Molecular epidemiological and genotypic analysis of human adenovirus infection in children with acute diarrhea in Tianjin from 2017 to 2018

Xuan Li, Chao-Meng Fan, Shu-xiang Lin, Wei Wang, Ping Wang, Yulian Fang, Hualei Cui
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Abstract

Objective To understand the infection status, epidemiological characteristics and genetic evolution of adenovirus in children with diarrhea in Tianjin. Methods A total of 1 609 fecal specimens were collected from hospitalized children with diarrhea from July 2017 to July 2018 in Tianjin Children's Hospital. Viral nucleic acid was extracted and amplified by the hexon gene fragment. Positive specimens were used for nucleic acid sequence determination and sequence alignment and phylogenetic tree analysis with known sequences in GenBank. Rotavirus in the stool specimens was detected by gold standard method, and campylobacter was detected by latex agglutination method. Bocavirus, Norovirus and Clostridium difficile were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Results A total of 69 specimens with adenoviruses were detected in 1 609 cases, with a positive rate of 4.3%, in which 82.6% adenovirus-positive children were between 7 and 48 months old. The positive rate of adenovirus peaked in the summer and autumn, and the differences of this value among seasons were statistical significance (χ2=11.467, P=0.009). In these cases, the mixed infection rate of adenovirus was 26.1% (18/69), in which 7 cases were mixed with Norovirus, 7 cases were mixed with rotavirus and 4 cases were mixed with Clostridium difficile. A total of 39 adenovirus-positive PCR products were randomly selected for gene sequence detection, and 7 adenovirus genotypes were detected. Results showed that these viruses were mainly the type 41 enteric adenovirus (46.1%, 18/39), followed by type 31, type 3 and type 7 non-intestinal adenovirus, while types 1, 5 and 6 were relatively rare. Conclusions There are diverse types of adenovirus in children with diarrhea in Tianjin. The adenovirus-infected diarrhea mostly happen in summer and autumn, and is common in children. Key words: Diarrhea; Adenovirus infections, human; Molecular epidemiology; Genetic testing; Children
天津市2017~2018年急性腹泻患儿人腺病毒感染的分子流行病学和基因型分析
目的了解天津地区腹泻患儿腺病毒感染状况、流行病学特征及基因进化。方法收集2017年7月至2018年7月在天津市儿童医院住院的腹泻患儿粪便标本1609份。提取病毒核酸并通过六角体基因片段进行扩增。阳性标本用于核酸序列测定和序列比对,并与GenBank中的已知序列进行系统发育树分析。用金标法检测粪便标本中的轮状病毒,用乳胶凝集法检测弯曲杆菌。采用实时定量聚合酶链反应(qRT-PCR)检测博卡病毒、诺如病毒和艰难梭菌。结果在1609例腺病毒感染病例中,共检测到69例腺病毒,阳性率为4.3%,其中82.6%的腺病毒阳性儿童年龄在7至48个月之间。腺病毒阳性率在夏秋季达到高峰,季节间差异有统计学意义(χ2=11.467,P=0.009),腺病毒混合感染率为26.1%(18/69),其中7例混合诺如病毒,7例混合轮状病毒,4例混合艰难梭菌。随机选择39个腺病毒阳性PCR产物进行基因序列检测,共检测到7种腺病毒基因型。结果显示,这些病毒主要是41型肠道腺病毒(46.1%,18/39),其次是31型、3型和7型非肠道腺病毒,而1型、5型和6型相对罕见。结论天津地区腹泻患儿存在多种类型的腺病毒。腺病毒感染的腹泻多发生在夏季和秋季,在儿童中很常见。关键词:腹泻;腺病毒感染,人类;分子流行病学;基因检测;儿童
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