2017-2021年广州市病毒性腹泻病原学特征分析  

Etiological characteristics of viral diarrhea in Guangzhou,2017-2021

作　　者：刘静雯[1] 曾庆 耿进妹[1] 鲁影[1] 李魁彪[1] 狄飚[1] 谢华萍[1] LIU Jing-wen;ZENG Qing;GENG Jin-mei;LU Ying;LI Kui-biao;DI Biao;XIE Hua-ping(Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,China)

机构地区：[1]广州市疾病预防控制中心,广州510440

出　　处：《中国人兽共患病学报》2023年第9期872-878,共7页Chinese Journal of Zoonoses

基　　金：广州市卫生健康科技项目(No.20221A010041,No.20201A011059);广州市医学重点学科建设项目(No.2021-2023-11);广州市科技计划项目(No.202102100001)联合资助。

摘　　要：目的分析2017-2021年广州市病毒性腹泻主要病原轮状病毒和诺如病毒的特征,为病毒性腹泻病例监测和防控提供参考依据。方法收集广州市2017年1月1日-2021年12月31日各哨点监测医院的疑似及确诊腹泻病例标本,使用实时荧光RT-PCR法检测病毒核酸。结果5年内共采集粪便或肛拭子等标本共5364份,检测为阳性的有1583份,阳性率为29.51%;A组轮状病毒和诺如病毒的阳性率分别为11.26%、20.74%;检出轮状病毒和诺如病毒混合感染134份,GI和GII混合感染30份。诺如病毒GII型主要在秋冬季高发。轮状病毒全年均可发病,其高发季节为冬春季。患者年龄主要集中在0~5岁。A组轮状病毒阳性者的男女比为1.27∶1,诺如病毒阳性者的男女比1.52∶1,GII.4[P31]型和GII.2[P16]型是诺如病毒最主要的2种基因亚型。A组轮状病毒以G9P[8]型最多,其次分别是G8P[8]、G2P[8]、G3P[8]型,同一病例多重基因型别感染的情况暂未发现。结论广州地区诺如病毒的高发季节为秋冬季,轮状病毒则是每年11月至次年3月,两种病毒均在5岁以下儿童更易感染,GII.4[P31]型和GII.2[P16]型是诺如病毒最主要的2种基因亚型,轮状病毒以G9P[8]型流行为主,G8P[8]型出现小流行。应加强病毒性腹泻的日常监测,分析该病毒病原谱的变化,做好预防控制措施。This study was aimed at analyzing the epidemiological characteristics of viral diarrhea in Guangzhou form 2017 to 2021,to understand related rotavirus and norovirus characteristics,and to provide a reference for viral diarrhea case surveillance,prevention and control.Samples from suspected and confirmed diarrhea cases in patients treated at sentinel surveillance hospitals in Guangzhou from January 1,2017,to December 31,2021,were collected.Viral nucleic acid was tested with real-time fluorescence RT-PCR.A total of 5364 stool or anal swab samples were detected in 5 years.The total number of positive cases was 1583.The positivity rates of rotavirus and norovirus were 11.26%and 20.74%,respectively.A total of 134 cases of mixed rotavirus and norovirus infection,and 30 cases of mixed GI and GII infection,were detected.The high incidence seasons of norovirus GII were mainly autumn and winter.Rotavirus infections can occur year-round,and its high incidence seasons were primarily winter and spring.The most susceptible age group to A rotavirus and norovirus was 0-5 years.The group A rotavirus positive rates of males and females were 1.27∶1,and rates of norovirus were 1.52∶1.GII.4[P31]and GII.2[P16]were the two main norovirus subtypes.G9P[8]was the rotavirus genotype with the highest positivity rate in group A,and was followed by G8P[8],G2P[8]and G3P[8].No infections with multiple genotypes were found in the same case.The high incidence seasons of norovirus in Guangzhou were autumn and winter,and the rotavirus infection rates were high from November to March of the following year.Children younger than 5 years had a high susceptibility to both viruses.GII.4[P31]and GII.2[P16]were the two main subtypes of norovirus,and rotavirus was prevalent in G9P[8].A minor epidemic of type G8P[8]was found.Daily monitoring of viral diarrhea and understanding of the epidemic characteristics of the pathogen are necessary to analyze changes in the pathogen spectrum,and rapidly initiate prevention and control measures.

关 键 词：病毒性腹泻 轮状病毒 诺如病毒 病原学特征 

分 类 号：R373.25[医药卫生—病原生物学]