沈玲羽, 田竞, 张铁钢, 龚成, 黄芳. 北京市房山区首例肠道病毒D68病例临床症状与体征及病原学监测研究[J]. 疾病监测, 2019, 34(4): 327-331. DOI: 10.3784/j.issn.1003-9961.2019.04.011
引用本文: 沈玲羽, 田竞, 张铁钢, 龚成, 黄芳. 北京市房山区首例肠道病毒D68病例临床症状与体征及病原学监测研究[J]. 疾病监测, 2019, 34(4): 327-331. DOI: 10.3784/j.issn.1003-9961.2019.04.011
Lingyu Shen, Jing Tian, Tiegang Zhang, Cheng Gong, Fang Huang. Clinical manifestations and etiological characteristics of the first enterovirus-D68 positive case in Fangshan district of Beijing[J]. Disease Surveillance, 2019, 34(4): 327-331. DOI: 10.3784/j.issn.1003-9961.2019.04.011
Citation: Lingyu Shen, Jing Tian, Tiegang Zhang, Cheng Gong, Fang Huang. Clinical manifestations and etiological characteristics of the first enterovirus-D68 positive case in Fangshan district of Beijing[J]. Disease Surveillance, 2019, 34(4): 327-331. DOI: 10.3784/j.issn.1003-9961.2019.04.011

北京市房山区首例肠道病毒D68病例临床症状与体征及病原学监测研究

Clinical manifestations and etiological characteristics of the first enterovirus-D68 positive case in Fangshan district of Beijing

  • 摘要:
    目的了解北京市1例支气管肺炎患者感染肠道病毒D68型(EV-D68)的临床症状与体征及病原学特征。
    方法收集该患者临床资料,进行病例病程及诊疗分析,采集患者的痰液标本,提取样本的核酸,进行18种常见呼吸道病原体核酸检测,对检测阳性病原体进行VP1区和全基因组测序,并对序列进行遗传进化分析。
    结果该支气管肺炎患者以高热、咳嗽起病,高热消退后呼吸道症状加重,以喘息和咳嗽为主,抗哮喘药治疗后效果显著。 痰液标本病原学检测为EV-D68阳性,其他17种病原体均为阴性。 基于VP1区构建的系统进化树显示为EV-D68 B3基因亚型,全基因组同源性分析显示同源性最高的是2015年日本株(98.72% nt, 99.95% aa)、2015年香港株(98.61% nt,99.86% aa)和2016年美国株(98.24% nt,99.86% aa),与北京市报道的EV-D68同源性最高的是2014年“2014-R132”株(96.89% nt,99.45% aa)。
    结论EV-D68是引起支气管肺炎的重要病原体,应该加强EV-D68的病原学监测,为临床诊疗及疾病控制提供基础数据。

     

    Abstract:
    ObjectiveTo analyze the clinical manifestations and etiological characteristics of enterovirus D68 (EV-D68) infection in a patient with bronchopneumonia in Fangshan district of Beijing.
    MethodsThe clinical data of the case were collected for disease progression and diagnosis/treatment analyses and the sputum sample collection of the case was done for the nucleic acid tests of 18 common respiratory pathogens. The sequences of VP1 gene region and complete genome of EV-D68 were amplified with pairs of primers and the sequence was used for genetic evolution analysis.
    ResultsThe initial symptoms the bronchopneumonia case were high fever and cough, and respiratory symptoms of wheezing and coughing were exacerbated after high fever. The effect of anti-asthma drugs was significant. The sputum sample of this case was positive for EV-D68 and negative for other 17 pathogens. Phylogenetic analysis showed the pathogen belonged to EV-D68 subclade B3. Homology analysis showed that the EV-D68 strain shared high homology with Japanese strain in 2015 (98.72% nt, 99.95% aa), Hong Kong strain in 2015 (98.61% nt, 99.86% aa) and American strain in 2016 (98.24% nt, 99.86% aa), as well as " 2014-R132” strain in Beijing in 2014 (96.89% nt, 99.45% aa).
    ConclusionEV-D68 was the important pathogen causing bronchopneumonia. It is necessary to strengthen the etiological surveillance for EV-D68 to provide evidence for the clinical diagnosis and control of EV-D68 infection.

     

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