河南省2008年至2015年5岁以下儿童病毒性腹泻病原谱及流行病学分析
Etiological agents distribution and epidemiology of viral diarrhea in children below 5 years old in He′nan ;province,2008-2015
目的:分析2008年至2015年河南省5岁以下腹泻患儿轮状病毒(A、B、C 组)、杯状病毒(诺如病毒Ⅰ/Ⅱ型、札如病毒)、星状病毒及肠道腺病毒的感染状况及病原学、流行病学特征。方法采集河南省4个监测哨点医院5岁以下腹泻患儿的粪便样本2541份,双抗体夹心法检测 A 组轮状病毒, A 组轮状病毒 G/P 基因分型采用套式 PCR,采用二步法多重反转录(RT)-PCR 检测 B、C 组轮状病毒、杯状病毒、星状病毒和肠道腺病毒。结果2541份腹泻样本中共检出阳性样本1421份(包括混合感染样本102份),总阳性率为55.9%。检出轮状病毒914份(A 组785份,B 组36份,C 组93份),阳性率为36.0%;检出杯状病毒308份(诺如病毒Ⅰ型64份,诺如病毒Ⅱ型193份,札如病毒51份),阳性率为12.1%;检出星状病毒151份,阳性率5.9%;检出肠道腺病毒48份,阳性率为1.9%。A 组轮状病毒型别以 G9[8]、G1P[8]、G3P[8]、G2P[4]为主,G9P[8]为优势型别,每年9月至11月和3月至5月为感染季节;杯状病毒以诺如Ⅱ型为主,3月至5月为感染季节。4~12月龄婴儿主要感染轮状病毒,3~5岁幼儿主要感染杯状病毒。临床症状均存在不同程度的发热、腹泻、呕吐、脱水等症状,性别及地区分布存在病原学差异。结论河南省5岁以下腹泻患儿以感染 A 组轮状病毒和诺如病毒Ⅱ型为主。不同类别病毒感染呈现不同的流行病学及临床特点。
更多Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.
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