P2、G4型轮状病毒引起产科新生儿腹泻暴发流行  

An Outbreak of neonatal diarrhea caused by a rotavirus with specificity of P2, G4 in an obstetric roomingin ward.

作　　者：钱渊[1,2] 张又[1,2] 肖玮[1,2] 李国华 吴婉芳[1,2] 杨松[1,2] 孙爱平[1,2] 万理[1,2] 赵玉芳 

机构地区：[1]首都儿科研究所北京感染与免疫中心实验室 [2]北京医院产科

出　　处：《中华儿科杂志》1999年第5期283-286,共4页Chinese Journal of Pediatrics

基　　金：国家自然科学基金;卫生部科研基金;北京市自然科学基金

摘　　要：目的查明１９９７年１１月在北京医院产科母婴同室病房发生的新生儿腹泻暴发流行的病原。方法对患儿的粪便进行了细菌培养及聚丙烯酰胺凝胶电泳检测，并进一步采用逆转录聚合酶链反应（ＲＴＰＣＲ）扩增标本中检测到的轮状病毒ＶＰ７全基因及ＶＰ４基因，再用巢式ＰＣＲ和核酸杂交分别对扩增得到的ＶＰ７及ＶＰ４基因进行分型。结果采集到的９例腹泻患儿的粪便标本中显示完全一致的Ａ组轮状病毒核酸图型，而４例无腹泻症状的新生儿粪便标本３例为阴性，１例为阳性（经随访，该例患儿出院后发生腹泻），表明这是一次由轮状病毒引起的新生儿腹泻流行。此次新生儿腹泻标本中检测到的轮状病毒均为ＶＰ４２型（Ｐ２）、ＶＰ７４型（Ｇ４）型，不同于从同期门诊收集到的婴幼儿腹泻标本中的轮状病毒。结论通常认为Ｐ２型轮状病毒是无毒株或减毒株，仅引起新生儿的无症状感染，而作者的研究证明：（１）此次新生儿腹泻暴发流行的病原为轮状病毒是独立的病原；（２）Ｐ２型轮状病毒可以引起较严重的新生儿腹泻的暴发流行。这是国内外首次报告由Ｐ２型轮状病毒引起新生儿病房内腹泻的暴发流行，对该病毒株的更深入的分子生物学研究将进一步进行。Objective To identify and characterize the etiological agent of the diarrhea outbreak. Methods Stool specimens were collected from 9 newborn babies with diarrhea and 4 without diarrhea and the polyacrylamide gel electrophoresis was used to identify rotavirus dsRNA. For those rotavirus positive specimens, the genes of VP4 and VP7 were characterized by RTPCR amplification and followed by nested PCR (for VP7 gene) and dot blot hybridization (for VP4 gene). Results Identical rotavirus dsRNA patterns were detected from the those 9 specimens from babies with diarrhea, whereas out of those 4 specimens from babies without diarrhea, 3 were rotavirus negative and one was positive. The baby with rotavirus positive stool developed diarrhea after discharge from the hospital. All the rotaviruses identified from the outbreak were found to have the specificity of VP4 type 2 (P2) and VP7 type 4 (G4). Conclusion The data suggested that this outbreak of neonatal diarrhea was caused by rotavirus with the types of P2 and G4, which had been thought to cause asymptomatic infections in neonates in previously published literatures.

关 键 词：腹泻 新生儿 轮状病毒感染 

分 类 号：R722.132[医药卫生—儿科]