90例儿童人博卡病毒感染临床分析

目的：探讨儿童人博卡病毒（HBoV）感染的临床特征。方法：采集843例下呼吸道感染患儿鼻、咽拭子标本,用多重RT-PCR方法检测HBoV和其他6种常见呼吸道病毒,分析HBoV阳性病例临床特征。结果：843例标本中检测出HBoV阳性90例（10.7%）,呼吸道合胞病毒（RSV）131例（15.5%）,流感病毒（IFV）117例（13.9%）,副流感病毒(PIV)84例（10.0%）,鼻病毒(RV)55例（6.5%）,冠状病毒(OC43)48例（5.7%）,人类偏肺病毒(HMPV)33例（3.7%）。HBoV合并其他呼吸道感染者45例（50%）,其中HBoV合并１种其他病毒感染者33例（37％）,合并2种其他病毒感染者11例（12％）,合并3种其他病毒感染者1例（1％）。伴喘息的患儿HBoV检出率高于不伴喘息的患儿（17.0% vs 9.2%,P<0.01）。HBoV阳性患儿常见的临床表现为频咳、喘息和发热。HBoV阳性组与RSV阳性组中喘息发生的构成比差异无统计学意义。结论：伴喘息发作的下呼吸道感染患儿中,HboV阳性检出率明显高于不伴喘息发作患儿,提示HBoV可能是除RSV外另一种引起儿童喘息的呼吸道病毒。HBoV与其他呼吸道病毒存在着混合感染。     

人类博卡病毒感染的持续喘息患儿临床特点分析

目的探讨人类博卡病毒（HBoV）感染的持续喘息患儿临床特点。方法从2006年4月至2007年1月共收集39例持续喘息患儿的呼吸道分泌物标本,其中33例通过纤维支气管镜检查吸取下呼吸道分泌物,6例为鼻咽分泌物。先进行呼吸道常见7种病毒筛查,并采用PCR的方法检测HBoV基因片段,对检出的阳性标本进行测序分析。结果（1）用免疫荧光快速诊断的方法在39例持续喘息患儿呼吸道分泌物中共检出呼吸道合胞病毒阳性13例,腺病毒阳性9例,副流感病毒3阳性4例,流感病毒A阳性2例。对检出的13例RSV阳性的标本进行病毒分离培养后提取RNA,RT-PCR进行呼吸道合胞病毒检测,检出8例阳性。（2）PCR和测序均证实,39例患儿呼吸道分泌物标本中有12例检出HBoV阳性。（3）12例HBoV阳性标本中的10例收集于冬春季,其余2例收集于夏秋季,与RSV的流行季节相似。（4）12例HBoV阳性患儿中7例出现发热,其中高热5例,明显高于RSV感染的患儿（1／13）,其胸X线改变出现间质性改变的例数也多于RSV感染患儿。其他如咳嗽、喘息、呼吸困难等临床表现两者差异均无统计学意义。结论HBoV感染是引起小儿下呼吸道感染的重要病毒病原之一,首次发现在持续喘息的患儿呼吸道分泌物中HBoV的阳性率高达31％。与RSV感染的患儿相比,HBoV感染发热例数相对多,但其他的临床症状与RSV相似。     

2009—2010年苏州地区博卡病毒感染住院患儿临床特征分析

目的探讨苏州地区因急性呼吸道感染住院患儿中人类博卡病毒(human bocavirus,HBoV)感染的临床特征。方法收集2009年1月—2010年12月因急性呼吸道感染住院的3 826例患儿的痰标本,应用实时PCR检测HBoV DNA,直接免疫荧光法检测呼吸道合胞病毒、流感病毒(A、B)、副流感病毒(1～3)和腺病毒,同时采用逆转录PCR检测人偏肺病毒RNA,并进行细菌培养及荧光定量PCR检测支原体DNA,分析HBoV感染的临床特点及流行病学特征,并与呼吸道合胞病毒(RSV)进行比较。结果 3 816份标本共检测到HBoV 272例(7.13%),仅次于RSV;HBoV单独感染率为32.7%,与其他呼吸道病毒的合并感染率为18.38%,高于RSV和其他病毒的合并感染率(P<0.05)。HBoV感染全年均有发生,夏季最多;6～18月龄婴幼儿检出率最高,占48.17%。在住院患儿中,HBoV主要引起支气管肺炎(85.39%),临床症状主要表现为咳嗽(96.63%)、喘息(46.07%)、发热(56.18%)。与RSV相比,HBoV感染患儿的白细胞、中性粒细胞比例、CRP均高于RSV,差异有统计学意义(P<0.05)。结论 HBoV是苏州地区小儿呼吸道感染的重要病原体之一,有单独的致病性,与RSV相比,在年龄、季节分布、临床症状、实验室指标等方面有明显差异。     

太原地区急性呼吸道人偏肺病毒和人博卡病毒感染患儿临床特征分析

目的了解太原地区急性呼吸道感染(ARTIs)儿童人偏肺病毒(hMPV)与人博卡病毒(HBoV)的感染情况及其临床和流行病学特征。方法采集2012年11月—2013年5月及2013年11月—2014年5月就诊的ARTIs患儿549例,采集咽拭子标本,应用实时PCR方法检测hMPV与HBoV。结果 549例患儿的咽拭子标本中hMPV阳性56例(10.2%),HBoV阳性15例(2.7%)。其中2012年11月—2013年5月hMPV与HBoV检出率分别为12.3%和2.0%,2013年11月—2014年5月hMPV与HBoV检出率分别为6.5%和4.0%,两时间段hMPV检出率差异有统计学意义(P0.05),HBoV检出率差异无统计学意义(P0.05);不同月份hMPV、HBoV检出率差异无统计学意义(P0.05)。hMPV与HBoV均在2岁组中检出率最高。hMPV在喘息性支气管炎与毛细支气管炎患儿中检出率最高。结论太原地区hMPV和HBoV与部分儿童尤其是婴幼儿ARTIs有关,hMPV是诱发部分婴幼儿喘息性疾病的重要病原体之一。     

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目的了解博卡病毒(HBOV)在急性喘息患儿中的流行病学特点及病毒载量与相应疾病严重程度的关系。方法收集2011年3月至2011年8月温州育英儿童医院住院部237例急性喘息患儿和同期96例无喘息住院患儿鼻咽部分泌物标本。采用荧光定量多聚酶链反应方法进行HBOV检测。结果 237例急性喘息患儿鼻咽部吸取物中共检出HBOV阳性62例(26.2%),96例无喘息患儿鼻咽部吸取物中,共检出HBOV12例(12.5%),两组HBOV检出率差异有统计学意义(χ2=7.377,P<0.01)。62例HBOV阳性患儿中,28例(45.16%)混合其他病毒感染,其中合并RSV感染21例(33.87%)。RSV单一感染与HBOV单一感染患儿、HBOV单一感染与HBOV混合感染患儿临床资料两两比较,差异无统计学意义(P>0.05)。HBOV阳性患儿的鼻咽部吸取物中病毒载量介于2.59×103～5.36×109拷贝/mL,中位数为6.2×103拷贝/mL(四分位数间距,2.6×103～4.4×104拷贝/mL);HBOV单一感染组患儿疾病严重程度与病毒载量的等级呈显著正相关,相关系数r=0.752(P<0.01);HBOV混合感染组患儿疾病严重程度评分与病毒载量的等级无相关性(P>0.05)。结论 HBOV在急性喘息患儿中流行,是导致婴幼儿喘息的重要病原。HBOV单一感染时其致病作用随着病毒载量等级的升高而增强。     

急性呼吸道感染住院儿童人类博卡病毒感染的临床特征

目的 了解西安地区以急性呼吸道感染住院患儿的人类博卡病毒(HBoV)感染的临床特征.方法 将2008年1月-12月以急性呼吸道感染住院患儿的咽拭及痰液标本252例分成2份,1份应用直接免疫荧光法检测RSV,甲、乙型流感病毒,Ⅰ、Ⅱ、Ⅲ型副流感病毒和腺病毒常见的7种呼吸道病毒;另1份用于提取HBoV DNA,分析HBoV感染的临床特点及流行病学特征.随机抽取1份HBoV DNA阳性扩增产物进行序列测定,并通过Clustal W软件与GenBank中其他HBoV序列进行多序列比对分析.结果 252份标本共检测到15份(6.0%)HBoV PCR阳性扩增产物.HBoV感染全年均有发生,冬春季多发;73.3%HBoV感染患儿的年龄为6个月至3岁;53.3%的患儿诊断为支气管肺炎(包括毛细支气管炎);53.3%患儿合并有其他呼吸道病毒的感染.HBoV单独感染与合并其他呼吸道病毒感染在临床特征方面无明显差别.HBoV NS1测序的291 bp与GenBank中2个原型株HBoV Stockholm 1(stl,No.DQ00495)、HBoY Stockholm2(st2,No.DQ00496)和北京的2株(No.DQ988934.2及No.DQ988933.1)的同源性为99.0%.结论 HBoV在15例以急性呼吸道感染住院患儿的咽拭及痰液标本中检出,HBoV感染以下呼吸道感染为著,与其他呼吸道病毒有较高的合并感染,HBoV单独感染与合并其他呼吸道病毒感染在临床特征方面无明显差别.     

长沙地区急性下呼吸道感染住院儿童人博卡病毒感染的初步研究

目的 了解人博卡病毒(HBoV)在长沙地区急性下呼吸道感染住院儿童中的流行情况及临床特征,比较分析其区域流行特点.方法 收集2007年9月 - 2008年3月长沙地区773份急性下呼吸道感染住院儿童鼻咽抽吸物(nasopharyngeal aspirates,NPAs)样本进行HBoV病毒NP1基因检测,将PCR阳性产物测序,并将所测序列在GenBank中进行比较分析.结果 773例样本中,HBoV阳性例数87例,HBoV感染患儿年龄为18 d ～ 64个月,冬春季节流行,主要的临床诊断与症状是支气管肺炎与咳嗽;所测序列与GenBank公布的不同地区的HBoV NP1基因核苷酸序列同源性达99.53%,氨基酸序列同源性达99.8%,对核苷酸序列作基因进化树分析显示属于1种基因型.结论 长沙地区部分急性下呼吸道感染儿童与人博卡病毒有关,且HBoV 感染在低年龄组的儿童中更常见;一种基因型在长沙地区流行.     

住院呼吸道感染患儿博卡病毒检测分析

目的 了解人博卡病毒(HBoV)在天津地区急性呼吸道感染患儿中的检测情况和基因的遗传进化特征。方法 收集2012 年1~12 月确诊为急性呼吸道感染患儿的鼻咽抽吸物标本1 259 份,提取病毒核酸,采用实时荧光定量PCR 法检测HBoV,并采用PCR 法扩增阳性标本HBoV 核衣壳蛋白基因片段;随机选取部分产物进行测序确证,将所获得的序列与已知的HBoV 基因序列进行比对并进行系统进化分析;同时对所有标本进行其他多种呼吸道相关病毒检测。结果 1 259 份标本中HBoV 阳性检出率为4.53%(57/1 259),其中75%(43/57)发生在6~36 月龄的患儿;检出高峰主要集中在夏季(6~8 月);存在与其他病毒的混合感染情况。对其中36 份阳性标本的PCR 产物进行序列分析,证实检测结果确为HBoV,且与已知HBoV 的基因序列同源性较高。结论 天津地区部分儿童的急性呼吸道感染可能与HBoV 感染相关,且HBoV 感染在6~36 月龄的婴幼儿中更为常见,夏季为流行高峰;系统进化分析显示与已知HBoV 的基因序列同源性高,基因序列变异较小。     

长沙市急性下呼吸道感染并粒细胞减少症111例病毒病原学分析

目的 探讨儿童急性下呼吸道感染并粒细胞减少症病毒病原学的特点.方法 选取湖南省人民医院2007年6月- 2008年10月111例急性下呼吸道感染并粒细胞减少症(粒细胞减少组)及1014例急性下呼吸道感染但粒细胞数正常的住院患儿(粒细胞正常组).患儿入院第2天收集鼻咽分泌物标本,采用反转录(RT) -PCR、PCR或巢式PCR扩增方法进行病毒基因检测,并将阳性产物测序,经序列测定及对比分析后确定为所检测病毒.结果 粒细胞减少组与粒细胞正常组病种构成及性别构成比较差异均无统计学意义(Pa＞0.05).粒细胞减少组37例未检出病毒,74例检出至少有1种病毒;各种病毒中,呼吸道合胞病毒(RSV)检出率最高,其次是副流感病毒3(PIV3)、鼻病毒(HRV)及人博卡病毒(HBoV).粒细胞正常组295例术检出病毒,719例检出至少有1种病毒;RSV检出率最高,其次是PIV3、HRV及HBoV.2组病毒总检出率及各种病毒检出率比较差异均无统计学意义(Pa＞0.05).2组年龄段分布差异有统计学意义(x2=8.89,P=0.012).其中1个月～1岁年龄段差异最大(X2=8.83,P=0.003).结论 1.急性下呼吸道感染住院患儿粒细胞减少的发生与病毒感染无明显相关.2.大于1岁的急性下呼吸道感染住院患儿更易出现粒细胞减少.3.急性下呼吸道感染住院患儿粒细胞减少与性别及疾病种类无关.     

儿童急性呼吸道感染病毒感染特点分析

目的分析儿童急性呼吸道感染患儿腺病毒(AdV)感染特点。方法 2009年5月至2009年6月北京儿童医院门诊急性呼吸道感染患儿共492例,入选患儿在就诊当日采集咽拭子标本1份,采用逆转录(RT)-PCR方法进行常见呼吸道病毒核酸检测,包括呼吸道合胞病毒(RSV),鼻病毒(RV),副流感病毒(PIV)1-4型,流感病毒甲型及乙型(IFA、IFB),腺病毒(AdV),肠道病毒(EV),人冠状病毒(HCoV),人偏肺病毒(HMPV)及人博卡病毒(HBoV)。AdV核酸扩增阳性片段进行克隆测序,对序列进行Blast和进化分析以对AdV进行分型。结果 492例急性呼吸道感染患儿的咽拭子标本中,165例检出至少1种病毒,总阳性检出率为33.5%。其中53份检出AdV,检出率为10.8%,在所有检出病毒中阳性率最高。53份AdV阳性标本中共检出3个亚组,7个血清型,以3型(23/53)为主,其次是7(8/53)型和1型(7/53)。结论 2009年春季北京地区AdV有多个血清型流行,以3型为主。AdV仍然是儿童呼吸道感染的重要病原。     

Human bocavirus infection in children with respiratory tract disease

BACKGROUND: Human bocavirus (HBoV) is a ubiquitous, newly described member of the Parvoviridae family frequently detected in the respiratory tract of children, but only few reports provide data proving the link between HBoV and respiratory tract disease (RTD). OBJECTIVES: To evaluate the incidence of HBoV infection in children with RTD; to analyze the clinical features of HBoV infection; and to clinically compare HBoV, respiratory syncytial virus (RSV), and human metapneumovirus (HMPV) infections. STUDY DESIGN: A prospective 1-year study was conducted in children <5 years of age hospitalized with RTD and in asymptomatic control children. RESULTS: Human bocavirus was detected in 55 (10.8%) of the 507 children tested and in none of the 68 asymptomatic control children (P = 0.01). About 80% of these infections occurred between November and March. Coinfection with another virus was observed in 22 (40%) of the HBoV-positive children. HBoV viral load was significantly higher in samples from children with HBoV monoinfection than in those with coinfection. Subsequent detection of HBoV more than 2 months after the initial detection could be documented in 3 children. Clinical features associated with HBoV infection were similar to those observed with either RSV or HMPV infections, but HBoV infections were less severe than RSV infections. CONCLUSIONS: The difference observed in HBoV prevalence between children with RTD and controls provides support for a role of this virus in RTD. The frequent associations of HBoV with other respiratory viruses might be explained by the persistence of HBoV in the respiratory tract. The significance of HBoV viral load in nasopharyngeal secretions as a marker of pathogenicity merits further investigation.     

Detection of human bocavirus in hospitalised children

Aim:   The objectives of this study are to assess the frequency of human bocavirus (HBoV) infection in hospitalised children and to study the clinical symptoms associated with the detection of HBoV.
Methods:   Two groups of hospitalised children were included in this study: group 1 consisted of 1946 children hospitalised from 1st September 2004 to 30th May 2005, and group 2 consisted of 448 children hospitalised from 1st November 2003 to 30th March 2004. The respiratory specimens were tested by polymerase chain reaction.
Results:   In the first group, HBoV was detected by polymerise chain reaction in 11/828 (1.3%) of nasal specimens that tested negative for other respiratory viruses. One child tested positive for HBoV in both a nasal aspirate and stool sample. In the second group, nasal specimens were tested for all respiratory viruses, including HBoV. The presence of HBoV infection was detected in seven children (1.6%). Detection of a mixed viral population was observed in four of these children. The main symptoms in children infected with HBoV were rhinitis (50%), cough (45%), dyspnoea (28%), wheezing (28%), fever (23%) and diarrhoea (22%). The final clinical diagnoses were bronchiolitis (seven children), rhinopharyngitis (five children), the exacerbation of asthma (two children) and pneumonia (one child). Moreover, four children have associated gastroenteritis.
Conclusion:   These results contribute to the interest in the HBoV detection in children. HBoV detection in hospitalised children with or without any other respiratory virus detection was essentially associated with lower respiratory tract infection and in a lower score with upper respiratory tract infection and gastroenteritis.     

Clinical characteristics of human bocavirus infections compared with other respiratory viruses in Spanish children

BACKGROUND: Human bocavirus (HBoV) can be found in a substantial proportion of children with respiratory tract diseases. The relative importance of HBoV in viral respiratory tract illnesses is not yet well known. OBJECTIVE: In this study, we looked for HBoV in pediatric patients to determine the incidence of HBoV as single infection and compared it with other commonly found respiratory viruses to describe the clinical differences associated with HBoV infections in children. PATIENTS AND METHODS: A prospective study was conducted on children less than 14 years old, admitted with respiratory infection from September 2005 to August 2007 to the Pediatrics Department of the Severo Ochoa Hospital, Madrid, Spain. We studied the frequency of HBoV and 15 other respiratory viruses in nasopharyngeal aspirates and compared the clinical course of the infections caused by HBoV with those caused by other common respiratory viruses. RESULTS: Positive results were confirmed in 435 (61.2%) of the 710 children studied. A single virus was detected in 308 patients. HBoV was found in 99 (13.9%) samples, but it was recovered as a single virus in only 35. Most of patients with HBoV infection (75%) were aged < or =26 months. The most common clinical diagnosis was recurrent wheezing (53%), followed by bronchiolitis (32%). Clinical differences were observed between HBoV and respiratory syncytial virus (RSV) infections (children were older and bronchiolitis less frequent), adenovirus (fever less frequent in HBoV group), and rhinovirus-associated infections (less hypoxia in HBoV group). CONCLUSIONS: HBoV was the fourth most frequent single virus after RSV, rhinovirus, and adenovirus in children hospitalized because of respiratory infection. It was associated with recurrent wheezing and bronchiolitis showing a different clinical course from other virus in terms of diagnosis, fever, and age.     

618例儿童呼吸道感染的病毒病原学分析

目的 了解儿童常见呼吸道病毒感染的发生率,比较不同年龄段儿童呼吸道感染的病毒检出情况,并分析儿童喘息症状与病毒感染的关系.方法 以618例呼吸道感染住院患儿为研究对象,取其鼻咽分泌物进行七项呼吸道病毒抗原检测并分析其结果,包括呼吸道合胞病毒(RSV)、腺病毒(ADV)、甲型流感病毒(IFA)、乙型流感病毒(IFB)、副流感病毒Ⅰ、Ⅱ、Ⅲ(PIVⅠ、Ⅱ、Ⅲ).结果 (1)618例送检标本中,166例阳性,总阳性率为26.86％,其中RSV最高,阳性率为17.96％,其余依次为PIVⅢ(5.99％),IFA(1.62％),ADV(0.81％),PIVⅠ (0.49％);混合感染1例,阳性率为0.16％,为RSV与PIVⅠ混合感染.(2)14d～ ＜1岁、1岁～＜3岁、3岁～＜6岁及≥6岁不同年龄组病毒检出阳性率依次为35.04％、18.25％、17.11％、9.26％.(3)不同呼吸道感染性疾病病毒检出率不同,以毛细支气管炎检出率最高,为47.37％.(4)所检测呼吸道感染患儿中婴幼儿更易出现喘鸣体征,喘息患儿中以RSV检出阳性率最高,为42.17％.结论 RSV和PIVⅢ是儿童呼吸道感染的最常见病毒;呼吸道感染的儿童年龄越小,越容易发生病毒感染;喘息患儿中RSV感染率最高.     

Clinical and microbiological impact of human bocavirus on children with acute otitis media

Human Bocavirus (HBoV) as a newly discovered parvovirus has been commonly detected in respiratory tract infections. However, its role in acute otitis media (AOM) has not been well studied. We examined HBoV in Japanese children with AOM and evaluated the virus prevalence together with clinical manifestations and bacterial findings. Overall, 222 nasopharyngeal swabs and 176 middle ear fluids (MEF) samples were collected from 222 children with AOM (median age, 19 months) between May 2006 and April 2007. HBoV detection was performed by PCR and bacterial isolation by standard culture methods. HBoV was found in the nasopharyngeal aspirates of 14 children (6.3%) and in the MEF of six children (2.7%). When HBoV detection results were evaluated with clinical characteristics of children, resolution time of AOM was significantly longer (p=0.04), and rate of fever symptom was also higher in HBoV-positive group (p=0.04). Furthermore, we found positive correlation between detection of HBoV and Streptococcus pneumoniae in the MEF (p=0.004). Nevertheless, nasopharyngeal proportion of S. pneumoniae was similar between virus positive and negative groups. Furthermore, S. pneumoniae was detected as a single pathogen in all MEF of HBoV-positive cases but one, while it presents mixed with other pathogenic bacteria in nasopharynx. In conclusion, HBoV may worsen the clinical symptoms and prolong the clinical outcome of AOM in pediatric population. Finally, HBoV may prime the secondary bacterial infection in the middle ear in favor of S. pneumoniae.