文章摘要
寇宇,潘劲草,于新芬,李钧,杨旭辉,文艳苹,周银燕,濮小英,孙昼,谢立.杭州地区2011-2013年儿童呼吸道感染人偏肺病毒分子流行病学研究[J].中华流行病学杂志,2014,35(12):1384-1388
杭州地区2011-2013年儿童呼吸道感染人偏肺病毒分子流行病学研究
Molecular epidemiology of human metapneumovirus in children with respiratory tract infection in Hangzhou
收稿日期:2014-07-19  出版日期:2014-12-10
DOI:10.3760/cma.j.issn.0254-6450.2014.12.016
中文关键词: 人偏肺病毒;呼吸道感染;流行病学特征
英文关键词: Human metapneumovirus;Respiratory infection;Molecular epidemiology
基金项目:杭州市科技局资助项目(20110833B36,20120533Q24)
作者单位E-mail
寇宇 杭州市疾病预防控制中心微生物检验科 310021 kouyu09@126.com 
潘劲草 杭州市疾病预防控制中心微生物检验科 310021  
于新芬 杭州市疾病预防控制中心微生物检验科 310021  
李钧 杭州市疾病预防控制中心微生物检验科 310021  
杨旭辉 杭州市疾病预防控制中心微生物检验科 310021  
文艳苹 杭州市疾病预防控制中心微生物检验科 310021  
周银燕 杭州市疾病预防控制中心微生物检验科 310021  
濮小英 杭州市疾病预防控制中心微生物检验科 310021  
孙昼 杭州市疾病预防控制中心微生物检验科 310021  
谢立 杭州市疾病预防控制中心微生物检验科 310021  
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中文摘要:
      目的 了解杭州地区儿童人偏肺病毒(hMPV)的分子流行病学特点.方法 收集2011年1月至2013年12月杭州市2所哨点医院儿科呼吸道门诊和住院病例2 593例,门诊病例采集咽拭子1 676份,住院病例采集气管吸取物917份.用实时荧光定量PCR方法检测hMPV核酸,阳性样本用RT-PCR方法对hMPV 融合蛋白(F)部分基因片段扩增和序列测定.所测基因序列与GenBank代表株核苷酸同源性比较,并构建基因进化树.结果采用描述性统计和样本率的χ2检验.结果 杭州地区呼吸道患儿hMPV检出率为6.51%(169/2 593).门诊检出率为6.62%(111/1 676),住院检出率为6.32%(58/917),检出率差异无统计学意义(χ2=0.086,P=0.769).2岁和3岁组检出率最高,分别为14.14%(28/198)、14.01%(22/158),与其他组比较差异有统计学意义(χ2=38.654,P=0.000).冬春季检出高于夏秋季(χ2=67.032,P=0.000).测序的88株阳性基因序列与GenBank参考株核苷酸序列同源性为81.6%~100.0%,基因进化树分析显示分属于2个基因型的4个亚型. 2011-2012年B1亚型占优势,2012年底至2013年A2型为流行.<1岁组A基因型(67.56%,25/37)与≥1岁组(43.13%,22/51)检出率差异有统计学意义(χ2=5.143,P=0.023).结论 杭州地区儿童呼吸道感染hMPV存在4种基因型,<1岁组A基因型感染较多,2、3岁组hMPV检出率最高.
英文摘要:
      Objective To understand the molecular epidemiologic features of human metapnenmovirus (hMPV) in children with respiratory tract infection in Hangzhou. Methods 2 593 throat swabs were collected from patients with respiratory tract infections who visited the hospitals with sentinel surveillance programs from January 2011 to December 2013,including 1 676 outpatients and 917 inpatients. Total nucleic acid was extracted from the specimens and the fusion (F) protein gene of hMPV was amplified by quantitative real-time reverse transcription polymerase chain reaction (RT-PCR),with positive samples picked to compare with the sequence of hMPV in GenBank,after the sequence of amplification products were determined. Other two types of common respiratory virus were tested using RT-PCR. Results The overall positive rate in this study was 6.51% (169/2 593),with 6.62% (111/1 676) in outpatients and 6.32% (58/917) in inpatients,but no statistically significant difference was found (χ2=0.086,P=0.769). The rates was 7.01% in males and 5.72% in females,with no statistically significant difference in different sex (χ2=1.676,P=0.195). The positive rate was 14.14% (28/198) in the 2- year-olds,14.01%(22/158) in 3- year olds. The rate in 2- year olds was higher than in other groups,with statistically significant differences between the groups (χ2=38.654,P=0.000). Of the 169 positive cases,153 (90.53%) in the younger than 5 years olds. The rates of infection with hMPV in winter and spring were statistically higher than in summer and autumn (χ2=67.032,P=0.000). The rate of co-infection was 19.52% (33/169). 88 amplified productions were selected for gene sequence analysis,and the F gene homology were 81.6%-100.0% with reference strains in GenBank. Data showed that all the 4 viral subtypes:A2 (52.27%,46/88),B1(37.51%,33/88),B2(9.09%,8/88) and A1(1.13%,1/88) co-circulated during the study. However,different subtypes appeared predominant in different years:hMPV subtype B1 was in 2011 and 2012,subtype A2 in the end of 2012 and in 2013. Of the 88 specimens,gene sequences were determinate,with A genotype accounted for 67.56% (25/37),B genotype for 32.43% (12/37) in children younger than 1-year olds,and A genotype accounted for 43.13%(22/51),B genotype for 56.86% (29/51) in children above 1-year olds. Significant differences between the two groups (χ2=5.143,P=0.023) were noticed. Conclusion It was confirmed that hMPV was one of the substantial pathogens causing the respiratory tract infections. Data from our study suggested that the peak time of hMPV infection predominated during winter and spring in Hangzhou. Both hMPV subtype B1 and subtype A2 were found popular in this study,with hMPV genotype A dominating in children younger than 1-year olds.
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