2015—2020年湖南省感染性腹泻病原学及分子流行病学特征分析  

Etiological and molecular-epidemiological characteristics of infectious diarrhea in Hunan Province, 2015-2020

作　　者：周帅锋[1] 郑星星 李世康[1] 陈雨[1] 张帆[1] 夏昕[1] 贺子翔 覃迪[1] 戴志辉 赵善露 刘子言 张红[1] 胡世雄[1] 湛志飞[1] ZHOU Shuai-feng;ZHENG Xing-xing;LI Shi-kang;CHEN Yu;ZHANG Fang;XIA Xin;HE Zi-xiang;QIN Di;DAI Zhi-hui;ZHAO Shang-lu;LIU Zi-yan;ZHANG Hong;HU Shi-xiong;ZHAN Zhi-fei(Hunan Provincial Key Laboratory for Microbial Molecular Biology,Hunan Provincial Center for Disease Control and Prevention,Changsha,Hunan 410005,China;Xiangnan University,Chenzhou,Hunan 423009,China)

机构地区：[1]湖南省疾病预防控制中心,微生物分子生物学湖南省重点实验室,湖南长沙410005 [2]湖南省湘南学院,湖南郴州423099

出　　处：《实用预防医学》2021年第11期1281-1286,共6页Practical Preventive Medicine

基　　金：湖南省卫生健康委科研课题(20200249);科技部十三五科技重大专项课题(2018ZX10713002)。

摘　　要：目的了解湖南省感染性腹泻的病原谱,追踪其分子流行病学演变趋势,为感染性腹泻的综合防治提供科学依据。方法通过哨点监测结合暴发疫情监测的方法,收集2015—2020年湖南省感染性腹泻标本,对细菌病原采用细菌培养、生化鉴定进行检测;对病毒病原采用分子生物学方法进行分型鉴定,并对部分PCR阳性标本进行序列测定。结果哨点医院主动监测的总阳性率为35.61%,病毒检出率20.26%高于细菌检出率11.26%,混合病原感染检出率为4.09%。细菌病原谱以沙门菌O∶4群鼠伤寒型为主,病毒病原谱以轮状病毒A组G9P[8]型和诺如病毒GⅡ.4Sydney[P31]型感染为主。不同监测、不同年份的病原谱构成及其基因型变迁规律各不相同:哨点医院监测细菌阳性率低而病毒阳性率高时,诺如暴发疫情随之增加;暴发疫情中诺如病毒感染为86.78%,其中69.43%为GⅡ型感染,12.42%为GⅠ型感染,混合感染占3.03%。诺如病毒暴发疫情具有明显季节性,优势基因型为GⅡ.2[P16]占42.97%。结论 2015—2020年湖南省感染性腹泻病毒类病原体高于细菌类,鼠伤寒沙门菌、A组轮状病毒G9P[8]和诺如病毒GⅡ.4 Sydney [P31]是最主要的病原体和优势血清/基因型;GⅡ.2 [P16]是诺如病毒暴发流行的优势基因型;通过连续哨点监测的数据支持,提前为暴发疫情做好了防控,促成了湖南省感染性腹泻发病率的平稳下降。Objective To understand the pathogen spectrum of infectious diarrhea and track its molecular epidemic trend in Hunan Province, and to provide a scientific basis for comprehensive prevention and treatment of infectious diarrhea. Methods Through sentinel surveillance combined with outbreak monitoring system, infectious diarrhea samples in Hunan Province from 2015 to 2020 were collected, and bacterial pathogens were detected by bacterial culture and biochemical identification. The pathogen of the virus was identified by molecular biological methods, and some PCR positive samples were then sequenced. Results The total positive rate of samples from active monitoring of sentinel hospitals was 35.61%. The detection rate of virus was higher than that of bacteria(20.26% vs. 11.26%), and the detection rate of mixed pathogen infection was 4.09%. Salmonella infection was dominant in bacterial pathogens, and Salmonella typhimurium O∶4 was the main serotype. Rotavirus(group A) type G9 P [8] and norovirus type GⅡ.4 Sydney [P31] infections were predominant in virus pathogens. The pathogen composition and genotypes of different monitoring varied greatly in different years. Norovirus outbreaks increased when the positive rate of bacteria was low but the positive rate of virus was high through sentinel hospital monitoring. Among infectious diarrhea outbreaks, 86.78% were norovirus infection, of which 69.43% were GⅡ infection, 12.42% G I infection, and 3.03% GⅡ and GⅠ mixed infections. Norovirus outbreaks showed significant seasonal variation, and the dominant genotype was GⅡ.2 [P16], accounting for 42.97%.Conclusion The proportion of virus in infectious diarrhea pathogens in Hunan Province from 2015 to 2020 was higher than that of bacteria. Salmonella typhimurium,rotavirus( group A) type G9 P [8 ],and norovirus G Ⅱ. 4 Sydney [P31] were the main pathogen and dominant serotype/genotype. GⅡ.2 [P16]was the dominant genotype of norovirus in outbreak surveillance. Through continuous sentinel surveillance data support,we m

关 键 词：感染腹泻 分子流行病学 沙门菌 轮状病毒 诺如病毒 

分 类 号：R512.5[医药卫生—内科学]