Study On The Status Of Human Rhinovirus And Human Rhinovirus C Infections In Hospitalized Children With Respiratory Tract Infections In Suzhou

Objective To investigate the frequency and clinical characteristics of human rhinovirus(HRV) and human rhinovirus C in hospitalized children with respiratory tract infections(RTIs) in Suzhou.Methods From Jan 2013 to Dec 2014, 3430 nasal aspirate specimens from children with RTIs were obtained, RNA was extracted from the specimens and reverse transcription polymerase chain reaction(RT-PCR) was performed for HRV RN A. HRV-C was detected by the real-time fluorescent PCR and high resolution melting curve for the HRV positive specimens from Jan 2014 to Dec 2014.Medical records of patients with a positive test for HRV and HRV-C in RTIs patients were analyzed. Direct immuno-fluorescence assay was done directly on the respiratory specimens from RTIs and tested for respiratory syncytial virus(RSV), influenza virus types A, B(Inf-A, B), parainfluenza virus types 1-3(Pinf 1-3), and adenovirus(ADV). Using real-time PCR method for human bocavirus(HBo V) and mycoplasma pneumonia(MP), and RT-PCR for human metapneumovirus(h MPV). putum culture was applied to detect bacterial.Results 1. From the 3430 RTIs specimens, 1339 viruses were detected(39.0 %), 439 HRV(12.8%), including 195 HRV(11.3%) o f 2013, 244 HRV(14.3%) of 2014. 244 HRV positive specimens were detection HRV-C 69, accounting for 28.3% of the total HRV.2. The detection of coinfections: HRV coinfections with virus were detected in 70 patients(70/439,16.0%), with HBo V as the most frequent virus coinfections(30/70, 43.5%). HRV coinfections with bacterial were detected in 170 patients(170/439, 38.7%), with streptococcus pneumoniae as the most frequent bacterial coinfections(69/170,40.6%). HRV coinfections with mycoplasma pneumonia were detected in 187 patients(187/439,42.6%)). HRV-C coinfections with virus were detected in 6 patients(3 HBo V,1 RSV,1 Pinf-3,1 HBo V+RSV). HRV-C coinfections with bacterial were detected in 32 patients, with streptococcus pneumoniae as the most frequent bacterial coinfections(9 case). HRV-C coinfections with mycoplasma pneumonia were detected in 26 patients.3. HRV distributed sporadically throughout the year, with a peak in September. The detection rate was higher in spring,summer and autumn seasons than winter(P<0.005). There was no statistically significant differences between males and females(c2 =1.728,P=0.189), majority of the infected children was under 2 years old(70.4%), and the positive number decreased gradually with age. The HRV detection positive ra te has no statistically significant difference between age groups((c2 =3.343,P=0.342). HRV-C distributed sporadically throughout the year, with a peak in October and November. The detection rate was higher in autumn seasons than spring, summer and winter(P<0.005). The rate of children infected HRV-C between 2~5 years old was significantly higher than other age groups(P<0.05).4. The clinical manifestations of HRV were similar to ot her viruses, presented with fever, cough and wheezing. Compared with RSV intection,HRV intection was more susceptible to have fever(c2 =14.860,P<0.001), but RSV infection were more likely to appear breathing(c2 =9.141,P=0.002).In patients diagnosed with lobar pneumonia or asthma, HRV was detected more frequently than other common viruses, and was second to RSV infection in bronchiolitis. There was no statistical difference between HRV infection with HRV-A/B infection in gender and clinical manifestations(P>0.05). In patients diagnosed with lobar pneumonia or asthma, HRV-C was detected more frequently than HRV-A/B(P<0.05).Conclusion HRV was a major viral pathogen of RTIs in Suzhou, sporadically distributed throughout the year with a peak in September, mainly infected children less than 2 years old. HRV-C infection accounted for about 1/3 of the HRV, sporadically distributed throughout the year with a peak in October and November. The rate of children infected HRV-C between 2~5 years old was the highest. The clinical features were similar with HRV- A/B. In patients diagnosed with lobar pneumonia or asthma, HRV-C was detected more frequently than HRV-A/B.