区采集的人粪便标本用改良抗酸染色法检查隐孢子虫卵。结果共采集1 238份标本,隐孢子虫卵检出率为3.39%;其中,屠宰场从业人员(16人)感染率为6.25%,医院就诊患者(1 062人)感染率为3.48%,散居人群(160人)感染率为2.50%。男性673例,隐孢子虫检出率3.42%,女性565例,检出率3.36%,男女性别差异无统计学意义(χ2=0.00,P>0.05);儿童388例,检出率4.12%,成人850例,检出率3.06%,儿童与成人差异无统计学意义(χ2=0.00,P>0.05)。结论重庆市渝东片区人群隐孢子虫感染率较高,且无性别及年龄差异。     

Sendai Virus-Vectored Vaccines That Express Envelope Glycoproteins of Respiratory Viruses

Human respiratory syncytial virus (HRSV), human metapneumovirus (HMPV), and human parainfluenza viruses (HPIVs) are leading causes of respiratory disease in young children, the elderly, and individuals of all ages with immunosuppression. Vaccination strategies against these pneumoviruses and paramyxoviruses are vast in number, yet no licensed vaccines are available. Here, we review development of Sendai virus (SeV), a versatile pediatric vaccine that can (a) serve as a Jennerian vaccine against HPIV1, (b) serve as a recombinant vaccine against HRSV, HPIV2, HPIV3, and HMPV, (c) accommodate foreign genes for viral glycoproteins in multiple intergenic positions, (d) induce durable, mucosal, B-cell, and T-cell immune responses without enhanced immunopathology, (e) protect cotton rats, African green monkeys, and chimpanzees from infection, and (f) be formulated into a vaccine cocktail. Clinical phase I safety trials of SeV have been completed in adults and 3–6-year-old children. Clinical testing of SeVRSV, an HRSV fusion (F) glycoprotein gene recombinant, has also been completed in adults. Positive results from these studies, and collaborative efforts with the National Institutes of Health and the Serum Institute of India assist advanced development of SeV-based vaccines. Prospects are now good for vaccine successes in infants and consequent protection against serious viral disease.     

Incidence and morbidity of human metapneumovirus and other community‐acquired respiratory viruses in lung transplant recipients

A. Weinberg, D.M. Lyu, S. Li, J. Marquesen, M.R. Zamora. Incidence and morbidity of human metapneumovirus and other community‐acquired respiratory viruses in lung transplant recipients
Transpl Infect Dis 2010: 12: 330–335. All rights reserved. Abstract: To determine the role of human metapneumovirus (HMPV) in respiratory tract infections (RTIs) of lung transplant recipients, 60 patients were prospectively enrolled in this study spanning from September 2005 to November 2007. Community‐acquired respiratory viruses (CARVs) were identified by polymerase chain reaction and tissue culture in respiratory secretions. Of 112 RTIs, 51 were associated with ≥1 CARV, including 7 HMPV, 13 respiratory syncytial virus (RSV), 19 parainfluenza virus 1, 2, or 3 (PIV), 16 influenza A or B (FLU), and 3 human rhinoviruses (HRV). Sixteen CARV‐RTIs had multiple pathogens. While the standard protocol was to admit all paramyxoviral RTIs for inhaled ribavirin, 16% CARV‐RTIs required hospitalization because of the severity of their respiratory compromise, including 25% of HPMV‐single‐agent RTI, 38% of RSV single‐agent RTI, 10% of PIV‐single‐agent RTI, and 19% of multiple‐agent RTIs. None of those with non‐CARV RTIs required hospitalization. The incidence of clinically diagnosed acute graft rejection in the first 2 months after an RTI varied from 0 for single‐agent HRV to 88% for single‐agent RSV (25% for single‐agent HMPV). A new diagnosis of chronic graft rejection in the first year after an RTI was made in approximately 25% of the RTIs and did not significantly vary with the etiologic agent. No deaths occurred during this study. In conclusion, HMPV was associated with 6% of the RTIs in lung transplant recipients and its morbidity was similar to the average moribidity of CARVs.     

2665例急性上呼吸道感染患儿的病原学及临床特征

目的 分析急性上呼吸道感染儿童患者的病原学及临床特征。方法 以南方医科大学珠江医院2009年11月至2015年9月收治的2 665例急性上呼吸道感染儿童为研究对象,采用qRT-PCR方法检测临床上常见的8种呼吸道病毒(流感病毒、呼吸道合胞病毒、副流感病毒、腺病毒、人类博卡病毒、人类冠状病毒、人类偏肺病毒、鼻病毒)。结果 共检测患儿标本2 665份,其中阳性标本1 566份,总阳性率为58.8%。四个季节中8种呼吸道病毒检出率存在明显差异,并以春季最高,夏冬季次之,秋季最低。儿童呼吸道病毒感染率随着年龄增加而逐渐降低,并以0~1岁婴幼儿病毒检出率最高64.5%。男童呼吸道病毒感染率高于女童,住院患儿呼吸道病毒检出率高于门诊患儿。混合感染标本260份,占阳性标本数的16.6%,主要集中于0~3岁儿童患者标本中,并因季节而异,秋冬季节较少,而春夏季节较为普遍。咳嗽为呼吸道病毒感染的主要临床症状,咳痰和流涕次之,临床症状在8种呼吸道病毒感染患儿中存在差异。结论 本调查分析了急性上呼吸道感染患儿中8种常见呼吸道病毒的病原学及临床特征,为指导临床治疗及防控提供相关数据。     

Viral respiratory tract infections among patients with acute undifferentiated fever in Vietnam

To investigate the proportion of viral respiratory tract infections among acute undifferentiated fevers (AUFs) at primary health facilities in southern Vietnam during 2001-2005, patients with AUF not caused by malaria were enrolled at twelve primary health facilities and a clinic for malaria control program. Serum was collected on first presentation (t0) and after 3 weeks (t3) for serology. After exclusion of acute dengue infection, acute and convalescent serum samples from 606 patients were using enzyme-linked immunoassays to detect IgA, as well as IgM and IgG antibodies against common respiratory viruses. Paired sera showed the following infections: human parainfluenza virus (HPIV, 4.7%), influenza B virus (FLUBV, 2.2%), influenza A virus (FLUAV, 1.9%) and human respiratory syncytial virus (HRSV, 0.6%). There was no association between type of infection and age, sex or seasonality; some inter-annual differences were observed for influenza. Antibody prevalence, indicative of previous infections, was relatively low: HPV, 56.8%, FLUBV, 12.1%; FLUAV, 5.9% and HRSV, 6.8%.     

Prevalence of human metapneumovirus infection in hospital wards handling patients with severe motor and intellectual disabilities

Epidemics of infectious diseases often occur in hospital wards handling patients with severe motor and intellectual disabilities. However, the causative pathogens are not identified in half of these epidemics. Recently, an epidemic occurred in 2 wards consecutively in the National Hospital Organization Ehime Hospital in March-April, 2010. In this epidemic, 18 of 40 patients in one ward and 14 of 60 patients in another ward showed symptoms, and human metapneumovirus (HMPV) was detected from pharyngeal and/or nasal swabs of 4 patients. Phylogenetic analysis of the viral genomes showed that the virus belonged to subgroup B2, and the same virus had spread consecutively in 2 wards. High fever lasted for 5.3 days on average in the 32 inpatients, was mostly over 38 degrees C and was accompanied by productive coughs. In the 4 patients in whom human HMPV was detected, the number of peripheral blood lymphocytes decreased but that of monocytes increased. Pneumonia developed in two patients as shown by chest radiography, and an increased number of peripheral blood neutrocytes and increased CRP levels were noted. Of the 151 inpatients, anti-human HMPV antibody was found in the sera of 143 (95%), and the relationship between high fever and antibody titer was not significant, indicating that HMPV infection could recur in spite of the presence of specific antibodies. Because human HMPV is highly prevalent, and causes high fever and pneumonia, hospital staff should be vigilant for any signs of this virus in hospital wards and take steps to prevent infection in long-term inpatients.     

Molecular epidemiology of human rhinovirus C in patients with acute respiratory tract infections in Osaka City, Japan

Human rhinovirus (HRV) is a causative agent of acute respiratory tract infection (ARTI). In 2007, a novel HRV group, HRV-C, was discovered. This study, which assessed whether HRV-C is epidemic among patients with ARTI, was aimed at analyzing the seasonal prevalence of HRV-C in Osaka City, Japan. Gene amplification tests were performed to detect 10 respiratory viruses in 336 specimens collected during November 2008-October 2009. In total, 364 viruses were detected in 271 specimens. The most commonly detected virus was HRV (n = 84). For HRV-positive specimens, we conducted phylogenetic analyses using the VP4/VP2 gene region to identify the HRV species (HRV-C, 30; HRV-A, 54). Both the number and rate of HRV-C detection were highest in December. The highest numbers and the highest rate of HRV-A detection were obtained in April and June and in April, respectively. Statistical analysis showed that the most probable prevalent period of HRV-C was between September and March, and that of HRV-A was between March and November. These results suggest that HRV-C is mainly epidemic during autumn and early spring; this seasonal prevalence was different from that of HRV-A. Moreover, the HRV-C Osaka strains were scattered in many genetic clusters along with previously reported strains from different parts of the world. This result also emphasizes the worldwide circulation of HRV-C.     

潮汕地区呼吸道感染患儿腺病毒流行情况及临床分析

目的 了解潮汕地区呼吸道感染患儿腺病毒流行情况及临床特征.方法 收集2012年7月至2016年6月因呼吸道感染入住汕头大学医学院第二附属医院儿科患儿的咽拭子标本2 668份,应用多重聚合酶链反应(PCR)技术,对咽拭子标本行腺病毒、呼吸道合胞病毒、人鼻病毒、WU多瘤病毒、人博卡病毒、流感病毒A、B型、副流感病毒1、3型、人类偏肺病毒共10种(型)病毒检测,并对腺病毒阳性病例进行临床资料分析.结果 2 668份咽拭子标本中,病毒阳性1 388份(52.02%),其中腺病毒95例(3.53%);腺病毒感染呈全年散发,年龄主要集中发生在6岁以下,尤其是3岁以下;主要临床症状表现为发热、咳嗽、喘息、气促,其中混合感染组中,随着合并感染病毒数增加,咳嗽、喘息症状越明显,95例中仅4例(4.21%)患儿符合重症肺炎诊断.结论 腺病毒2012年7月至2016年6月腺病毒在潮汕地区没有发生规模以上的流行和暴发;腺病毒与其他病毒混合感染普遍存在;呼吸道腺病毒感染的临床表现和实验室检查及影像学检查均无特异性特征,但随着合并感染病毒种类数目的增加,咳嗽、喘息、气促发生率更高;近4年来潮汕地区腺病毒呼吸道感染临床症状普遍较轻,重症肺炎发生率低.