CAJ | 학술논문

目的了解重庆地区呼吸道感染住院忠儿新型冠状病毒MERS-CoV和人冠状病毒(HCoV)229E、HCoV-OC43、HCoV-NL63和HCoV-HKU1的流行情况和临床特征.方法收集2009年7月至2013年6月因呼吸系统感染住院儿章的鼻咽抽吸物,采用多重巢式PCR和实时荧光定量PCR检测5种冠状病毒,统计分析相应临床资料.结果 2 188份标本中,MERS-CoV末检测出,其他4种冠状病毒共检出74例(3.38％),其中HCoV-229E共31例(1.42％),HCoV-NL63共21例(0.96％),HCoV-OC43共6例(0.27％),HCoV-HKU1共15例(0.69％),HCoV-229E和HCoV-NL63混合检出1例(0.04％).这4种冠状病毒呈全年散发,HCoV-229E和HCoV-NL63检出以夏、秋季为主,而HCoV-OC43以夏季为主,HCoV-HKU1以冬季为主.74例阳性患儿中,男56例(75.7％),年龄分布集中在0～6个月(36/74例,48.6％)和7～ 12个月(19/74例,25.7％),有基础疾病忠儿达20例(27.0％).临床症状主要为咳嗽(66/74例,89.2％)、咳痰(53/74例,71.6％)、喘息(39/74例,52.7％)、发热(33/74例,44.6％)、腹泻(26/74例,35.1％).大部分患儿诊断为肺炎(54/74例,73.0％),其中10例为重症肺炎.50例患儿为混合感染,其中HCoV-HKU1最易混合感染(14/15例,93.3％),混合检出最高的是呼吸道合胞病毒.混合感染组与单独感染组比较,更易山现咳嗽和喘息(P＜0.05).结论重庆地区在呼吸道感染住院的患儿中无MERS-CoV的检出,HCoV-229E、HCoV-OC43、HCoV-NL63和HCoV-HKU1的检出率较低.HCoV主要感染1岁内男性婴儿,能引起下呼吸道感染,尤其是有基础疾病的忠儿,且在重症肺炎中起一定作用.
목적 료해중경지구호흡도감염주원충인신형관상병독MERS-CoV화인관상병독(HCoV)229E、HCoV-OC43、HCoV-NL63화HCoV-HKU1적류행정황화림상특정.방법 수집2009년7월지2013년6월인호흡계통감염주원인장적비인추흡물,채용다중소식PCR화실시형광정량PCR검측5충관상병독,통계분석상응림상자료.결과 2 188빈표본중,MERS-CoV말검측출,기타4충관상병독공검출74례(3.38％),기중HCoV-229E공31례(1.42％),HCoV-NL63공21례(0.96％),HCoV-OC43공6례(0.27％),HCoV-HKU1공15례(0.69％),HCoV-229E화HCoV-NL63혼합검출1례(0.04％).저4충관상병독정전년산발,HCoV-229E화HCoV-NL63검출이하、추계위주,이HCoV-OC43이하계위주,HCoV-HKU1이동계위주.74례양성환인중,남56례(75.7％),년령분포집중재0～6개월(36/74례,48.6％)화7～ 12개월(19/74례,25.7％),유기출질병충인체20례(27.0％).림상증상주요위해수(66/74례,89.2％)、해담(53/74례,71.6％)、천식(39/74례,52.7％)、발열(33/74례,44.6％)、복사(26/74례,35.1％).대부분환인진단위폐염(54/74례,73.0％),기중10례위중증폐염.50례환인위혼합감염,기중HCoV-HKU1최역혼합감염(14/15례,93.3％),혼합검출최고적시호흡도합포병독.혼합감염조여단독감염조비교,경역산현해수화천식(P＜0.05).결론 중경지구재호흡도감염주원적환인중무MERS-CoV적검출,HCoV-229E、HCoV-OC43、HCoV-NL63화HCoV-HKU1적검출솔교저.HCoV주요감염1세내남성영인,능인기하호흡도감염,우기시유기출질병적충인,차재중증폐염중기일정작용.
Objective To detect the existence of Middle East respiratory syndrome coronavirus (MERS-CoV) in the hospitalized children with respiratory infection in Chongqing area and study the clinical symptoms associated with the detection of 4 human coronaviruses (HCoV):HCoV-229E,HCoV-OC43,HCoV-NL63 and HCoV-HKU1 types.Methods Nasopharyngeal aspirates collected over a 4-year period (from Jul.2009 to Jun.2013) from pediatric inpatients with respiratory infection were analyzed for the presence of 5 coronavirus subtypes by using multi-nested polymerase chain reaction and sensitive real-time polymerase chain reaction assays.The clinical characteristics associated with coronavirus infection were examined.Results MERS-CoV was not found and other 4 coronaviruses were positive in 74 (3.38％) of 2 188 children,in which 31 (1.42％),21 (0.96％),6 (0.27％) and 15 (0.69％) specimens were positive for subtypes HCoV-229E,HCoV-NL63,HCoV-OC43,and HCoV-HKU1,respectively,and 1 case was co-detected with HCoV-229E and HCoV-NL63.HCoV infection was sporadic in the whole year,of which HCoV-229E and HCoV-NL63 infection mainly occurred in summer and autumn,while HCoV-OC43 in summer and HCoV-HKU1 in winter.Of the 74 chilhen,56 (75.7％) were male,36 (48.6％) were at ages of 0-6 months and 19 (25.7％) at 7-12 months,and 20 (27.0％) had underlying diseases.The clinical symptoms of HCoV infection included cough (66/74 cases,89.2％),sputum (53/74 cases,71.6％),wheezing (39/74 cases,52.7％),fever (33/74 cases,44.6％)and diarrhea (26/74 cases,35.1％).Most patients were diagnosed as pneumonia (54/74 cases,73.0％),including 10 cases of severe pneumonia.Fifty patients were co-infected with another respiratory virus,in which respiratory syncytial virus was the mostly detected.HKU1 was the most likely to detect in the co-infected group.Patients who were co-infected with another respiratory virus were more likely to have cough and wheezing than sole-infected patients (P ＜ 0.05).Conclusions No MERS-CoV existed in the hospitalized chikren with respiratory infection in Chongqing area and HCoV-229E,HCoV-OC43,HCoV-NL63 and HCoV-HKU1 are of low prevalent.HCoV that primarily infects male infants less than 1 year old and lead to lower rcspiratory tract infection,especially in children with underlying diseases and plays a role in severe pneumonia disease.