2009年-2012年上海地区儿童甲型H3N2流感病毒的耐药性监测

发布时间：2018-01-31 22:47

本文关键词： 流感病毒耐药金刚烷胺奥司他韦　出处：《中国卫生检验杂志》2014年11期 　论文类型：期刊论文

【摘要】：目的了解2009年-2012年上海地区儿童流行的甲型H3N2流感病毒对金刚烷胺和奥司他韦(达菲)的耐药情况。方法收集2009年6月-2012年5月期间复旦大学儿科医院、31家上海市流感哨点医院门诊类流感患儿的鼻咽拭子标本,所有的标本抽提核酸后采用荧光RT-PCR检测甲型H3N2流感病毒。选取部分检测阳性标本行普通RTPCR进一步扩增H3N2流感病毒基质蛋白2(Matrix protein,M2)和神经氨酸酶(Neuraminidase,NA)的部分基因片段并测序,通过相关耐药位点的分子标志来评价抗病毒耐药。结果在17 312份标本中,1 148份(6.63%)检测为H3N2亚型流感病毒阳性。测序的76株甲型H3N2病毒均携带介导对金刚烷胺耐药的S31N突变标志,未发现甲型H3N2病毒株携带对奥司他韦耐药的分子标志。结论目前上海地区儿童中流行的甲型H3N2流感病毒对金刚烷胺普遍耐药,金刚烷胺不应该推荐治疗儿童流感。奥司他韦是防治甲型H3N2流感病毒敏感的药物。
[Abstract]:Objective to investigate the prevalence of influenza A (H3N2) virus in children in Shanghai from 2009 to 2012 and to understand the effects of amantadine and oseltamivir (Tamiflu). Methods collected from June 2009 to May 2012 Fudan University Pediatrics Hospital. Nasopharyngeal swabs of outpatients with influenza in 31 Shanghai influenza sentinel hospitals. Nucleic acids were extracted from all samples for detection of influenza A A virus by fluorescence RT-PCR. Partial positive samples were selected for further amplification of H3N2 influenza virus matrix protein 2 (2) by ordinary RTPCR. Matrix protein. M2) and neuraminidase Neuraminidase (NAA) were sequenced. Antiviral resistance was evaluated by molecular markers of relevant drug resistance sites. The results were obtained in 17 312 specimens. 1 148 strains of H3N2 subtype influenza virus were positive. All the 76 strains of A / H 3N2 virus carried the S31N mutation marker mediated by amantadine resistance. No molecular marker of resistance to oseltamivir was found in A / H _ 3N _ 2 strain. Conclusion A / H _ 3N _ 2 influenza virus which is prevalent among children in Shanghai is generally resistant to amantadine. Amantadine should not recommend the treatment of childhood influenza. Oseltamivir is a sensitive drug against influenza A H 3 N 2.
【作者单位】：上海疾病预防控制中心;上海复旦大学附属儿科医院;上海交通大学附属儿童医院;
【基金】：Fogarty基金项目(TW005741-07)
【分类号】：R181.3;R446.5
【正文快照】： 流感病毒引起的流行性感冒(简称流感)每年在全球范围内都有季节性流行。在季节性流感病毒中,甲型H3N2流感病毒常在人群中局部暴发,2009年之前全球监测研究数据显示甲型H3N2流感病毒引起人群更为严重的呼吸道感染[1,2]。儿童是流感的主要易感人群,最近,一项意大利的研究提示甲

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