2021年安徽蚌埠秋冬季肺炎患者鼻病毒检测及基因特征分析
Detection and phylogenetic analysis of human rhinovirus in hospitalized patients with pneumonia in autumn and winter in Bengbu, Anhui province, 2021
摘要目的:了解人鼻病毒(human rhinovirus,HRV)在成人住院肺炎患者中的检出率及基因特征。方法:采集2021年9~12月安徽蚌埠某医院住院肺炎患者咽拭子,以实时荧光定量PCR方法进行14种常见呼吸道病原体检测。巢式PCR法扩增HRV阳性样本的VP4/VP2编码区基因,扩增产物测序。使用MEGA7.0软件构建HRV-VP4/VP2基因序列系统发育树。结果:共采集住院肺炎患者咽拭子146份,其中检出阳性样本52份,检出率为35.62%(52/146),HRV、腺病毒、冠状病毒OC43和乙型流感病毒检出率位居前四位。HRV共检出23例,占检出病毒样本的44.23%(23/52),其中HRV混合感染有9例(39.13%,9/23);结合临床数据分析,HRV混合感染组白细胞、中性粒细胞计数、合并高血压、糖尿病、辅助通气比例以及不良预后比例均高于单一感染组( P<0.05)。系统发育树结果显示本研究的HRV感染主要以A组与B组为主。 结论:HRV是2021年安徽蚌埠秋冬季成人肺炎患者中最常见的病原体,其中HRV-A与HRV-B为优势株。HRV与其他呼吸道病毒混合感染易出现在合并高血压和糖尿病的患者,临床治疗中更需要辅助通气,易出现不良预后。
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abstractsObjective:To investigate genetic characteristics of human rhinovirus (HRV) in adult inpatients with pneumonia in autumn and winter in Bengbu, Anhui province, 2021.Methods:The pharyngeal swabs of inpatients with pneumonia in Bengbu were collected for the detection of 14 common respiratory pathogens by Real-time PCR during September to December 2021. VP4/VP2 coding regions of HRV positive samples were amplified by nested PCR and phylogenetic tree was constructed using MEGA7.0.Results:A total of 146 samples were collected from inpatients with pneumonia; 35.62% (52/146) samples were positive with at least one pathogen. The four viruses with high detection rate were HRV, adenovirus, human coronavirus OC43 and influenza B virus. HRV positive samples accounted for 44.23% (23/52) of the positive samples, among which 9 cases (39.13%, 9/23) co-infected with HRV. Phylogenetic analysis found that HRV infection were dominated by HRV-A and HRV-B groups. The analysis based on clinical syndrome found that the white blood cells count and the proportion neutrophils of patients with HRV co-infection were higher that of HRV single infection. The proportion of patients with hypertension, diabetes, mechanical ventilation and poor prognosis in the HRV co-infection group were higher than that of HRV single infection group ( P<0.05). Conclusions:HRV is the predominant pathogen among the adult inpatients with pneumonia in Bengbu. HRV-A and HRV-B groups are common. Patients accompanied by hypertension, diabetes were easily co-infected with HRV. Patients coinfeted with HRV are more likely to be mechanical ventilation and poor prognosis.
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