2011-2017年北京市朝阳区5岁以下儿童病毒性腹泻病原学研究
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摘要
目的分析北京市朝阳区2011-2017年5岁以下儿童腹泻病毒多病原流行特征,比较其病原谱流行变化规律,为制定该地区病毒感染性腹泻的预防控制措施提供科学依据。方法收集北京市朝阳区2011-2017年首都儿科研究所送检的婴幼儿腹泻粪便监测样本,应用real-time PCR和PCR法进行诺如病毒、肠道腺病毒、星状病毒核酸检测,应用ELISA法进行轮状病毒抗原检测。结果 2011-2017年共收集5岁以下婴幼儿腹泻粪便监测样本1 451份(男性977份,女性474份)。经确诊,轮状病毒感染374例,诺如病毒感染237例,肠道腺病毒感染100例,星状病毒感染69例,其中复合感染者75例。轮状病毒冬春季高发(11月~次年3月),诺如病毒全年均可发生,但秋冬季多见(10~12月),肠道腺病毒和星状病毒流行季节性不明显。结论北京市朝阳区2011-2017年监测结果显示腹泻患儿轮状病毒和诺如病毒感染率较高,应加强对病毒性腹泻的监测,预防暴发疫情尤其是轮状病毒和诺如病毒感染的发生。
Objective To study the epidemic strains of enteric viruses in infants with diarrhea from 2011 to2017 in Chaoyang district of Beijing,China. Methods Stool samples were collected from the Capital Institute of Pediatrics to confirm the enteric virus infection,including norovirus,adenovirus,astrovirus and rotavirus by using PCR,real-time PCR and ELISA methods. Results A total of 1 451 samples were detected.The infection rates of rotavirus,norovirus,adenovirus and astrovirus were 25.78%(374/1 451),16.33%(237/1 451),6.89%(100/1 451)and 4.76%(69/1 451),respectively.Multi-virus infections were found in 75 samples.Rotavirus infection mainly found in autumn and winter with dramatic seasonality.Norovirus also mainly found in autumn and winter but can be detected in the whole year.Adenovirus and astrovirus infections were sporadic throughout the whole year. Conclusions Rotavirus and norovirus were still in the first and second place of pathogens inducing viral diarrhea in infants under 5 years in Chaoyang district of Beijing,China.
Objective To study the epidemic strains of enteric viruses in infants with diarrhea from 2011 to2017 in Chaoyang district of Beijing,China. Methods Stool samples were collected from the Capital Institute of Pediatrics to confirm the enteric virus infection,including norovirus,adenovirus,astrovirus and rotavirus by using PCR,real-time PCR and ELISA methods. Results A total of 1 451 samples were detected.The infection rates of rotavirus,norovirus,adenovirus and astrovirus were 25.78%(374/1 451),16.33%(237/1 451),6.89%(100/1 451)and 4.76%(69/1 451),respectively.Multi-virus infections were found in 75 samples.Rotavirus infection mainly found in autumn and winter with dramatic seasonality.Norovirus also mainly found in autumn and winter but can be detected in the whole year.Adenovirus and astrovirus infections were sporadic throughout the whole year. Conclusions Rotavirus and norovirus were still in the first and second place of pathogens inducing viral diarrhea in infants under 5 years in Chaoyang district of Beijing,China.
引文
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[18]Walter JE,Mitchell DK.Astrovirus infection in children[J].Curr Open Infect Dis,2003,16(3):247-253.
[19]Fang ZY,Sun YP,Ye XH,et al.Astrovirus infection among hospitalized children with acute diarrhea in seven regions of China,1998-2005[J].Zhonghua Liuxingbingxue Zazhi,2006,26(8):673-676.(in Chinese)方肇寅,孙亚萍,叶新华,等.中国七个地区1998-2005年急性腹泻住院患儿中星状病毒感染研究[J].中华流行病学杂志,2006,26(8):673-676.
[20]Marie-Cardine A,Gourlain K,Mouterde O,et al.Epidcmiology of acute viral gastroenteritis in children hospitalized in Rouen,France[J].Clin Infect Dis,2002,34(9):11701178.
[2]Duan ZJ,Liu N,Yang SH,et al.Hospital-based surveillance of rotavirus diarrhea in the people republic of China[J].J Infect Dis,2009,200(suppl 1):S167-173.
[3]Phan TG,Kuroiwa T,Kaneshi K,et al.Changing distribution of norovirus genotypcs and genetic analysis of recombinant G II b among infants and children with diarrhea in Japan[J].J Med Virol,2006,78(7):971-978.
[3]Liu L,Johnson HL,Cousens S,et al.Global,regional,and national causes of child mortality:an updated systematic analysis for 2010with time trends since 2000[J].Lancet,2012,379:2151-2161.
[4]Bishop R.Discovery of rotavirus:implications for child health[J].J Gastroenterol Hepatol,2009,24(Suppl 3):S81-S85.
[5]Liu L,Qian Y,Zhang Y,et al.Epidemiological aspects of rotavirus and adenovirus in hospitalized children with diarrhea:a 5-year survey in Beijing[J].BMC Infect Dis,2016,16(1):508.
[6]Wang YQ,Miao Y,Liu J,et al.Study on the etiological characteristics of viral diarrhea of infants under 5years in Beijing[J].Guoji Bingduxue Zazhi,2012,19(5):215-217.(in Chinese)王永全,苗元,刘静,等.北京市5岁以下儿童病毒性腹泻病原学研究[J].国际病毒学杂志,2012,19(5):215-217.
[7]Ahmed SM,Hall AJ,Robinson AE,et al.Global prevalence of norovirus in cases of gastroenteritis:a systematic review and meta-analysis[J].Lancet Infect Dis,2014,14(8):725-730.
[8]Fu JG,Shi C,Xu C,et al.Outbreaks of acute gastroenteritis associated with a re-emerging GII.P16-GII.2norovirus in the spring of 2017in Jiangsu,China[J].PLoS One,2017,12(12):e0186090.
[9]Qin SW,Chan TC,Cai J,et al.Genotypic and epidemiological trends of acute gastroenteritis associated with noroviruses in China from 2006to 2016[J].Int J Environ Res Public Health,2017,14(11):E1341.
[10]Gong ZX.Molecular epidemiology of viral diarrhea among children in Shanghai[D].Shanghai:Second Military Medical University,2010.(in Chinese)龚智翔.上海地区儿童病毒性腹泻分子流行病学研究[D].上海:第二军医大学,2010.
[11]Wu ZC,Chen JY,Cai ZQ.Investigation on gastroenteritis by enteric adenoviruses infection for infants in Fuzhou[J].Haixia Yufang Yixue Zazhi,2004,10(5):36-37.(in Chinese)吴志潮,陈骏扬,蔡忠钦.福州市儿童肠道腺病毒感染的调查与研究[J].海峡预防医学杂志,2004,10(5):36-37.
[12]Qi HM,Jin Y,Duan ZJ,et al.Molecular epidemiology of human adenovirus diarrhea among infants and young children in Lanzhou from July 2005to June 2008[J].Zhonghua Erke Zazhi,2009,47(12):922-925.(in Chinese)祁红梅,金玉,段招军,等.2005-2008年兰州地区婴幼儿腹泻腺病毒感染的分子流行病学调查[J].中华儿科杂志,2009,47(12):922-925.
[13]Ji YL,Wang YQ,Yang QJ,et al.Investigation on the infection status of the five diarrhea-related viruses among acute infantile diarrhea cases in Beijing[J].Gonggong Weisheng Yu Yufang Yixue,2017,28(5):42-45.(in Chinese)吉彦莉,王永全,杨青俊,等.北京地区婴幼儿急性腹泻病例5种腹泻相关病毒感染情况[J].公共卫生与预防医学,2017,28(5):42-45.
[14]Wang S,Wang YQ,Miao Y,et al.Etiology of viral diarrhea in children aged<5years in Beijing,2013[J].Jibing Jiance,2014,29(5):344-348.(in Chinese)王森,王永全,苗元,等.2013年北京地区5岁以下儿童病毒性腹泻病原学研究[J].疾病监测,2014,29(5):344-348.
[15]Anderson EJ.Prevention and treatment of viral diarrhea in pediatrics[J].Expert Rev Anti Infect Ther,2010,8(2):205-217.
[16]Gray JJ,Wreghitt TG,Cubitt WD,et al.An outbreak of gastroenteritis in a home for the elderly associated with astrovirus type 1and human calicivirus[J].J Med Virol,1987,23(4):377-381.
[17]Grohmann GS,Glass RI,Pereira HG,et al.Enteric virus and diarrhea in HIV-infected patients.Enteric Opportunistic Infectiom Working Group[J].N Engl J Med,1993,329(1):14-20.
[18]Walter JE,Mitchell DK.Astrovirus infection in children[J].Curr Open Infect Dis,2003,16(3):247-253.
[19]Fang ZY,Sun YP,Ye XH,et al.Astrovirus infection among hospitalized children with acute diarrhea in seven regions of China,1998-2005[J].Zhonghua Liuxingbingxue Zazhi,2006,26(8):673-676.(in Chinese)方肇寅,孙亚萍,叶新华,等.中国七个地区1998-2005年急性腹泻住院患儿中星状病毒感染研究[J].中华流行病学杂志,2006,26(8):673-676.
[20]Marie-Cardine A,Gourlain K,Mouterde O,et al.Epidcmiology of acute viral gastroenteritis in children hospitalized in Rouen,France[J].Clin Infect Dis,2002,34(9):11701178.