上海市普陀区食源性疾病病例检出的诺如病毒的分子流行病学分析  

Molecular epidemiological characteristics of Norovirus in foodborne disease cases in Putuo district of Shanghai

作　　者：顾文超[1] 唐海丰[1] 吴婷婷 李勇[1] 闫浩 张玉 张焕生[1] GU Wen-chao;TANG Hai-feng;WU Ting-ting;LI Yong;YAN Hao;ZHANG Yu;ZHANG Huan-sheng(Putuo District Center for Disease Contort and Prevention,Shanghai 200333,China)

机构地区：[1]上海市普陀区疾病预防控制中心,上海200333

出　　处：《现代预防医学》2022年第1期41-46,87,共7页Modern Preventive Medicine

基　　金：上海市公共卫生体系建设三年行动计划-重点学科建设(2020-2022)(GWV-10.1-XK03);2017上海市普陀区卫生系统自主创新科研项目(ptkwws201724)。

摘　　要：目的了解上海市普陀区哨点医院食源性疾病病例诺如病毒的感染情况和病毒基因特征,为辖区内诺如病毒引起的感染性腹泻病的防控提供科学依据。方法收集2018年1月至2019年12月上海市普陀区哨点监测医院的食源性疾病病例的肛拭标本和流行病学资料,采用实时荧光定量逆转录PCR方法检测诺如病毒,部分阳性标本使用逆转录PCR的方法扩增聚合酶-衣壳蛋白链接区并测序,通过生物信息软件进行基因分型和系统进化分析。结果诺如病毒阳性检出率33.33%(134/402),以诺如病毒GII组为主(65.67%,88/134);诺如病毒检出阳性率在不同性别、不同年龄组、不同职业的差异均有统计学意义(P<0.05),阳性病例和阴性病例在发热、恶心、呕吐、腹痛等临床特征的差异有统计学意义(P<0.05),春季和冬季是诺如病毒高发季节。45份诺如病毒测序成功,通过序列比对分析获得15种基因型别,GI组以GI.P13-GI.3型和GI.P4-GI.4型为主,GⅡ组以GII.P17-GII.17型和GII.P16-GII.2型为主。同源性和遗传进化分析结果显示:8株GII.P17-GII.17型核苷酸同源性为98.2%~100%,与参考株MN461100.1同源性差异最大;7株GII.P16-GII.2型与参考株均在同一进化分支上,与日本的AB629946.1参考株同源性差异最大;其余基因型别与所选参考株均在同一进化分支上。结论诺如病毒是上海市普陀区食源性疾病的重要病原体,基因型别存在多样性,GII.P17-GII.17型和GII.P16-GII.2型是2018—2019年的主要流行株。Objective To investigate the infection and genetic characteristics of norovirus in food borne diseases in Shanghai Putuo sentinel hospital,and to provide scientific basis for the prevention and control of infectious diarrhea caused by norovirus.Methods From January 2018 to December 2019,anal swab samples and epidemiological data of patients in food borne disease surveillance sentinel Hospital of Putuo District,Shanghai were collected.Norovirus was detected by real-time reverse transcription polymerase chain reaction.Polymerase capsid protein linkage region was amplified by reverse transcription PCR in some positive samples and sequenced,Genotyping and phylogenetic analysis were performed by bioinformatics software.Results The positive rate of norovirus was 33.33%(134/402),and norovirus GⅡgroup was the main group(65.67%,88/134).The differences of norovirus positive rate in different genders,age groups and occupations were all statistically significant(P<0.05).The differences of fever,nausea,vomiting,abdominal pain and other clinical characteristics between positive cases and negative cases were statistically significant(P<0.05).Spring and winter were the high incidence seasons of norovirus.Fifteen genotypes of norovirus were obtained by sequence alignment analysis.GI.P13-GI.3 and GI.P4-GI.4 were the main genotypes in group GⅠ,and GII.P17-GII.17 and GII.P16-GII.2 were the main genotypes in group GⅡ.The results of homology and genetic evolution analysis showed that the nucleotide homology of 8 strains of GII.P17-GII.17 was 98.2%-100%,which was the most different from the reference strain MN461100.1.The 7 strains of GII.P16-GII.2 were in the same evolutionary branch with the reference strain,and had the highest homology with the Japanese reference strain AB629946.1.The other genotypes were in the same evolutionary branch as the selected reference strains.Conclusion Norovirus is an important pathogen of foodborne diseases in Putuo District of Shanghai.The genotypes of norovirus were widely distributed,GII.P17-GI

关 键 词：食源性疾病 诺如病毒 基因分型 分子流行病学 

分 类 号：R155.3[医药卫生—营养与食品卫生学]