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目的了解2006—2007年度重庆地区住院急性呼吸道感染(ARTIs)儿童两亚型呼吸道合胞病毒(RSV)的感染特点及流行规律。方法收集2006年4月至2007年3月全年在重庆医科大学附属儿童医院呼吸科住院的部分ARTIs患儿的鼻咽深部吸取物390份,针对RSVG基因保守区序列设计分型引物,采用RT-PCR方法检测标本中RSV的基因组RNA。结果390例标本中RSV阳性例数为133例(133/390,阳性率为34.10%)。阳性标本中A亚型阳性129例,B亚型阳性4例。RSV阳性患儿中,84.9%为2岁以下小儿。2006年11月～2007年1月为RSV高发季节,RSV检测阳性率为55.6%～62.3%,2006年12月RSV检测阳性率最高。B亚型出现于本地区RSV感染低发季节(4、5、6月)。RSV感染的临床表现主要为发热(56.4%)、咳嗽(98.5%)、喘息(63.9%)、气促(76.7%)、紫绀(84.9%)。临床诊断依次为毛细支气管炎(33.1%),支气管肺炎(27.8%),间质性肺炎(18.1%),重症肺炎伴呼吸衰竭(10.5%),喘息性支气管炎(5.3%),支气管哮喘(4.5%)。结论本研究初步阐明了重庆地区两亚型RSV感染的流行病学特点,证实RSV是重庆地区冬春季婴幼儿ARI的重要病原,2006—2007年度以A亚型RSV流行为主。今后的研究将纳入门诊及社区患儿并进行多年度连续监测以进一步阐明重庆地区两亚型RSV流行规律及病毒进化特点。
Objective To investigate the characteristics and prevalence of infection of two subtype respiratory syncytial virus (RSV) in children with acute respiratory infections (ARTIs) in Chongqing during 2006-2007. Methods A total of 390 nasopharyngeal aspirates were collected from children with ARTIs who were hospitalized in Respiratory Department of Children’s Hospital of Chongqing Medical University from April 2006 to March 2007. Genotyping primers were designed according to the conserved regions of RSVG gene. RT- -PCR method for detecting genomic RNA of RSV in specimens. Results Among the 390 cases, the number of RSV positive cases was 133 cases (133/390, the positive rate was 34.10%). Positive samples in the A subtype 129 cases, B subtype 4 cases. Of RSV-positive children, 84.9% were children under 2 years of age. From November 2006 to January 2007, the RSV detection rate was 55.6% -62.3%. RSV detection was the highest in December 2006. Subtype B appears in the low season of RSV infection in this region (April, May, June). The main clinical manifestations of RSV infection were fever (56.4%), cough (98.5%), wheezing (63.9%), shortness of breath (76.7%) and cyanosis (84.9%). The clinical diagnosis followed by bronchiolitis (33.1%), bronchopneumonia (27.8%), interstitial pneumonia (18.1%), severe pneumonia with respiratory failure (10.5%), asthmatic bronchitis 4.5%). Conclusions The study initially clarified the epidemiological characteristics of two subtype RSV infections in Chongqing and confirmed that RSV is an important pathogen of ARI in winter and spring infants in Chongqing. The epidemic of RSV A was predominant in 2006-2007. Future studies will include outpatients and community-based children and carry out multi-year continuous monitoring to further clarify the prevalence and evolutionary characteristics of RSV subtype in Chongqing.