Rhinovirus infection among severe acute respiratory infection cases in hospitalized children in Xuzhou city, Jiangsu province, 2015−2021
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摘要:
目的 了解2015—2021年江苏省徐州市住院儿童严重急性呼吸道感染（SARI）病例中病毒谱的构成，进一步探究人鼻病毒（hRV）的分子流行病学特征。 方法 使用实时荧光定量聚合酶链式反应技术（RT-PCR）对咽拭子标本中的常见呼吸道病毒进行检测。 巢式 PCR 法扩增hRV阳性样本的VP4/VP2区基因序列，构建系统发育树，并进行同源性分析。 结果 1663份标本中呼吸道病毒检出阳性641份（38.54%）。 hRV的检出率位居第1位，为13.95%（232/1663）。 2018年hRV的检出率明显较高（28.08%）；呈现夏秋高峰的季节性流行特征。 2020年后，hRV在1—6月的检出率明显降低，但7月后检出率迅速回升，且在3～6岁年龄组中明显上升，≥6岁组中明显下降。 hRV的VP4/VP2区序列比对分析发现涉及29种血清型，以hRV-A组为主。 结论 hRV是2015—2021年徐州市住院儿童SARI病例中主要流行的呼吸道病毒，以hRV-A组为主要流行，血清型具有多样性。 hRV的流行在2020年受到了短暂的抑制之后迅速回升，提示需要对hRV感染进行持续监测。 Abstract:Objective To understand the composition of viral profiles in cases of severe acute respiratory infection (SARI) in hospitalized children in Xuzhou city, Jiangsu province, 2015−2021, and further investigate the molecular epidemiological characteristics of human rhinovirus (hRV). Methods Common respiratory viruses were detected in pharyngeal swab specimens using real-time fluorescence quantitative polymerase chain reaction (PCR). A nested PCR method was used to amplify the gene sequences of the VP4/VP2 region of hRV-positive samples, construct a phylogenetic tree, and perform homology analysis. Results Respiratory viruses were detected positively in 641 of 1663 specimens (38.54%). hRV had the highest detection rate of 13.95% (232/1663). hRV detection rate was significantly higher in 2018 (28.08%); showing seasonal epidemiological characteristics of summer and autumn peaks. After 2020, the detection rate of hRV decreased significantly from January to June, but rebounded rapidly after July and increased significantly in the age group of 3−6 years and decreased significantly in the group of ≥6 years. hRV sequence comparison analysis of the VP4/VP2 region revealed that 29 serotypes were involved, with hRV-A group predominating. Conclusion hRV is the main prevalent respiratory virus among SARI cases in hospitalized children in Xuzhou from 2015−2021, with hRV-A group as the main prevalent group and a diversity of serotypes. The prevalence of hRV rebounded rapidly in 2020 after a brief suppression., suggesting the need for continuous surveillance of hRV infection. -
图 1 2015－2021年徐州市严重急性呼吸道感染儿童病例中鼻病毒检出的月份分布
Figure 1. Month distribution of human rhinovirus detection in children with severe acute respiratory infection in Xuzhou, 2015−2021
图 2 2015－2021年徐州市严重急性呼吸道感染儿童病例中鼻病毒检出率分布
注：A. 鼻病毒的月检出率变化图；B. 防控措施实施前后鼻病毒在不同年龄组内的变化；C. 构成比分布
Figure 2. Distribution of human rhinovirus detection rates in children with severe acute respiratory infection in Xuzhou, 2015-2021
图 3 基于VP4/VP2区域构建的鼻病毒系统发育进化树
注：红色标记的菌株为本实验标本株
Figure 3. Phylogenetic tree of rhinovirus based on VP4/VP2 region
表 1 2015－2021年徐州市严重急性呼吸道感染儿童病例中呼吸道病毒的检出情况（n=1663）
Table 1. Detection of respiratory virus in children with severe acute respiratory infection in Xuzhou, 2015−2021 (n=1663)
病毒种类 检出数（例） 检出率（%） 鼻病毒 232 13.95 呼吸道合胞病毒 218 13.11 副流感病毒3型 121 7.28 冠状病毒-OC43 36 2.16 冠状病毒-229E 20 1.20 甲型流感病毒 40 2.41 乙型流感病毒 13 0.78 腺病毒 48 2.89 
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表 2 2015－2021年徐州市严重急性呼吸道感染儿童病例中人鼻病毒在性别、年龄、季节和年份中的分布情况
Table 2. Distribution of human rhinovirus by sex, age, season and year in children with severe acute respiratory infection in Xuzhou city, 2015-2021
变量 病例数 鼻病毒 χ2值 P值 检出数
（例）检出率
（%）性别 0.327 0.567 男性 1040 149 14.33 女性 623 83 13.32 年龄组（岁） 4.621 0.202 ＜1 982 125 12.73 1～ 326 57 17.48 3～ 233 33 14.16 ≥6 122 17 13.93 季节 34.009 ＜0.001 春 394 55 13.96 夏 429 77 17.95 秋 426 76 17.84 冬 414 24 5.80 年份 66.813 ＜0.001 2015 184 17 9.24 2016 290 22 7.59 2017 259 41 15.83 2018 260 73 28.08 2019 270 21 7.78 2020 110 19 17.27 2021 290 39 13.45
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表 3 2019－2021年徐州市严重急性呼吸道感染儿童病例中鼻病毒阳性标本的VP4/VP2区基因序列分型结果型结果
Table 3. Genotype typing results of VP4/VP2 region of human rhinovirus positive specimens in children with severe acute respiratory infection in Xuzhou, 2019−2021
种群 亚型 数量/条 种群 型别 数量/条 hRV-A A2 1 hRV-A A85 1 hRV-A A7 1 hRV-A A89 1 hRV-A A8 1 hRV-A A105 2 hRV-A A15 1 hRV-A A106 1 hRV-A A19 1 hRV-B B3 1 hRV-A A20 1 hRV-B B42 1 hRV-A A29 1 hRV-B B48 1 hRV-A A30 1 hRV-B B70 1 hRV-A A38 1 hRV-C C5 1 hRV-A A45 1 hRV-C C8 2 hRV-A A49 5 hRV-C C19 1 hRV-A A56 1 hRV-C C23 2 hRV-A A58 1 hRV-C C40 1 hRV-A A78 1 hRV-C C45 1 hRV-A A80 1
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