Non-polio enterovirus infections in children with central nervous system disorders in Shanghai, 2016-2018: Serotypes and clinical characteristics
Non-polio enterovirus infections in children with central nervous system disorders in Shanghai, 2016-2018: Serotypes and clinical characteristics
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DOI：
10.1016/j.jcv.2020.104516
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发表时间：
2020-08-01
影响因子：
8.8
通讯作者：
Zeng, Mei
中科院分区：
文献类型：
--
作者：
Li, Jingjing;Wang, Xiangshi;Zeng, Mei
背景：非脊髓灰质炎脑炎病毒可引起广泛的神经综合征。目的：了解2016-2018年上海市儿童肠道病毒相关性无菌性脑膜炎、脑炎和脑膜脑炎的患病率、血清型和临床特征。方法：收集2016-2018年上海市儿童无菌性脑膜炎、脑炎和脑膜脑炎患者的临床资料和脑脊液标本。结果：本研究共纳入424例患者，均在发病急性期采集非重复脑脊液标本。用聚合酶链式反应检测肠道病毒272例(64.15%)，其中男女比例1.99，平均年龄5.71±3.55岁(0.03~16岁)。共鉴定出17个血清型。Echo病毒30(24.63%)、柯萨奇病毒A10(20.96%)、柯萨奇病毒A6(18.01%)占63.6%，其次是柯萨奇病毒B5(7.72%)、Echo病毒6(5.88%)和其他血清型(22.8%)。危重患者10例(3.68%)，均有难治性癫痫发作，8例需要机械通气，7例复发癫痫，3例放弃治疗，检出柯萨奇病毒A10、艾柯病毒9、柯萨奇病毒A2、柯萨奇病毒A6和艾柯病毒6。结论：非脊髓灰质炎肠道病毒是引起中国儿童无菌性脑膜炎、脑炎和脑膜脑炎的主要病原体，可引起危及生命的脑炎和严重后遗症。
Background: Non-polio enrerovirus causes a wide spectrum of neurologic syndromes. The epidemiological and clinical profiles of non-polio enrerovirus-associated central nervous system infections vary by regions and over year.Objectives: This study aimed to understand the prevalence, serotypes and clinical characteristics of enterovirusassociated aseptic meningitis, encephalitis and meningo-encephalitis in children in Shanghai during 2016-2018.Methods: We collected the clinical data and the cerebrospinal fluid specimens from the pediatric patients with aseptic meningitis, encephalitis and meningo-encephalitis during 2016-2018. The nested RT-PCR and sequencing were performed to identify enterovirus and serotypes.Results: A total of 424 patients were included in this study and their non-duplicated cerebrospinal fluid specimens were collected during the acute stage of illness. Based on PCR assay, enterovirus was detected in 272 (64.15 %) patients, of whom, the ratio of male to female subjects was 1.99, and the mean age was 5.71 +/- 3.55 years (range: 0.03-16 years). There were 17 serotypes identified. Echovirus 30 (24.63 %), Coxsackievirus A10 (20.96 %), Coxsackievirus A6 (18.01 %) accounted for 63.6 %, followed by Coxsackievirus B5 (7.72 %), Echovirus 6 (5.88 %), and other serotypes (22.8 %). Of the 10 (3.68 %) critically severe patients, all had refractory seizure, 8 required mechanical ventilation, 7 survivors had recurrent attacks of epilepsy and 3 abandoned treatment; Coxsackievirus A10, Echovirus 9, Coxsackievirus A2, Coxsackievirus A6 and Echovirus 6 were identified.Conclusions: Non-polio enterovirus is the major pathogen causing aseptic meningitis, encephalitis and meningoencephalitis in Chinese children and can cause life-threatening encephalitis and severe sequelae.