2015—2019年苏州市5岁以下儿童轮状病毒腹泻流行病学特征分析  

Epidemiological characteristics of rotavirus diarrhea among children under 5 years of age in Suzhou during 2015-2019

作　　者：包林[1] 艾静[2] 付建光[2] 陈海燕[3] 刘成[1] 崔朋伟[1] 王笛 董泽锋 张洪明 Bao Lin;Ai Jing;Fu Jianguang;Chen Haiyan;Liu Cheng;Cui Pengwei;Wang Di;Dong Zefeng;Zhang Hongming(Department of Infectious Disease Control and Prevention,Suzhou municipal Center for Disease Control and Prevention,Suzhou 215004,China;Institute of Acute Infectious Diseases,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Department of Gastroenterology,Affiliated Children's Hospital of Suzhou University,Suzhou 215004,China;Department of Infectious Disease Control and Prevention,Suzhou City Wujiang District Center for Disease Control and Prevention,Suzhou 320509,China)

机构地区：[1]苏州市疾病预防控制中心传染病防制科,215004 [2]江苏省疾病预防控制中心急性传染病防制所,南京210009 [3]苏州大学附属儿童医院消化科,215004 [4]苏州市吴江区疾病预防控制中心传染病防制科,320509

出　　处：《国际病毒学杂志》2021年第2期111-115,共5页International Journal of Virology

基　　金：苏州市2020年度科技发展计划项目(SS202073);苏州市医学重点学科(Szxk201516);江苏省卫生健康委科研项目(Z2019006)。

摘　　要：目的了解苏州市5岁以下儿童A组轮状病毒(group A rotavirus,RVA)腹泻流行特征,为科学防控提供依据。方法采集2015—2019年在苏州某儿童医院住院的5岁以下腹泻患儿粪便标本1634份,进行RVA/诺如病毒GІ/诺如病毒GΠ核酸三重实时荧光PCR检测,对RVA阳性标本进行札如病毒/腺病毒/星状病毒三重实时荧光PCR检测和G、P分型。同时收集患儿的人口学、临床症状和流行病学资料。结果检出RVA核酸阳性标本426份,检出率为26.01%,其中350份为单一RVA感染,混合感染76份,混合感染以RVA合并诺如病毒为主。RVA检出率高峰为每年11月至次年3月,检出率与气温成负相关。13~18月龄和19~24月龄组检出率较高,24月龄以下患儿占所有阳性患儿的85.55%(365/426)。RVA阳性组发生水样便和入院前呕吐的比例高于RVA阴性组,且呕吐次数更多。G9P[8]为优势基因型,感染不同基因型的患儿临床症状未见明显差异。结论RVA是苏州地区5岁以下儿童腹泻的重要病原体,需在冬春季加强2岁以下儿童轮状病毒腹泻的防控。Objective To understand the epidemiological characteristics of group A rotavirus diarrhea among children under 5 years old in Suzhou,so as to provide references for scientific prevention and control.Methods A total of 1634 fecal samples were collected from children with diarrhea who were hospitalized in a children's hospital of Suzhou from 2015 to 2019 for detection of rotavirus A(RVA),norovirus GI and norovirus GII with triple real-time fluorescence PCR.For RVA positive samples,zarovirus,adenovirus and astrovirus were detected by triple real-time fluorescence PCR and the G and P genotyping was performed.At the same time,demographic,clinical and epidemiological data of the children were collected.Results A total of 426 samples were positive for RVA nucleic acids and,the detection rate was 26.01%.Among the positive samples,350 were single RVA infection and 76 were mixed infection with other diarrheal viruses.The mixed infection was dominated by RVA combined with norovirus infection.The peak detection rate of RVA appeared from November to March of the next year.The detection rate was negatively correlated with temperature.The detection rate among children aged 13-18 months and 19-24 months was higher.Children aged below 24 months accounted for 85.55%(365/426)of all positive children.The incidence of watery stools and vomiting before admission was higher in the RVA-positive group than in the RVA-negative group,and the frequency of vomiting was higher.G9P[8]was the dominant genotype,and no significant difference was found in clinical symptoms of children infected with different genotypes.Conclusions Rotavirus is an important pathogen of diarrhea among children under 5 years old in Suzhou area.It is necessary to strengthen the prevention and control of rotavirus diarrhea in children under 2 years old in winter and spring.

关 键 词：轮状病毒 病毒性腹泻 儿童 

分 类 号：R181.3[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]