儿童人偏肺病毒感染的临床和遗传特征

Clinical and genetic features of human metapneumovirus infection in children.

作者信息

Park Ji Young, Yun Ki Wook, Lim Jae Woo, Lee Mi Kyung, Lim In Seok, Choi Eung Sang

机构信息

Departments of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea.

Neuroscience and Behavioral Biology, Emory College of Arts and Sciences, Emory University, Atlanta, Georgia, USA.

出版信息

Pediatr Int. 2016 Jan;58(1):22-6. doi: 10.1111/ped.12782. Epub 2016 Jan 15.

DOI:10.1111/ped.12782

PMID:26260168

Abstract

BACKGROUND

Human metapneumovirus (hMPV) is one of the main pathogens responsible for respiratory tract infection in children.

METHODS

From 2011 to 2013, nasopharyngeal aspirates were obtained from Korean children and tested for hMPV on reverse transcription-polymerase chain reaction (RT-PCR). The genotype of hMPV in each sample was identified on PCR-restriction length polymorphism analysis of the fusion gene. We divided patients into three groups according to degree of fever. Patients with fever peaking at >39.5°C or lasting >7 days were classified as the high fever (HF) group; those with fevers peaking at <38.5°C and lasting <72 h were classified as the low fever (LF) group; and the other subjects were classified as the moderate fever group.

RESULTS

Among 457 samples positive for hMPV, hMPV genotype was able to be identified in 399 (87.3%); of these, A2a was found in 97 (24.3%), B1 in 186 (46.6%), and B2 in 116 (29.1%). Clinical features of hMPV infection were compared between the HF and LF groups. We classified 80 subjects into the HF group and 84 subjects into the LF group. Mean absolute neutrophil count (5625 ± 4418 vs 4072 ± 3076/μL, P = 0.010) and C-reactive protein (2.39 ± 3.39 vs 0.96 ± 1.77 mg/dL, P = 0.001) were higher in the HF group. Wheezing (5.0% vs 32.1%, P < 0.001) and dyspnea (2.5% vs 15.5%, P = 0.010) were more frequently seen in the LF group. Genotype distribution was similar in the two groups.

CONCLUSION

Two distinct clinical presentations of hMPV infection were identified in this study.

摘要

背景

人偏肺病毒（hMPV）是引起儿童呼吸道感染的主要病原体之一。

方法

2011年至2013年，从韩国儿童中采集鼻咽吸出物，采用逆转录聚合酶链反应（RT-PCR）检测hMPV。通过对融合基因进行PCR-限制性片段长度多态性分析，确定每个样本中hMPV的基因型。根据发热程度将患者分为三组。发热峰值>39.5°C或持续>7天的患者归为高热（HF）组；发热峰值<38.5°C且持续<72小时的患者归为低热（LF）组；其他受试者归为中度发热组。

结果

在457份hMPV阳性样本中，399份（87.3%）能够鉴定出hMPV基因型；其中，A2a型97份（24.3%），B1型186份（46.6%），B2型116份（29.1%）。比较了HF组和LF组hMPV感染的临床特征。我们将80名受试者归为HF组，84名受试者归为LF组。HF组的平均绝对中性粒细胞计数（5625±4418对4072±3076/μL，P = 0.010）和C反应蛋白（2.39±3.39对0.96±1.77mg/dL，P = 0.001）更高。LF组喘息（5.0%对32.1%，P<0.001）和呼吸困难（2.5%对15.5%，P = 0.010）更为常见。两组的基因型分布相似。