天津市2019年住院散发急性胃肠炎患儿中诺如病毒感染分子流行病学特征分析  

Molecular epidemiological characteristics of norovirus in hospitalized children with sporadic acute gastroenteritis in Tianjin in 2019

作　　者：方玉莲[1,2] 张同强 王维[1,2] 侯梦珠[1,2] 王露 武晋英 林书祥 Fang Yulian;Zhang Tongqiang;Wang Wei;Hou Mengzhu;Wang Lu;Wu Jinying;Lin Shuxiang(Tianjin Institute of Pediatric Research,Tianjin Children's Hospital,Tianjin 300134,China;Tianjin Key Laboratory for Prevention and Treatment of Birth Defects^Tianjin 300134,Chirm;Department of Respiratory,Tianjin Children's Hospital,Tianjin 300134^China)

机构地区：[1]天津市儿童医院天津市儿科研究所,300134 [2]天津市儿童出生缺陷防治重点实验室,300134 [3]天津市儿童医院呼吸科,300134

出　　处：《中华微生物学和免疫学杂志》2021年第2期126-132,共7页Chinese Journal of Microbiology and Immunology

基　　金：天津市重大疾病防治科技重大专项(18ZXDBSY00170)。

摘　　要：目的了解天津市2019年散发急性胃肠炎患儿中诺如病毒(Norovirus,NoV)感染的分子流行病学特征。方法收集2019年1—12月就诊于天津市儿童医院住院散发急性胃肠炎患儿的粪便标本3116份,收集患儿临床资料和个人信息,采用实时荧光定量PCR方法对NoV进行初筛,应用反转录PCR方法对初筛阳性标本的聚合酶区和衣壳蛋白区进行扩增,并对序列进行比对和系统进化分析。结果3116份粪便标本中检出NoV阳性809份,阳性率为26.0%(809/3116)。不同年龄组NoV检出率差异有统计学意义(P=0.000),其中7~12月龄组检出率最高(31.6%);不同季节间NoV检出率差异有统计学意义,其中冬季为高发季节(39.0%)。序列分析发现,286份阳性标本的两个区域均测序成功,分成6个基因型,分别是GⅡ.P12-GⅡ.3,GⅡ.P16-GⅡ.2,GⅡ.P17-GⅡ.17,GⅡ.Pe-GⅡ.2,GⅡ.Pe-GⅡ.3和GⅡ.Pe-GⅡ.4。其中以GⅡ.Pe-GⅡ.4为主,占61.2%(175/286)。其次为GⅡ.P12-GⅡ.3,占33.6%(96/286);GⅡ.Pe-GⅡ.3占2.4%(7/286);GⅡ.P16-GⅡ.2占2.1%(6/286);GⅡ.Pe-GⅡ.2和GⅡ.P17-GⅡ.17均占0.3%(1/286)。GⅡ.Pe-GⅡ.4中全部为GⅡ.Pe-GⅡ.4 Sydney 2012。携带GⅡ.Pe-GⅡ.4 Sydney 2012型NoV患儿较GⅡ.P12-GⅡ.3更容易出现呕吐。结论NoV是儿童病毒性急性胃肠炎的重要病原体,GⅡ.Pe-GⅡ.4 Sydney 2012和GⅡ.P12-GⅡ.3是2019年天津地区住院散发急性胃肠炎中NoV感染的主要流行株。Objective To investigate the molecular epidemiological characteristics of norovirus(NoV)in hospitalized children with sporadic acute gastroenteritis in Tianjin in 2019.Methods Fecal specimens and clinical data were collected from 3116 hospitalized children with sporadic acute gastroenteritis possibly caused by viral infection in Tianjin Children′Hospital between January and December,2019.Real-time quantitative PCR was used to detect NoV.Partial sequences of RNA-dependent RNA polymerase(RdRp)and capsid genes of NoV were amplified by RT-PCR.Sequence alignment and phylogenetic analysis were performed for further analysis.Results Among the 3116 specimens,809(26.0%)were positive for NoV.There were significant differences in NoV detection rate between different age groups(P=0.000),and the highest NoV detection rate(31.6%)was observed in the age group of 7-12 months.Moreover,the detection rate of NoV varied with seasons(P=0.000),and the NoV detection rate was highest in winter(39.0%).Based on the sequence analysis of RdRp and capsid genes,286 identified NoV strains belonged to six genotypes,which were GⅡ.P12-GⅡ.3,GⅡ.P16-GⅡ.2,GⅡ.P17-GⅡ.17,GⅡ.Pe-GⅡ.2,GⅡ.Pe-GⅡ.3 and GⅡ.Pe-GⅡ.4.The predominant genotype was GⅡ.Pe-GⅡ.4 Sydney 2012(61.2%),followed by GⅡ.P12-GⅡ.3(33.6%,96/286),GⅡ.Pe-GⅡ.3(2.4%,7/286),GⅡ.P16-GⅡ.2(2.1%,6/286),GⅡ.Pe-GⅡ.2(0.3%,1/286)and GⅡ.P17-GⅡ.17(0.3%,1/286).Patients carrying the NoV of GⅡ.Pe-GⅡ.4 Sydney 2012 genotype were likely to suffer from vomiting than those positive for NoV of GⅡ.P12-GⅡ.3 genotype.Conclusions NoV was an important pathogen causing acute gastroenteritis in children.GⅡ.Pe-GⅡ.4 Sydney 2012 and GⅡ.P12-GⅡ.3 were the major genotypes of NoV in hospitalized children with sporadic acute gastroenteritis in Tianjin in 2019.

关 键 词：诺如病毒 急性胃肠炎 基因型 分子流行病学 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]