广州地区病毒性腹泻的病原分布和病毒基因分型调查  

Distribution and genotype of diarrhea causing viruses in children and adults patients in Guangzhou

作　　者：邓间开[1] 王瑞莲[1] 罗欣[1] 郭勇晖[1] 于长辉[2] 兰萌[1] 车小燕[1] 丁细霞[1] 

机构地区：[1]南方医科大学珠江医院检验医学部,广东广州510280 [2]南方医科大学珠江医院消化内科,广东广州510280

出　　处：《现代预防医学》2015年第13期2393-2396,2400,共5页Modern Preventive Medicine

基　　金：国家重大科技专项课题(2012ZX10004-213);国家高技术研究发展计划(863计划)重大项目(2011AA02A116)

摘　　要：目的初步了解广州地区儿童和成人病毒性腹泻的病原学构成和分布情况及相关病毒的分子特征。方法收集2012年11月-2013年5月于珠江医院就诊的腹泻患者的粪便标本,采用免疫层析法检测轮状病毒和腺病毒抗原,实时荧光PCR检测诺如病毒GI/GII,上述检测阳性标本进行病毒基因测序分型。结果 290例患者中,3种常见病毒的检出率分别为21.4%、15.5%和1.7%;男性患者病毒阳性率显著高于女性患者(χ2=0.017,P<0.05);≤5岁患者轮状病毒阳性率最高,为28.49%(χ2=0.017,P<0.05),>5岁患者诺如病毒阳性率最高,为21.62%;轮状病毒性腹泻秋冬季节高发;轮状病毒G/P分型以G1P8、G9P8、G2P4和G3P8为主,占92.16%,诺如病毒共检测出8种基因型,以GII.4型为主,占53.33%;病毒合并其他常见腹泻病原体感染占病毒阳性标本的15.89%。结论轮状病毒和诺如病毒分别是广州地区婴幼儿和成人病毒性腹泻的主要病原体,本地区流行的轮状病毒和诺如病毒优势株分别是G1P8和GII.4,诺如病毒基因型多样性更丰富;混合感染常见,需引起重视。Objective To understand the distribution and genotype of virus associated with diarrhea in children and adults in Guangzhou, China. Methods Fecal specimens were collected from patients with acute diarrhea from November, 2012 to December,2013. Rotavirus and enteral adenovirus were detected by immunochromatographic assay and norovirus GI/GII were detected by real-time RT-PCR. Fecal specimens positive for virus detected were further genotyping by sequencing. Results 290 fecal specimens, 62 rotavirus, 45 norovirus and 5 enteral adenovirus were identified. Virus were more frequently identified in males（P〈0.05）. Rotavirus was the most common virus in patients under 5 years old（28.49%）, with G1P8, G9P8, G2P4 and G3P8 as the most commonly observed G and P combinations（92.16%）, and norovirus were the most frequent virus in patients older than 5 years（21.74%）, with GII.4 was the most commonly observed serotype（53.33%）. Among 107 fecal specimens positive for virus, 15.89%were co-infections with common pathogens associated with diarrhea. Conclusion Rotavirus was the major cause of viral diarrhea in patients under 5 years old and norovirus was the major pathogen of viral diarrhea in patients aged over 18. While rotavirus G1P8 and norovirus GII.4 remain predominant, the diversity of norovirus strains is much greater than those previously recognized.

关 键 词：病毒性腹泻 轮状病毒 诺如病毒 基因分型 

分 类 号：R117[医药卫生—公共卫生与预防医学]