中国26省(直辖市、自治区)2011-2014年5岁以下儿童腹泻病例轮状病毒流行特征分析  

Epidemiological characteristics of rotavirus caused diarrhea in children aged<5 years in 26 provinces in China,2011-2014

作　　者：耿启彬[1,2] 赖圣杰[2,3] 余建兴[2,4] 张子科 杨婉琪[1,2] 李中杰[2] 吴建国[1] 杨维中[6] 

机构地区：[1]武汉大学生命科学学院,病毒学国家重点实验室,湖北武汉430072 [2]中国疾病预防控制中心传染病预防控制处,传染病监测预警中国疾病预防控制中心重点实验室,北京102206 [3]南安普顿大学地理环境系,英国南安普顿SO171BJ [4]中国医学科学院病原生物学研究所梅里埃实验室,北京100176 [5]浙江大学医学院第一附属医院传染病诊断与治疗重点实验室,浙江杭州310003 [6]中国疾病预防控制中心,北京102206

出　　处：《疾病监测》2016年第6期463-470,共8页Disease Surveillance

基　　金：国家科技重大专项(No.2012ZX10004-201,2012ZX10004-207,2012ZX10004-210)~~

摘　　要：目的了解我国5岁以下儿童腹泻患者中轮状病毒的流行特征。方法在国内26省（直辖市、自治区）162家医院的门/急诊中开展腹泻监测,收集腹泻病例临床和流行病学资料,同时采集病例粪便标本,送92家网络实验室采用酶联免疫吸附试验（ELISA）、反转录-聚合酶链反应（RT-PCR）和巢式PCR等方法检测轮状病毒,并分析2011 2014年不同时间、不同地区5岁以下儿童腹泻患者中轮状病毒检出率以及不同基因型的变异变迁情况。结果在19 849例儿童腹泻病例中,22.9%的病例检出轮状病毒,其中,1~2岁和6月龄至1岁儿童检出率最高,分别为29.0%和26.1%。轮状病毒在水样便中检出率最高,为26.2%。轮状病毒在冬季检出率最高,为39.4%,夏季检出率最低,为9.9%。轮状病毒在我国南部和中部地区的检出率最高,分别为28.0%和27.0%。A组轮状病毒为常见的血清型,占95.1%,其中G9 P[8]、G1 P[8]和G3 P[8]最为常见,分别占39.5%、16.8%和9.9%。2011年以来,G9 P[8]逐渐取代G1 P[8]和G3 P[8]成为目前我国最主要的流行株。结论轮状病毒是我国5岁以下儿童腹泻的常见病原体,并且呈现明显的时间和空间流行特征,G9 P[8]为主要流行株。Objective To investigate the epidemiological characteristics of rotavirus caused diarrhea in children aged 〈 5years in China. Methods Diarrhea surveillance was conducted in emergency or outpatient departments of 162 hospitals in 26 provinces of China,the clinical and epidemiological data of the diarrhea cases collected and fecal specimens collected from the cases were sent to 92 network laboratories for detection of rotavirus by enzyme linked immunosorbent assay（ ELISA）,reverse transcription PCR（ RT-PCR） and nested PCR,etc. The detection rate of rotavirus in different areas,population and times as well as its gene mutation during 2011- 2014 were analyzed. Results Among 19 849 diarrheal cases surveyed,22. 9% were infected with rotavirus. The positive rate in age group 12- 24 months was highest（ 29. 0%）,followed by age group 6- 12months（ 26. 1%）. The detection rate was highest in watery stool samples（ 26. 2%）. The detection rate of rotavirus was highestin winter（ 39. 4%） and lowest in summer（ 9. 9%） in a year. The detection rate was higher in southern China（ 28. 0%） and central China（ 27. 0%） than in other areas. The most prevalent genogroup of rotavirus detected was group A,accounting for95. 1%. Among rotavirus group A,G9 P[8]（ 39. 5%）,G1 P[8]（ 16. 8%） and G3 P[8]（ 9. 9%） were the most common genotype,and G9 P[8] had become the most common type of rotavirus group A gradually in China instead of G1 P[8] and G3 P[8]. Conclusion Rotavirus was the major pathogen causing diarrhea in children aged 〈 5 years in China. The positive detection of rotavirus showed obvious spatial-temporal pattern. G9 P[8] was the most common genotypes of rotavirus group A.

关 键 词：轮状病毒 腹泻病 哨点监测 基因分型 

分 类 号：R725.1[医药卫生—儿科]