2018 - 2019年浙江省儿童病毒性脑炎的病因分析

Etiological Analysis of Viral Encephalitis in Children in Zhejiang Province from 2018 to 2019.

作者信息

Liu Juan-Juan, Teng Li-Ping, Hua Chun-Zhen, Xie Yong-Ping, Pan Yan-Xiang, Hu Bo-Fei, Hu Wei-Lin, Wang Wei-Jian

机构信息

Department of Infectious Diseases, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.

Department of Rheumatology Immunology and Allergy, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.

出版信息

Diagnostics (Basel). 2022 Aug 14;12(8):1964. doi: 10.3390/diagnostics12081964.

DOI:10.3390/diagnostics12081964

PMID:36010314

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9407060/

Abstract

OBJECTIVE

To investigate the common pathogens of viral encephalitis (VE) in children, and to provide guidance for the empirical diagnosis and treatment of patients with VE.

METHODS

A total of 227 cerebrospinal fluid (CSF) samples were collected from pediatric patients with VE in Zhejiang province from January 2018 to December 2019. The samples were tested using multiplex and singleplex Reverse Transcription-Polymerase Chain Reaction (RT-PCR) with primers specific to enterovirus (EV), varicella-zoster virus (VZV), mumps virus (MuV), cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1)/type 2 (HSV-2), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV-6). The data of the two analyses were compared and then verified using Sanger sequencing.

RESULTS

Of the 227 CSF samples, 90 were shown to be positive for multiplex RT-PCR with a positivity rate of 39.65% and a 95% confidence interval (33.2%, 46.1%). EV was the most common cause of VE, followed by EBV, HHV-6, MuV, CMV, VZV, and HSV-1. Most included cases occurred in summer, accounting for 49.78% of all cases. For EV, EBV, and HSV-2, multiplex RT-PCR showed a positivity rate of 34.36%, which was not statistically different from that of 30.4% shown by singleplex RT-PCR. The sequences of EV, EBV, VZV, MuV, CMV, HSV-1, HHV-6, and HSV-2 were confirmed by sequencing the PCR products obtained from multiplex and singleplex PCR.

CONCLUSIONS

In children, VE is more prevalent in the summer than in other seasons in Zhejiang province, and EV may be the most common causative pathogen.

摘要

目的

调查儿童病毒性脑炎（VE）的常见病原体，为VE患者的经验性诊断和治疗提供指导。

方法

收集2018年1月至2019年12月浙江省儿科VE患者的227份脑脊液（CSF）样本。使用多重和单重逆转录聚合酶链反应（RT-PCR），采用针对肠道病毒（EV）、水痘带状疱疹病毒（VZV）、腮腺炎病毒（MuV）、巨细胞病毒（CMV）、单纯疱疹病毒1型（HSV-1）/2型（HSV-2）、爱泼斯坦-巴尔病毒（EBV）和人疱疹病毒6型（HHV-6）的引物对样本进行检测。比较两种分析的数据，然后使用桑格测序进行验证。

结果

在227份CSF样本中，90份多重RT-PCR呈阳性，阳性率为39.65%，95%置信区间为（33.2%，46.1%）。EV是VE最常见的病因，其次是EBV、HHV-6、MuV、CMV、VZV和HSV-1。大多数纳入病例发生在夏季，占所有病例的49.78%。对于EV、EBV和HSV-2，多重RT-PCR的阳性率为34.36%，与单重RT-PCR显示的30.4%无统计学差异。通过对多重和单重PCR获得的PCR产物进行测序，确认了EV、EBV、VZV、MuV、CMV、HSV-1、HHV-6和HSV-2的序列。