[2023至2024年北京急性呼吸道感染儿童人偏肺病毒感染的流行病学特征]

[Epidemiological characteristics of human metapneumovirus infection among children with acute respiratory infections in Beijing from 2023 to 2024].

作者信息

Li X Y, Zhu R N, Sun Y, Sun Y C, Zhou Y T, Yao Y, Guo Q, Zhang G Q, Zhu C M, Zhao L Q

机构信息

Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing 100020, China.

Department of Respiratory, Capital Center for Children's Health, Capital Medical University, Beijing 100020, China.

出版信息

Zhonghua Er Ke Za Zhi. 2025 Aug 2;63(8):858-863. doi: 10.3760/cma.j.cn112140-20250529-00457.

DOI:10.3760/cma.j.cn112140-20250529-00457

PMID:40692456

Abstract

To explore the molecular epidemiological characteristics of human metapneumovirus (HMPV) in children with acute respiratory infection (ARI) in Beijing from 2023 to 2024. In the longitudinal study, 9 834 children with ARI were enrolled from August 2023 to December 2024, including the influenza-like illness (ILI) group from emergency and outpatient department receiving influenza virus (Flu) and HMPV test and the ARI inpatient group for 13 common respiratory pathogen screening test including HMPV, Flu, respiratory syncytial virus, and so on. All respiratory samples positive with HMPV were genotyped by amplifying and sequencing of G gene and further phylogenetic analysis. The test and Wilcoxon rank-sum test were used to compare the positive rate and basic clinical data of the 2 groups. Among 9 834 enrolled patient, there were 5 276 male and 4 558 female children, with age 5.4 (1.9, 8.2) years. In ILI group of 1 460 patients, there were 83 cases (5.7%) positive for HMPV, with the age 4.9 (3.6, 6.6) years and children under 6.0 years old 59 cases (71.1%). Among 8 374 ARI inpatients, there were 256 cases (3.1%) positive for HMPV, with age 3.5 (1.3, 6.4) years and children under 6.0 years old 188 cases (73.4%). The HMPV positive rate and the age of children positive for HMPV in ARI inpatient group were significantly lower than that in ILI group (both <0.001). In December, 2024, the HMPV positive rates of ILI and ARI inpatient group (21.3% (17/80), 15.0% (47/314)) were significantly higher than the total positive rates of each group (both <0.001). Among 279 subtyped specimens, there were 155 cases (55.6%) belonging to genotype A and 124 cases (44.4%) belonging to genotype B. Sub-lineage A2.2.2 containing 111nt-insertions was predominate one in 2023 with positive ratio 89.2% (91/102), and B2 was predominate in 2024 with positive ratio 64.4% (114/177). From 2023 to 2024, the positive rate of HMPV in the ILI group was higher than that in the ARI inpatient group, suggesting a common epidemic of HMPV infection. Children positive for HMPV in the ARI inpatient group were younger than that in the ILI group. A severe epidemic of HMPV was observed in the winter of 2024, which requires attention. Sub-lineage A2.2.2 with 111nt-duplicate insertions and B2 were the predominant epidemic strains in 2023 and 2024, respectively.

摘要

探索2023年至2024年北京急性呼吸道感染（ARI）儿童中人偏肺病毒（HMPV）的分子流行病学特征。在这项纵向研究中，2023年8月至2024年12月纳入了9834例ARI儿童，包括来自急诊科和门诊接受流感病毒（Flu）和HMPV检测的流感样疾病（ILI）组，以及进行包括HMPV、Flu、呼吸道合胞病毒等13种常见呼吸道病原体筛查检测的ARI住院组。所有HMPV阳性的呼吸道样本通过G基因扩增和测序进行基因分型，并进一步进行系统发育分析。采用检验和Wilcoxon秩和检验比较两组的阳性率和基本临床资料。在9834例纳入患者中，男性5276例，女性4558例，年龄5.4（1.9，8.2）岁。在1460例ILI组患者中，HMPV阳性83例（5.7%），年龄4.9（3.6，6.6）岁，6.0岁以下儿童59例（71.1%）。在8374例ARI住院患者中，HMPV阳性256例（3.1%），年龄3.5（1.3，6.4）岁，6.0岁以下儿童188例（73.4%）。ARI住院组HMPV阳性率及HMPV阳性儿童年龄均显著低于ILI组（均<0.001）。2024年12月，ILI组和ARI住院组HMPV阳性率（21.3%（17/80），15.0%（47/314））显著高于各组总体阳性率（均<0.001）。在279份亚型标本中，155例（55.6%）属于A基因型，124例（44.4%）属于B基因型。含111nt插入的A2.2.2亚谱系在2023年占主导，阳性率89.2%（91/102），B2在2024年占主导，阳性率64.4%（114/177）。2023年至2024年，ILI组HMPV阳性率高于ARI住院组，提示HMPV感染呈共同流行。ARI住院组HMPV阳性儿童年龄小于ILI组。2024年冬季观察到HMPV严重流行，需予以关注。含111nt重复插入的A2.2.2亚谱系和B2分别是2023年和2024年的主要流行株。