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人偏肺病毒(Human metapneumovirus,h MPV)是引起儿童急性呼吸道感染(Acute respiratory tract infections,ARTIs)的常见病毒病原体。本研究通过分析2022年1月至2023年6月北京地区ARTIs患儿感染h MPV分子流行病学特征，为h MPV流行监测、防控提供基础数据。2023年5至6月，h MPV RNA阳性患儿人数激增，h MPV RNA检出率可达6.39%。h MPV RNA阳性住院患儿发病年龄的中位数为3.8岁；多数住院患儿诊断为肺炎，36.62%的患儿进展为重症肺炎。本研究共获得49例流行株G基因序列，系统进化树分析提示45例属A2c111nt-dup基因亚型、3例属B1基因亚型和1例属B2基因亚型，检出的流行株与国内外其他地区的流行株存在交叉流行。G基因与A2c111nt-dup、B1和B2基因亚型的代表株相比，其核苷酸(氨基酸)序列同源性分别为92.7%～96.8%(86.3%～93.7%)、89.7%～90.2%(85.3%)和92.2%(88.0%)。其中，A2c111nt-dup基因亚型流行株PP69162与其他株相比，其G蛋白新增I/M55L、Q56R、K57A和S60C氨基酸位点改变。A2c111nt-dup和B1基因亚型G蛋白的N-糖基化位点和O-糖基化位点较参考株而言，均有所增加，提示h MPV基因组仍不断发生变异。2023年5至6月出现的h MPV感染ARTIs患儿人数激增、检出率升高提示儿童h MPV感染可能存在流行趋势。此外，尽管A2c111nt-dup基因亚型仍是北京地区流行的优势型别，但G蛋白仍存在不断地变异过程，持续动态监测不同基因亚型h MPV感染的临床表现和h MPV分子流行特征具有重要意义。
Abstract：Human metapneumovirus (h MPV) is a common viral pathogen responsible for acute respiratory tract infections (ARTIs) in children.This study aimed to investigate the molecular epidemiological characteristics of h MPV among pediatric ARTIs cases in Beijing,China from January 2022 to June 2023,providing fundamental data for surveillance and prevention efforts.A sharp increase in h MPV RNA-positive cases was observed in May and June 2023,with a detection rate reaching 6.39%.The median age of hospitalized children with h MPV RNA positivity was 3.8 years.Most hospitalized cases were diagnosed with pneumonia,and 36.62%developed severe pneumonia.A total of 49 G gene sequences of circulating h MPV strains were obtained.Phylogenetic analysis revealed that 45 strains belonged to the A2c111nt-dup genotype,3 to the B1 genotype,and 1 to the B2genotype.Cross-regional transmission patterns were observed between Beijing and other areas.Compared with reference strains,the nucleotide (amino acid) sequence identities of the G protein were 92.7%～96.8%(86.3%～93.7%) for A2c111nt-dup,89.7%～90.2%(85.3%) for B1,and 92.2%(88.0%) for B2.Notably,the A2c111nt-dup strain PP69162 showed unique amino acid substitutions in the G protein,including I/M55L,Q56R,K57A,and S60C.Additionally,an increased number of predicted N-linked and O-linked glycosylation sites were identified in the G proteins of A2c111nt-dup and B1 genotypes compared to reference strains,suggesting ongoing viral evolution.The spike in h MPV-positive pediatric ARTIs cases and the elevated detection rate in May–June 2023 suggest a potential emerging epidemic trend.Although A2c111nt-dup remains the predominant genotype circulating in Beijing,ongoing mutations in the G protein underscore the importance of continuous molecular surveillance to monitor genotype distribution and associated clinical manifestations of h MPV infection.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.2401314
中图分类号:R725.6;R181.3
引用信息:
[1]黄陆慈,郭雅洁,申晨等.2022年1月-2023年6月北京地区儿童急性呼吸道感染人偏肺病毒分子流行特征分析[J].病毒学报,2025,41(03):683-692.DOI:10.13242/j.cnki.bingduxuebao.2401314.
基金信息:
北京市自然科学基金-海淀原始创新联合基金(项目号:L242051),题目:基于急性呼吸道感染队列的人偏肺病毒感染流行病学及病原学研究; 国家重点研发计划(项目号:2023YFC2306002),题目:重要病毒变异规律及预测预警研究子课题二重要病毒关键突变位点功能分子机制研究; 中国医学科学院医学与健康科技创新工程(项目号:2019-I2M-5-026); 北京市卫生健康委员会改革与发展项目(项目号:EYGF-BD-03)~~