病毒学报

2003~2012年连续10年对北京地区儿科急性呼吸道感染患儿腺病毒(Adenovirus,ADV)的监测,了解儿科急性呼吸道感染患儿中ADV感染状况和流行型别。收集39 214份儿科急性呼吸道感染患儿标本(包括来自住院及重症监护患儿的32 016例鼻咽分泌物标本及门诊的咽拭子标本7 198例)进行病毒分离和/或免疫荧光法进行ADV检测,对其中848份毒株和/或阳性标本提取DNA,通过两套巢式聚合酶链反应(nested-PCR)进行ADV分型。首先用3、7型2对分型引物的PCR可确定3、7型ADV,对少数扩增阴性的标本或毒株再使用2对可扩增AF各组ADV的通用引物对其DNA六邻体片段进行扩增后直接测序,并与GenBank中的序列比较以确定其型别。在39 214份呼吸道标本中,经病毒分离和/或免疫荧光法确定为ADV阳性的标本884份,总阳性率为2.25%(884/39 214),其中住院患儿ADV检测阳性率为2.08%(665/32 016),门诊患儿为3.04%(219/7 198)。以ADV年检出率统计,2003~2012年10年期间只有2010年的阳性率较高,为3.69%,其余年份均在3.0%以下。对其中848份毒株或阳性标本的分型结果显示:3型ADV占53.18%(451/848),7型ADV占36.79%(312/848),2型占3.78%(32/848),55型占2.24%(19/848),1型占2.0%(17/848),5型占0.94%(8/848),14型占0.47%(4/848),6型占0.35%(3/848),4型占0.24%(2/848)。除2012年优势型别为7型,2003年和2007年为3、7型外,占23例(88.5%)。12例诊断为扁桃体炎患儿11例为ADV3(91.7%)感染。0³岁年龄组ADV阳性检出率高于4岁以上年龄组。男女性别比为1.9:1。近10年中ADV3和ADV7为主要的流行型别。儿童ADV重症肺炎多是由ADV7造成的。由11和14型重组的55型ADV从2006年开始在北京儿童中出现。

Adenovirus(ADV)is one of the most common causes of acute respiratory infections for infants and children.The objective of this study was to understand the prevalence of ADV in acute respiratory infections in infants and children in Beijing and the types of the circulating ADVs.Clinical specimens were collected from patients with acute respiratory infections in a consecutive period of 10years from Jan 2003to Dec 2012.ADVs were detected from the collected clinical specimens by tissue culture and/or immunofluorescence assay and typed by nested-PCR based on the sequence of hexon gene for ADV types 3and 7.For those strains which could not be typed by the nest-PCR,the gene fragment was amplified by a universal primer pair for all ADV types from group A to F and the PCR products were sequenced directly and analyzed with sequence comparison.Out of 39214clinical specimens collected,including 7198throat swabs from outpatients and 32016nasopharyngeal aspirates from hospitalized patients,884were ADV positive by tissue culture and/or immunofluorescence assay,the overall positive rate was 2.25%(884/39214).The positive rate of ADV from the hospitalized was 2.08%(665/32016),while from the outpatients was3.04%(219/7198).The ADV positive rate for year 2010was 3.69%,which was the highest among the10years.The types of the ADVs were tested for 848out of the 884patients by using the nest-PCR and sequence analysis.It was showed that AD3was the most prevalent with the rate of 53.18%(451/848),followed by AD7 36.79%(312/848),AD2 3.78%(32/848),AD55 2.24%(19/848),AD1 2.0%(17/848),AD5 0.94%(8/848),AD14 0.47%(4/848),AD6 0.35%(3/848)and AD4 0.24%(2/848).AD3was the most predominant in most of the years among these 10years,except 2012,2003and 2007.AD7was the most predominant in 2012,and AD3and AD7were co-circulated in 2003and 2007.Among 26ADV infected severe pneumonia cases with pulmonary failure,23(88.5%)were AD7positive,while 12ADV associated tonsillitis,11(91.7%)were AD 3.The ADV positive rates from age groups 0-3years were higher than age groups older than 4years.The ratio for ADV positive males to females was 1.9to 1.Adenovirus is still an important pathogen of acute respiratory infection in infants and young children.Most of the ADV associated acute respiratory infections in children in Beijing from 2003to 2012were AD3and AD7.Most of the severe lower respiratory infections were associated with AD7.AD55generated by recombination of AD11and AD14emerged in 2006.