上海地区643例呼吸道感染患儿鼻咽分泌物病毒病原检测分析

目的 探讨上海地区急性儿童呼吸道感染的病毒病原学特点,为临床诊断和治疗提供参考.方法 收集2012年1月至2013年12月,在上海交通大学医学院附属第九人民医院、新华医院、普陀区中心医院因急性呼吸道感染就诊的643例患儿的鼻咽抽吸物标本,采用反转录聚合酶链反应(RT-PCR)和聚合酶链反应(PCR)方法检测呼吸道相关病毒HRV、RSV、ADV、IFV (A、B型)、PIV(1～4型)、HMPV、HCoV-NL63,HCoV-HKU1、HBoV.结果 共643例患儿采集了鼻炎抽吸物标本,年龄从11d至12岁,中位年龄为12个月,男402例,女241例;共检出病毒感染阳性标本369份,总检出率57.4％ (369/643),2012年RSV检出率最高,2013年ADV检出率最高,新发现病毒中HBoV检出率最高,未检测到冠状病毒NL-63.6个月到1岁年龄段病毒的检出率最高,随年龄增长,病毒的检出率逐渐下降,病毒检出贯穿全年,诊断包括上、下呼吸道感染.结论 病毒是引起上海地区儿童呼吸道感染的主要病原,以RSV和ADV为丰.

Analysis of viral pathogens of acute respiratory tract infection in 643 children in Shanghai

Objective To explore the viral pathogens of acute respiratory tract infection in Shanghai,and to provide reference data for diagnosis and treatment.Methods Between January 2012 and December 2013,643 nasopharyngeal aspiration (NPA) samples were collected from children who had been hospitalized for acute respiratory tract infection at Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,the Ninth People's Hospital,Affiliated to Medical College of Shanghai Jiaotong University School and Putuo District Center Hospital Shanghai,China.Human rhinoviruses,Respiratory syncytial virus,Adenovirus,Influenza viruses A and B,Parainfluenza viruses 1-4,Human metapneumovirus,Human bocavirus,Human coronavirus HKU1 and Human coronavirus NL-63 were detected by reverse transcirption-polymerase chain reaction (RT-PCR) and standard polymerase chain reaction (PCR) methods.Epidemiology and clinical manifestations of each virus were analyzed.Results Six hundred and forty-three NPAs samples were collected from children (402 boys,241 girls) with ARTI,The mean age was 12 months(range from 11 days to 12 years).Viral pathogens were identified in 369 (57.4％) samples.RSV was the highest detection rate in 2012 and ADV was the highest detection rate in 2013,HCoV-NL63 was not detected.6 months to 1 year old age group virus detection rate was highest,along with the age growth,virus detection rate was falling,virus detection throughout the year,diagnosis includes upper and lower respiratory tract infection.Conclusions Viral pathogens are the main etiology of ARTI in children in Shanghai area.RSV and ADV are the most frequent viral pathogens.