Epidemiological Characteristics Of Human Rhinovirus With Respiratory Tract Infection And The Relationship Between Meteorological Factors In Hospitalized Children In Suzhou From 2013 To 2015

Objective:To study the epidemic characteristics of human rhinovirus with acute respiratory tract infection in hospitalized children and its relationship of meteorological factors in Suzhou.Method:Sputum was obtained from hospitalized children with acute respiratory tract infections(ARI)during Jan 2013 to Dec 2015.Samples were tested human rhinovirus(hRV)with reverse transcription polymerase chain reaction(RT-PCR).Nasopharyngeal aspirates were obtained from children according to a standard protocol and were tested for syncytial virus infection(RSV),influenza virus A(InfA),InfB,ParainfluenzaⅠ(PinfⅠ),PinfⅡ,PinfⅢ,and adenovirus(ADV)with direct immunofluorescence assay.Samples were tested human metapneumovirus(hMPV)with RT-PCR.Human bocavirus(hBoV)and Mycoplasma pneumoniae(MP)DNA were detected by real—time fluorescent PCR.Sputum culture for bacteria.Detection of serum MP-specific antibody was performed using enzyme-linked immunosorbent assay.The meteorological factors including average monthly temperature,relative humidity,rainfall amount,sum of sunshine and mean wind velocity were collected.The relationship between the detection of hRV and metrorological factors was analyzed by linear regression and stepwise regression analysis.Results:1.5994 specimens were tested in 3 years.The positive rate of Mycoplasma,respiratory virus and bacteria were 34.37%(2060/5994),32.27%(1934/5994)and13.10%(785/5994).The most common pathogen was MP(34.37%),followed by RSV(11.09%),hRV(10.78%),Streptococcus pneumoniae(7.87%),h BoV(5.54%).2.Of the 646 hRV positive patients,408(10.98%)were male,238(10.45%)were female.There was no significant difference between the positive rate in female and male(χ~2=0.415,P>0.05).3.Thepositiveratesoftheagegroupsof0~6months,6~12months,12~36months,36~72months and≧72 months were 11.21%、12.49%、11.44%、9.14%and 7.05%,respectively.Significant differences were showed in these age groups(χ~2=14.477,P<0.01).4.The positive rates of hRV during 2013 to 2015 were 8.17%(166/2032)、10.95%(224/2046)、13.36%(256/1916).The positive rates of hRV during 3 years differed significantly(χ~2=27.738,P<0.001).The positive rates in 2015 were the higher than in2013 and 2014.5.The results showed that the positive rates of hRV infection were 11.73%in spring,11.66%in summer,13.32%in autumn and 6.56%in winter.These data revealed that the prevalence of hRV infection was obviously higher during autumn and lower in winter.The positive rates in each season has a statistical significance(χ~2=40.552,P<0.001).The positive rate of hRV in winter showed statistical significances with other seasons(winter and springχ~2=24.748,P<0.001,winter and summerχ~2=23.716,P<0.001,winter and autumnχ~2=38.11,P<0.001).6.The positive rate of hRV of bronchopneumonia(11.59%)was higher than other diseases.The positive rate of hRV of upper respiratory tract infection is lower than others(5.47%).There was statistical significance between two disease groupes(χ~2=7.176,P<0.01).7.Of the 646 patients with hRV infection,63.93%(413)patients were co-infected with other pathogens.15.79%were co-infected with respiratory virus,while 17.18%were co-infected with bacteria.The most common pathogen co-infected was MP(30.96%),followed by Streptococcus pneumoniae(10.84%)and h BoV(6.66%).8.The positive rate of hRV showed a moderate correlation with average monthly temperature(r=0.366,P=0.028)and a low correlation with average monthly wind velocity(r=0.406,P=0.014).While it showed no correlation with average monthly rainfall,sunshine and humidity.In stepwise regression analysis temperature was the only independent covariant significantly associated with positive rate of hRV(β=0.499,t=2.112,P=0.043).The meteorological factors had a lag period effect for the positive rate of hRV.Conclusions:1.hRV was one of the most common pathogen in respiratory tract infection of hospitalized children in Suzhou.2.hRV infection mainly occurs in children under 3 years old.There was no significant difference between female and male.3.The positive rates of hRV was on the increase from 2013 to 2015 in Suzhou area.4.The prevalence of hRV infection was higher during autumn and lower during winter.5.Co-infection was common in patients with hRV infection.The most common pathogen co-infected was MP,Streptococcus pneumoniae and hBoV.6.The epidemic of hRV showed a correlation with meteorologicalFactors,especially average temperature.The meteorological factors had a lag period effect for the positive rate of hRV.