Investigation Of Virus Spectrum Of Hospitalized Children With Acute Low Respiratory Tract Infection From2012-2013in Changsha

ObjectiveUsing fluorescence quantitative PCR technology to detect12kinds of respiratory viruses in hospital children with acute low respiratory tract infection (ALRTI).To reveal the epidemic characteristics of common respiratory viruses in hospital children with ALRTI in Changsha area from April2012through to March2013, and provide basic data and scientific evidence of prevention and control with ALRTI.Method:1、From April2012through to March2013, NPAs specimens were randomly collected from653children with acute low respiratory tract infection, who was admitted to the pediatrics medical center of first affiliated hospital of Hunan normal university in Changsha.2、12kinds of common respiratory viruses were detected by real-time Polymerase Chain Reation (real-time PCR), includeing RSV、HRV、 IFVA、IFVB、HMPV、NL63、HKU1、PIV1-3、ADV、HBoV.3、Epedemiology and clinical manifestations of each virus in hospitalized children with ALRTI were analyzed.Results:1、Among the653NPAs samples, the total viruses detected rate was76.42%(499/653), PIV3is the most common virus. The detected rate of PIV3was37.98%(248/653), RSV was28.79%(189/653), HBoV was20.83%(136/653), HMPV was17%(111/653), ADV was13.48%(88/653), HRV was12.56%(82/653), HKU1was9.19%(60/653),influenza A virus was5.82%(38/653), NL63was3.83%(25/653), the PIV1was0.31%(2/653). No parainfluenza virus type2and influenza B viruses were detected. 2、The detected rate of males and females were76.67%(332/433) and75.91%(167/220) respectively, The detected rate was no significant difference between male and female (X2=0.047, P=0.828). And there was no significant difference in male and female of various viruses (P>0.05).3、The median ages of viruses infected patients was22months (range from1day to156months).79.72%(114/143) children with viruses infection were under6months old,84.91%(135/159) children with viruses infection were at age from6months to1year old,81.51%(119/146) children with viruses infection were at age from1year to2years old,75%(45/60) at age from2to3years old,60.71%(34/56) children with viruses infection were at age from3to4years old,54.84%(17/31) children with viruses infection were at age from4to5years old, and the virus detected rate of children over the age of5years old was60.34%(35/58). The positive detected rate in various age group had significant difference (x2=33.374, P<0.01), especially in the age of6months～1year old children whose positive virus detected rate was the highest. And the age distribution of different viruses were differences.4、There was remarkable seasonal distribution of the detected rate of total viruses in Changsha area, the peak prevalence of viruses was in winter. The peak seasonal distribution of different viruses had differences.5、The main clinical diagnoses of children with viruses infection included bronchitis(31), pneumonia(316)(including common pneumonia(238), severe pneumonia(78)), bronchiolitis(147), bronchial asthma with pulmonary infection (5), Pneumonia was the most common clinical diagnose.6、54.3%(271/499) positive children were found to be co-infected with other respiratory viruses, RSV, PIV3and HBoV were the most common co-infecting virus. There were co-infection in each month and the virus co-infected rate increased from2012.12to2013.03. 7、45.1%(228/499) positive children were found to be co-infected with other pathogens (including Mycoplasma pneumoniae, Chlamydophila pneumoniae and some kinds of bacterium just like Escherichia coli, Klebsiella pneumoniae and so on.Conclusion:1、From April2012to March2013, the positive rate of virus detection of hospital children with ALRTI was as high as76.42%, reveal that respiratory virus is the important pathogen in Changsha area.2、The virus spectrum of hospitalized children with ALRTI in2012.4-2013.3in Changsha area had changed. PIV3accounted for first place, and RSV was ranked second. In addition, recently identified HboV and HMPV were located in the third and fourth,which played important roles in ALRTI in Changsha.3、The detected rate was significant difference in the age distribution, especially in the age of6months to1year old, and the age distribution of different viruses had differences. The detected rate was no significant difference between male and female. There was remarkable seasonal distribution of the detected rate of total viruses in Changsha area, the peak prevalence of viruses was in winter, and the peak seasonal distribution of different viruses had differences.