多重PCR技术检测儿童下呼吸道感染病毒和不典型病原体的价值

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Abstract Objective: To understand the distribution of viruses and atypical pathogens in children’s lower respiratory tract infections (LRTI), and to investigate the clinical value of multiplex PCR technique. Methods: Nasopharyngeal secretions of 992 children under 5 years old who were hospitalized for LRTI in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University were collected, from January 2014 to December 2014. Direct immunofluorescence assay was used to detect respiratory syncytial virus (RSV), influenza virus A, influenza virus B, parainfluenza virus, adenovirus and Chlamydia antigen, and extract nucleic acid. Use multiple PCR method based on advanced fragment analysis to detect RSV, influenza A virus, influenza virus B, parainfluenza virus, adenovirus, human rhinovirus (HRV), bocavirus, human metapneumovirus, coronavirus, mycoplasma pneumonia and Chlamydia gene. Results: There were 662 males and 330 females, 587 were in <1 year old group, 287 were in 1-3 years old group, 118 were in 3-5 years old group, the median age was 10 month. By using multiple PCR method, nasopharyngeal secretions from 851 patients were detected at least one pathogen (85.8%), 224 detected two or more than two pathogens (22.6%). RSV and HRV accounted for the top two of all detected pathogens, and the positive rates of pathogens in different groups were 84.8%, 89.2% and 82.2%, there was no significant difference between the three groups (χ2=4.416, P=0.110). However, the mixed infection rates in <1 year old group and 1-3 year old group were significantly higher than 3-5 year old group (χ2=3.963 and 9.871, P=0.047 and 0.002). As for LRTI children, HRV can be detected of all ages, while RSV is mainly in infants. Compared with immunofluorescence, the consistency of the same pathogen detection is good (Kappa=0.615, P<0.01), but multiple PCR method was better for detecting other pathogens (58.37% vs. 41.53%, χ2=56.23, P<0.001). Conclusion: RSV and HRV are the first two of the major virus and atypical pathogens of LRTI in children under 5 years old in this region. Bocavirus, coronavirus, and human metapneumovirus can also be detected, mycoplasma was rare. Compared with the direct immunofluorescence method, multiple PCR is helpful in comprehensive understanding the etiology of LRTI in children.

Key words： lower respiratory tract infections noxae virus multiple polymerase chain reaction advanced fragment analysis

Received: 08 March 2017

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	ZHANG Hailin
	CHEN Xiaofang
	LYU Fangfang
	ZHONG Peipei
	CHEN Bo
	XU Zhi
	DONG Lin.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2017/V47/I11/791

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