儿童呼吸道博卡病毒感染流行特征分析：一项单中心回顾性研究

doi:10.12372/jcp.2025.24e0584

摘要/Abstract

摘要：

目的分析急性呼吸道感染住院患儿的人博卡病毒（HBoV）流行病学特征，为儿童急性呼吸道感染的诊断和防控提供依据。方法回顾性分析2021年3月至2024年2月石家庄地区某医院因急性呼吸道感染住院患儿痰液或肺泡灌洗液的病原学检测数据。检测采用13种呼吸道病原体多重检测试剂盒，描述并分析HBoV的人群分布、季节分布等流行病学特征。结果 HBoV总检出率为3.73%（1315/35220），男性患儿检出率（3.91%）高于女性患儿（3.49%）（χ²=4.08，P<0.05）。在年龄分布上，1~<3岁组检出率最高（9.25%，722/7805），其次为3~<6岁组（3.42%，362/10585），不同年龄段之间检出率差异有统计学意义（χ²=989.15，P<0.001）。不同年份HBoV检出率不同。2021至2022年HBoV检出率最高（5.20%，443/8519），2022至2023年检出率最低（2.22%，204/9195），差异有统计学意义（χ²=110.02，P<0.001）。研究期间夏季检出率最高（8.56%，823/9610），其次为秋季（3.15%，276/8773），不同季节感染患者检出率之间差异有统计学意义（χ²=939.36，P<0.001）。在检出HBoV感染的患者中，557例未检出其他病原，而758例合并检出至少一种其他病原微生物。结论 HBoV是石家庄地区儿童急性呼吸道感染的常见病原体，1~<3岁儿童在夏、秋季多发，男性多于女性，常与其他呼吸道病原体混合检出。

关键词: 急性呼吸道感染, 博卡病毒, 流行病学, 儿童

Abstract:

Objective To analyze the epidemiological characteristics of human bocavirus (HBoV) in hospitalized children with acute respiratory tract infections, and to provide evidence for the diagnosis and prevention of acute respiratory infection in children. Methods A retrospective analysis was conducted on the etiological test data of sputum or bronchoalveolar lavage fluid from children hospitalized due to acute respiratory tract infections in a hospital in Shijiazhuang from March 2021 to February 2024. Detection was carried out using a multiplex detection kit for 13 respiratory pathogens. The epidemiological characteristics of HBoV, including population distribution and seasonal distribution, were described and analyzed. Results The total detection rate of HBoV was 3.73% (1315/35220), with a higher detection rate in male (3.91%) than in female (3.49%) (χ²=4.08, P<0.05). The detection rate is highest in the 1- <3 years old group (9.25%, 722/7805), followed by the 3- <6 years old group (3.42%, 362/10585). There was a statistically significant difference in detection rates among different age groups (χ²=989.15, P<0 001). The detection rate of HBoV varied in different years. The highest detection rate was in 2021 - 2022 (5.20%, 443/8519), and the lowest was in 2022 - 2023 (2.22%, 204/9195), with a statistically significant difference (χ²=110.02, P<0.001). During the study period, the highest detection rate was 8.56% (823/9610) in summer, followed by 3.15% (276/8773) in autumn. And there was a statistically significant difference detection rates among different seasons(χ²=939.36, P<0.001). Among the patients with HBoV infection detected, 557 cases had no other pathogens detected, while 758 cases were co-infected with at least one other pathogenic microorganism. Conclusions HBoV is a common pathogen of acute respiratory infections in children in Shijiazhuang. It is more common in children aged 1- <3 in summer and autumn, with more males than females. It is often co-detected with other respiratory pathogens.

Key words: acute respiratory tract infection, human bocavirus, epidemiology, children

翟宇, 段素霞, 贾凡平, 贾永萍, 张京京, 郭映辉. 儿童呼吸道博卡病毒感染流行特征分析：一项单中心回顾性研究[J]. 临床儿科杂志, 2025, 43(3): 184-190.

ZHAI Yu, DUAN Suxia, JIA Fanping, JIA Yongping, ZHANG Jingjing, GUO Yinghui. Analysis of epidemiological characteristics of respiratory tract Boca virus infection in children: a single-center retrospective study[J]. Journal of Clinical Pediatrics, 2025, 43(3): 184-190.

图/表 5

表1

表2

图1

表3

表4

参考文献 30

[1]	Rikhotso MC, Kabue JP, Ledwaba SE, et al. Prevalence of human bocavirus in Africa and other developing countries between 2005 and 2016: a potential emerging viral pathogen for diarrhea[J]. J Trop Med, 2018, (2018): 7875482.
[2]	Brieu N, Guyon G, Rodière M, et al. Human bocavirus infection in children with respiratory tract disease[J]. Pediatr Infect Dis J, 2008, 27(11): 969-973. doi: 10.1097/INF.0b013e31817acfaa pmid: 18833027
[3]	Allander T, Tammi MT, Eriksson M, et al. Cloning of a human parvovirus by molecular screening of respiratory tract samples[J]. Proc Natl Acad Sci USA, 2005, 102 (36): 12891-12896. doi: 10.1073/pnas.0504666102 pmid: 16118271
[4]	Arunasalam S, Pattiyakumbura T, Shihab SR, et al. Demographic and clinical characteristics of human bocavirus-1 infection in patients with acute respiratory tract infections during the COVID-19 pandemic in the central province of Sri Lanka[J]. BMC Infect Dis, 2023, 23 (1): 425.
[5]	Oldhoff E, Bennet R, Eriksson M, et al. Human bocavirus 1 epidemiology in children in relation to virus load and codetection[J]. Acta Paediatr, 2023, 112 (5): 1049-1055.
[6]	Guido M, Tumolo MR, Verri T, et al. Human bocavirus: current knowledge and future challenges[J]. World J Gastroenterol, 2016, 22(39): 8684-8697.
[7]	Martin ET, Fairchok MP, Kuypers J, et al. Frequent and prolonged shedding of bocavirus in young children attending daycare[J]. J Infect Dis, 2010, 201(11): 1625-1632. doi: 10.1086/652405 pmid: 20415535
[8]	Christensen A, Kesti O, Elenius V, et al. Human bocaviruses and paediatric infections[J]. Lancet Child Adolesc Health, 2019, 3(6): 418-426. doi: S2352-4642(19)30057-4 pmid: 30948251
[9]	胡亚美, 江载芳, 申昆玲, 等. 诸福棠实用儿科学[M]. 8版, 北京: 人民卫生出版社, 2015.
	Hu YM, Jiang ZF, Shen KL, et al. Zhu Futang practice of pediatrics[M]. 8th ed, Beijing: People’s Medical Publishing House, 2015.
[10]	Ziemele I, Xu M, Vilmane A, et al. Acute human bocavirus 1 infection in child with life-threatening bilateral bronchiolitis and right-sided pneumonia: a case report[J]. J Med Case Rep, 2019, 13 (1): 290.
[11]	Piñana M, Vila J, Andrés C, et al. Molecular charac-terization and clinical impact of human bocavirus at a tertiary hospital in Barcelona (Catalonia, Spain) during the 2014-2017 seasons[J]. Infection, 2022, 51(4): 935-943. doi: 10.1007/s15010-022-01955-z pmid: 36401674
[12]	Eşki A, Öztürk GK, Çiçek C, et al. Is viral coinfection a risk factor for severe lower respiratory tract infection? A retrospective observational study[J]. Pediatr Pulmonol, 2021, 56 (7): 2195-2203.
[13]	周城波, 卢文波, 张艺之, 等. 2019—2021年宁波地区儿童13种呼吸道非细菌性病原体检出情况分析[J]. 中华预防医学杂志, 2022, 56(12): 1751-1758.
	Zhou CB, Lu WB, Zhang YZ, et al. Analysis of non-bacterial respiratory pathogens in children in Ningbo city from 2019 to 2021[J]. Zhonghua Yufang Yixue Zazhi, 2022, 56(12): 1751-1758.
[14]	Gamiño-Arroyo AE, Arellano-Galindo J, Del Carmen Guerra-de-Blas P, et al. Clinical and molecular charac-terization of children and adults with respiratory bocavirus infection in Mexico: a cross-sectional nested study within the ILI002 prospective observational study[J]. Lancet Reg Health Am, 2024, 29: 100647.
[15]	Tang X, Dai G, Wang T, et al. Comparison of the clinical features of human bocavirus and metapneumovirus lower respiratory tract infections in hospitalized children in Suzhou, China[J]. Front Pediatr, 2022, 10: 1074484.
[16]	Wang W, Guan R, Liu Z, et al. Epidemiologic and clinical characteristics of human bocavirus infection in children hospitalized for acute respiratory tract infection in Qingdao, China[J]. Front Microbiol, 2022, 13: 935688.
[17]	Trapani S, Caporizzi A, Ricci S, et al. Human Bocavirus in childhood: a true respiratory pathogen or a "passenger" virus? A comprehensive review[J]. Microorganisms, 2023, 11: 1243.
[18]	Yang Y, Yang M, Yuan J, et al. Laboratory diagnosis and monitoring the viral shedding of SARS-CoV-2 infection[J]. Innovation (Camb), 2020, 1 (3): 100061.
[19]	Ji K, Sun J, Yan Y, et al. Epidemiologic and clinical characteristics of human bocavirus infection in infants and young children suffering with community acquired pneumonia in Ningxia, China[J]. Virol J, 2021, 18(1): 212.
[20]	Caporizzi A, Ravidà F, Barneschi S, et al. Analysis of a cohort of 165 pediatric patients with human Bocavirus infection and comparison between mono-infection and respiratory co-infections: a retrospective study[J]. Pathogens, 2024, 13 (1): 55.
[21]	Zhang X, Zheng J, Zhu, L, et al. Human bocavirus-1 screening in infants with acute lower respiratory tract infection[J]. J Int Med Res, 2021, 49(8): 3000605211027739.
[22]	Alkhalf H, Almutairi AR, Almutairi A, et al. Prevalence and clinical characterization of Bocavirus infection in a specialized children's hospital in Saudi Arabia[J]. Cureus, 2022, 14 (2): e22127.
[23]	孟磊俊, 王洁, 蔡沁, 等. 新型冠状病毒流行前后上海单中心住院儿童常见呼吸道病毒及非典型病原体感染变化[J]. 中华微生物学和免疫学杂志, 2023, 43(3): 222-229.
	Meng LJ, Wang J, Cai Q, et al. Prevalence of respiratory viruses and atypical pathogens in hospitalized children with acute respiratory tract infections: impact of SARS-CoV-2 pandemic in single center in Shanghai[J]. Zhonghua Weishengwuxue He Mianyixue Zazhi, 2023, 43(3): 222-229.
[24]	Zhou JY, Peng Y, Peng XY, et al. Human bocavirus and human metapneumovirus in hospitalized children with lower respiratory tract illness in Changsha, China[J]. Influenza Other Respir Viruses, 2018, 12(2): 279-286.
[25]	Han X, Wang X, Zhang J, et al. Study on pathogen spectrum of 1,046 hospitalized children with respiratory tract infections during COVID-19[J]. J Lab Med, 2023, 47 (1): 47-54.
[26]	Mai W, Ren Y, Tian X, et al. Comparison of common human respiratory pathogens among hospitalized children aged ≤ 6 years in Hainan Island, China, during spring and early summer in 2019-2021[J]. J Med Virol, 2023, 95 (4): e28692.
[27]	董鸿铭, 黄利民, 杨燕清, 等. 南京地区成人上呼吸道感染患者鼻病毒分子流行病学特征分析[J]. 中华微生物学和免疫学杂志, 2023, 43(04):279-284.
	Dong HM, Huang LM, Yang YQ, et al. Molecular epidemiological characteristics of human rhinovirus in adults with upper respiratory tract infection in Nanjing[J]. Zhonghua Weishengwuxue He Mianyixue Zazhi, 2023, 43(4): 279-284.
[28]	李铭一, 沈袁恒, 陈峰, 等. 2019—2023年急性呼吸道感染儿童肺炎支原体流行病学特征分析:一项单中心回顾性研究[J]. 临床儿科杂志, 2024, 42(6): 485-490.
	Li MY, Shen YH, Chen F, et al. Epidemiological characteristics of Mycoplasma pneumoniae in children with acute respiratory infections from 2019 to 2023 : a single-center retrospective study[J]. Linchuang Erke Zazhi, 2024, 42(6): 485-490.
[29]	Cohen R, Ashman M, Taha MK, et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap?[J]. Infect Dis Now, 2021, 51(5): 418-423.
[30]	张晓飞, 刘颖, 张伟, 等. 2022—2023年北京市某儿童医院流感样疾病患儿呼吸道病原体流行病学特征分析[J]. 中华预防医学杂志, 2024, 58(6): 905-909.
	Zhang XF, Liu Y, Zhang W, et al. Analysis of epidemiological characteristics of respiratory pathogens in children with influenza-like illnesses in a children′s hospital in Beijing from 2022 to 2023[J]. Zhonghua Yufang Yixue Zazhi, 2024, 58(6): 905-909.

组别	例数	单一检出			混合检出			合计
组别	例数	阳性例数	χ²值	P	阳性例数	χ²值	P	阳性例数	χ²值	P
性别男		334(1.63)	0.77	0.379	466(2.28)	3.55	0.060	800(3.91)	4.08	0.043
年龄
<1岁	7 979	89(1.12)	429.44	<0.001	119(1.49)	543.17	<0.001	208(2.61)	989.15	<0.001
1~<3岁	7 805	313(4.01)			409(5.24)			722(9.25)
3~<6岁	10 585	143(1.35)			219(2.07)			362(3.42)
6~14岁	8 851	12(0.14)			11(0.12)			23(0.26)

季节	2021—2022年		2022—2023年		2023—2024年		合计
季节	例数	阳性数	例数	阳性数	例数	阳性数	例数	阳性数
春	1 626	74(4.55)	2 333	22(0.94)	3 450	61(1.77)	7 409	157(2.12)
夏	2 459	306(12.44)	3 322	93(2.80)	3 829	424(11.07)	9 610	823(8.56)
秋	1 801	41(2.28)	2 284	78(3.42)	4 688	157(3.35)	8 773	276(3.15)
冬	2 633	22(0.84)	1 256	11(0.88)	5 539	26(0.47)	9 428	59(0.63)
合计	8 519	443(5.20)	9 195	204(2.22)	17 506	668(3.82)	35 220	1315(3.73)

疾病	合计	2021—2022年	2022—2023年	2023—2024年	χ²值	P
支气管炎	623(47.38)	311(70.20)	107(52.45)	205(30.69)	169.31	<0.001
肺炎	522(39.70)	48(10.84)	68(33.33)	406(60.78)	281.62	<0.001
重症肺炎	101(7.68)	48(10.84)	15(7.35)	38(5.69)	9.99	0.007
急性上呼吸道感染	56(4.26)	29(6.55)	11(5.39)	16(2.40)	12.02	0.002
急性毛细支气管炎	13(0.99)	7(1.58)	3(1.47)	3(0.45)	4.05	0.132

HBoV合并一种病原体检出	例数	HBoV合并两种病原体检出	例数	HBoV合并三种病原体检出	例数
HBoV+HRV	262	HBoV+HRV+HPIV	43	HBoV+HRV+Mp+HPIV	4
HBoV+HPIV	105	HBoV+HRV+HAdV	18	HBoV+HRV+HPIV+HCoV	3
HBoV+RSV	81	HBoV+HRV+Mp	15	HBoV+HRV+HPIV+HMPV	3
HBoV+Mp	38	HBoV+HRV+RSV	15	HBoV+HRV+Mp+HMPV	2
HBoV+HAdV	31	HBoV+HRV+HMPV	13	HBoV+HRV+Mp+RSV	1
HBoV+HMPV	27	HBoV+Mp+HPIV	12	HBoV+HRV+Mp+HAdV	1
HBoV+HCoV	19	HBoV+HRV+HCoV	8	HBoV+HRV+RSV+HMPV	1
HBoV+FluB	4	HBoV+HPIV+HAdV	7	HBoV+Mp+HPIV+HCoV	1
HBoV+H3N2	4	HBoV+Mp+HMPV	4	HBoV+Mp+HPIV+HMPV	1
HBoV+Ch	1	HBoV+HPIV+HCoV	4	HBoV+Mp+HPIV+HAdV	1
		HBoV+HPIV+RSV	4	HBoV+Mp+HMPV+HCoV	1
		HBoV+RSV+HMPV	4	HBoV+Mp+H3N2+HAdV	1
		HBoV+HPIV+HMPV	3	HBoV+HPIV+HCoV+RSV	1
		HBoV+RSV+HAdV	3	HBoV+HPIV+H3N2+HMPV	1
		HBoV+HRV+FluB	2	HBoV+HPIV+HAdV+HMPV	1
		HBoV+Mp+RSV	2
		HBoV+HCoV+RSV	2
		HBoV+Mp+HCoV	1
		HBoV+Mp+H3N2	1
		HBoV+Mp+HAdV	1
		HBoV+HMPV+HAdV	1