上海地区人偏肺病毒致儿童急性下呼吸道感染的分子流行病学研究

摘要

目的 建立可靠的TaqMan-MGB实时荧光RT-PCR方法 ,检测临床样本中人偏肺病毒(hMPV)N基因,以了解2006年10月至2008年2月期间上海地区hMPV致儿童急性下呼吸道感染(ALRTI)的临床与分子流行病学特点.方法 为了明确hMPV在儿童ALRTI中的地位,用直接免疫荧光方法 检测呼吸道合胞病毒(RSV),腺病毒,A、B型流感病毒,1、2和3型副流感病毒7种儿童常见呼吸道病毒抗原,结合肺炎支原体、沙眼衣原体荧光定量PCR检测结果 及细菌学培养结果 进行分析.结果 2006年10月至2008年2月上海地区ALRTI儿童鼻咽分泌物中hMPV的检出率为3.86%(24/622),2006-2007年冬季和2007-2008年冬季检出率分别为6.60%(14/212)和1.11%(2/180);hMPV致儿童ALRTI以＜5岁儿童多见.该期间上海地区hMPV仅见A2亚型株流行.呼吸道病毒是上海地区儿童ALRTI主要病原,在儿童ALRTI中hMPV感染可能仅次于RSV,是常见的呼吸道病毒.结论 hMPV是上海地区儿童ALRTI的重要病原体.%Objective To understand the clinical and molecular epidemiologic features of human metapneumovirus (hMPV) in children with acute lower respiratory tract infection (ALRTI)from Oct.2006 to Feb.2008 in Shanghai.Methods We established a reliable and stable diagnostic method of TaqMan-MGB real-time reverse transcription polymerase chain reaction (RT-PCR) to detect hMPV in the clinically manifested respiratory samples.To understand the role of hMPV in children' s ALRTI,we tested other seven common respiratory viruses,using direct immunofluorescence assays (DFA).Results Data was analysed on the rates of detection among patients with respiratory bacteria,mycoplasma pneumonia and chlamydia among the targeted samples and enrolled patients to display the spectrum of respiratory pathogens and the changing pattern of pathogens with time.Of 622 samples,hMPV was detected to be positive in 24 (3.86%) samples.However,the prevalence of hMPV in the winter season of 2006 to 2007 was higher than that in the winter season of 2007 to 2008.The majority of children infected with hMPV were younger than 5 years old.Data from phylogenetic tree analysis further demonstrated A2 genotype hMPV circulating during the study period.Conclusion Respiratory viruses were important respiratory pathogens among children with ALRTI and respiratory syncytial virus.They were the two most common virus which might be followed by hMPV that causing the diseases.We confirmed that hMPV as an important pathogen of ALRTI in the children from Shanghai.