引起儿童呼吸道感染的优势肠道病毒及其血清型和流行特征分析

目的 了解近年杭州地区引起儿童呼吸道感染的优势肠道病毒(EVs)及其血清型以及流行特征和易感人群。方法 收集2016-2018年本地区2 164例发热伴呼吸道感染症状患儿咽拭标本,采用EVs通用引物的实时荧光定量RT-PCR检测EVs核酸,阳性标本采用EVs VP1/VP2基因通用引物的套式PCR扩增后测序分型。分析患儿性别、年龄、感染的优势EVs及其血清型等流行病学特征。结果 2 164 例患儿咽拭子标本中有508 例(23.5%)EVs核酸阳性,其中290 例成功测序分型。检出的EVs中,柯萨奇病毒A 组(CoxA)和B 组(CoxB)分别占75.2%和11.7%、EV71占8.9%、埃可病毒(Echo)占4.1%,CoxA检出率高于CoxB、EV71和埃可病毒(P<0.05)。在检出的CoxA中,CoxA6(39.5%)和CoxA10(33.0%)检出率高于CoxA16、CoxA4和CoxA2(P<0.05)。1~3 岁男性儿童是EVs易感人群(P<0.05),其中男性儿童易感CoxA6、女性儿童易感CoxA10(P<0.05)。结论 EVs是本地区儿童呼吸道感染的重要病原体,柯萨奇病毒及其CoxA6和CoxA10分别是优势EVs和血清型,1~3 岁儿童是本地区EVs主要易感人群,男性比女性更易感。

Analysis of predominant enterovirus and serotypes causing respiratory infection in children and their epidemiological features

To investigate the predominant enterovirus (EVs) and their serotypes causing respiratory infection in children as well as the epidemic features and susceptible population of the pathogens. The throat swab samples from 2 164 children with fever and acute respiratory infection symptoms in the local area during 2016 to 2018 were collected. The nucleic acids of EVs in the samples were detected by real-time fluorescent quantitative RT-PCR using EVs-universal primers. The viral nucleic acid-positive samples were amplified by Nested-PCR using EV-VP1/VP2 gene-universal primers for sequencing and typing. The epidemiological features such as sex, age and infected predominant EVs and their serotypes of the children were analyzed. The results showed that 508 cases (23.5%) of the 2 164 throat swab samples were positive for nucleic acids of EVs, in which 290 cases were successfully sequenced for typing. In the detected EVs, coxsackievirus group A (CoxA) and group B (CoxB) isolates were accounting for 75.2% and 11.7% while EV71 and echovirus isolates were made up to 8.9% and 4.1%, respectively. The positive rate of CoxA was significantly higher than that of CoxB, EV71 and echovirus (P<0.05). In the CoxA-positive samples, the detection rates of CoxA6 (39.5%) and CoxA10 (3.0%) were significantly higher than that of CoxA16, CoxA4 and CoxA2 (P<0.05). The 1-3 aged male children were the susceptible population (P<0.05), in which the male and female children were susceptible for CoxA6 and CoxA10, respectively (P<0.05). All the data indicated that EVs are the important pathogens of respiratory infection in children in the local area, and coxsackievirus and its CoxA6 and CoxA10 are the predominant pathogen and its serotypes in the EVs as well as 1-3 aged children were the major susceptible population for the infection in the local area but the male children are more susceptible than the female children.