Clinical Research Of Human Metapneumovirus Infection In Hospitalized Children Between 2009 And 2012 In Suzhou Area

Objective To investigate the status of human metapneumovirus(h MPV)infection among children with respiratory tract infection in suzhou area, to analyze epidemiology and clinical features of h MPV in children and to provide basic data and scientific evidence of prevention and control with ALRTI.Methods11080 patients admittted in Children’s Hospital Affiliated to Soochow University with acute respiratory tract infection between January 2009 and December 2012 were recruited in the study.We tested respiratory specimens for the presence of h MPV by reverse-transcription polymerse chian reaction(RT-PCR).These specimens also assayed for RSV,ADV,IFVA/B,PIV1-3,adenovirus,Hbo V by direct fluorescent antibody test.And we tested respiratory specimens by Bacterial culture.Analyze the epidemiology and clinical features of h MPV in children.Results1.In 11080 cases, human metapenumovirus positive specimens of 491 cases, the positive rate of 4.4%.2009 positive detection rate was 3.3%(82/2471), the positive detection rate was 6.5%(149/2307), 2010, 2011 positive detection rate was 4.4%(118/2698), the positive rate in 2012 was 3.9%(142/3604).2. Total of 11080 cases of specimens, including male 6981, female 4099 cases, partial pulmonary virus positive cases 311 cases(63.3%) of the men and women in 180 cases(36.7%), the ratio of male and female was 1.73:1, male, the female h MPV were no statistical differences(χ2 = 0.025, P = 0.025).3. The median ages of viruses infected patients were19 months(range from 1 month to132month). 82.3%(404/491)children with viruses infection were younger than 3 years old, 96.1%(472/491) children with viruses infection were younger than 5 years old.Detection rate among all age groups, statistically difference(χ2 = 24.60, P < 0.001).4. During the study period, in addition to 2009 July, August, October, November, in September 2011, h MPV are detected in the rest of the month, but the positive predictive value(11.7%) in January 2009, April 2010(23.0%), in March 2011(12.8%), in March2012(12.2%) to present the annual peak(figure 1).Partial pulmonary virus in March and April the highest detection rate, 12.5%, 10.0% respectively(figure 2).Spring appeared peak detection rate(2) and 4 month, h MPV detection rate of the four seasons, respectively,10.0%, 2.6%, 1.1%, 3.0%.5. In this study, mixed other virus positive detection rate 12.2%(60/491), the biggest percentage of complicated by RSV infection.6. 238 cases of h MPV infection, including 2 cases of acute upper respiratory tract infection,1 case of herpangina, 3 cases of acute capillary bronchitis,1 case of bronchitis,35 cases of asthematoid bronchopneumonia, 201 cases of bronchial pneumonia, 4 cases of lobar pneumonia in, 5 cases of severe pneumonia.7. The main clinical manifestations: fever(37.8%), cough(97.5%),wheezing,(42.7%),lung rale(93.1%), chest X-ray abnormalities(93.1%), including both lungs the deepening of the texture fuzzy flocculent and(or), patchy shadows, large patchy shadows.24 months to 36 months infections occur fever was 89.5%(17/19), 36 months to 60 months infection fever was 91.3%(21/23), chi-square was statistically difference between groups( table 5).0month to 6 months infections occur breathing was 41.6%(37/89), 6 months to 12 months infections occur breathing was 57.8%(37/64), 12 months to 24 months infections occur breathing was 51.4%(19/37), chi-square was statistically difference between groups( table6).Conclusion(1) h MPV is one of the important pathogens causing respiratory tract infection in hospitalized children in suzhou area.(2) Throughout the year there were h MPV infection,popular peak in the spring.,no difference in gender,most < 5 years of age, with an average age of 19 months.(3) children hospitalized h MPV infection is the most common clinical diagnosis with bronchial pneumonia.(4) The major clinical symptom were fever, coughing and wheezing.Give priority to with wet cough cough, cough is irregular.24 months to 60 months h MPV infection may be prone to heat.The majority of wheezing children infected h MPV were less than 24 months old.