成都地区儿童腹泻肠道腺病毒感染的流行病学特征调查
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摘要
目的了解成都地区儿童腹泻腺病毒(ADV)的感染情况和流行特点,为临床诊治提供参考依据。方法随机收集8 556例18岁以下腹泻患儿的粪便标本,采用双抗体夹心法及免疫层析分析技术检测粪便标本中的ADV抗原,分析阳性患儿流行病学资料。结果 8 556份腹泻患儿粪便标本中,ADV抗原阳性416份,阳性率4. 86%;其中5月、6月、7月、8月ADV阳性检出率较高,分别为5. 52%、9. 99%、7. 59%、5. 27%,其中6、7月阳性率最高,分别可达9. 99%及7. 59%,两月份阳性率比较,差异无统计学意义(P>0. 05)。6月与其他月份阳性率比较差异有统计学意义(P<0. 05);幼儿期及学龄前期患儿ADV感染率最高,为6. 45%及5. 80%,两个年龄段阳性率比较,差异无统计学意义(P>0. 05)。幼儿期与其他年龄段患儿ADV感染率比较,差异有统计学意义(P<0. 05);男性患儿ADV感染率为4. 90%,女性患儿为4. 82%,两者差异无统计学意义(P>0. 05)。结论成都地区儿童ADV感染高峰期在5～8月,峰值为6月,ADV感染年龄高峰为幼儿期。对儿童腹泻应尽早做ADV检测,及时发现病原体,以对ADV感染所致的儿童腹泻给予合理治疗,避免滥用抗菌药物,防止疾病传播。
Objective To investigate the prevalence and epidemic characteristics of adenovirus(ADV) in children with diarrhea in Chengdu,provide a reference basis for clinical diagnosis and treatment.Methods The fecal samples of 8 556 children under 18 years old with diarrhea were randomly collected.Double antibody sandwich method and immunochromatography were used to detect ADV antigen in the fecal samples,the epidemiological data of children with positive ADV antigen were analyzed.Results Among 8 556 fecal samples,416 fecal samples were found with positive ADV antigen,the positive rate was 4.86%.The positive rates of ADV antigen in May,June,July,August were 5.52%,9.99%,7.59%,and 5.27%,respectively,the highest positive rates of ADV antigen were in June and July.There was no statistically significant difference in positive rate of ADV antigen between June and July(P<0.05).There was statistically significant difference in positive rate of ADV antigen between June and other months(P<0.05).The infection rate of ADV in early childhood and preschool period were the highest(6.45% and 5.80%),there was no statistically significant difference between the two periods(P>0.05),there was statistically significant difference between preschool period and other periods(P<0.05).The infection rates of ADV in boys and girls were 4.90% and 4.82%,respectively,there was no statistically significant difference between boys and girls(P > 0.05).Conclusion The infection rates of ADV in children are high in May,June,July,and August,which peak in June.The children in early childhood are more susceptible to ADV.AVD test should be done as soon as possible for children with diarrhea,timely detection of pathogens,reasonable treatment of diarrhea in children caused by ADV infection,avoidance of abuse of antimicrobial agents,and prevention of the spreading of diarrhea are necessary.
Objective To investigate the prevalence and epidemic characteristics of adenovirus(ADV) in children with diarrhea in Chengdu,provide a reference basis for clinical diagnosis and treatment.Methods The fecal samples of 8 556 children under 18 years old with diarrhea were randomly collected.Double antibody sandwich method and immunochromatography were used to detect ADV antigen in the fecal samples,the epidemiological data of children with positive ADV antigen were analyzed.Results Among 8 556 fecal samples,416 fecal samples were found with positive ADV antigen,the positive rate was 4.86%.The positive rates of ADV antigen in May,June,July,August were 5.52%,9.99%,7.59%,and 5.27%,respectively,the highest positive rates of ADV antigen were in June and July.There was no statistically significant difference in positive rate of ADV antigen between June and July(P<0.05).There was statistically significant difference in positive rate of ADV antigen between June and other months(P<0.05).The infection rate of ADV in early childhood and preschool period were the highest(6.45% and 5.80%),there was no statistically significant difference between the two periods(P>0.05),there was statistically significant difference between preschool period and other periods(P<0.05).The infection rates of ADV in boys and girls were 4.90% and 4.82%,respectively,there was no statistically significant difference between boys and girls(P > 0.05).Conclusion The infection rates of ADV in children are high in May,June,July,and August,which peak in June.The children in early childhood are more susceptible to ADV.AVD test should be done as soon as possible for children with diarrhea,timely detection of pathogens,reasonable treatment of diarrhea in children caused by ADV infection,avoidance of abuse of antimicrobial agents,and prevention of the spreading of diarrhea are necessary.
引文
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[12]黄卫彤,王宗杰,黄高飞,等.6 812例腹泻病婴幼儿感染轮状病毒和腺病毒检测结果分析[J].国际检验医学杂志,2014,35(12):1629-1630.
[13]陈玲霞,姬莉莉,刘建荣,等.2011-2013年北京怀柔地区病毒性腹泻监测结果分析[J].现代预防医学,2014,41(13):2454-2456.
[14]杜伟平.轮状病毒和腺病毒联合检测在儿童腹泻诊断中的价值[J].延安大学学报(医学科学版),2013,11(3):53-54.
[15]谢佩言,刘萍,梁西强.西安地区住院腹泻患儿轮状病毒、腺病毒感染分析[J].成都医学院学报,2012,4(3z):469-470.
[16]肖凤娟,周浩,唐道洲,等.5岁以下住院儿童病毒性腹泻流行特征及病原学调查[J].中国公共卫生管理,2014,30(3):399-400.
[17]杨桂荣.824例儿童腹泻病原分析[J].内蒙古民族大学学报(自然科学版),2014,29(4):461-462.
[18]陈惠芳,胡婷婷,俞守义,等.广州地区5岁以内儿童病毒性腹泻病原及流行病学特点[J].中华疾病控制杂志,2014,18(4):336-338.
[19]傅益飞,孙乔,叶楚楚,等.2012年上海市浦东新区急性腹泻门诊病例病原谱特征分析[J].疾病监测,2014,29(5):349-353.
[20]刘翔,郝琼,马江涛,等.2011年宁夏地区感染性腹泻病原谱及流行特征[J].现代预防医学,2014,41(1):1-3.
[21]孙惠泉,张新星,顾文婧.等.2006~2015年苏州地区440例儿童呼吸道腺病毒感染的流行病学分析[J].中国当代儿科杂志,2017,19(1):34-38.
[22]Florescu DF,Islam MK,Mercer DF,et al.Adenovirus infections in pediatric small bowel transplant recipients[J].Transplantation,2010,90(1):198-204.
[2]Navaneethan U,Giannella RA,et al.Mechanisms of infectious diarrhea[J].Nat Clin Pract Gastroenterol Hepatol,2008,5(11):637.
[3]Liu J,Platts-Mills JA,Juma J,et al.Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children:a reanalysis of the GEMS case-controlstudy[J].Lancet,2016,388(10051):1291-1301.
[4]Kotloff KL,Nataro JP,Blackwelder WC,et al.Burden and aetiology of diarrhoeal disease in infants and young children in developing countries(the Global Enteric Multicenter Study,GEMS):a prospective,case-control study[J].Lancet,2013,382(9888):209-222.
[5]叶礼燕,陈凤钦.腹泻病诊断治疗指南[J].《中华实用儿科临床杂志》,2009,4(19):1538-1540.
[6]倪语星,尚红.临床微生物与检验[M].4版.北京:人民卫生出版社,2008:427-428.
[7]Liu M,Worley S,Arrigain S,et al.Respiratory viral infections within one year after pediatric lung transplant[J].Transpl Infect Dis,2009,11(4):304-312.
[8]Dey RS,Ghosh S,Chawla-Sarkar M,et al.Circulation of a novel pattern of infections by enteric adenovirus serotype41 among children below 5 years of age in Kolkata,India[J].J Clin Microbiol,2011,49(2):500-505.
[9]Sonia Etenna,Lekana-Douki,Claudine Kombila-Koumavor,et al.Molecular epidemiology of enteric viruses and genotyping of rotavirusA,adenovirus and astrovirus among children under 5 years old in Gabon[J].Int J Infect Dis,2015,34(1):90-95.
[10]Mu1oz-Hernandez AM,Duquesroix B,Benítez-Del-Castillo JM,et al.A Deno virus initiative study in epidemiology(ADVISE):results of a multicentric epidemiology study in Spain[J].Arch Soc Esp Oftalmol,2018,93(3):113-118.
[11]徐冬梅,胡小蕾,郑颖,等.腹泻儿童轮状病毒与腺病毒感染现况调查[J].浙江预防医学,2013,25(12):39-41.
[12]黄卫彤,王宗杰,黄高飞,等.6 812例腹泻病婴幼儿感染轮状病毒和腺病毒检测结果分析[J].国际检验医学杂志,2014,35(12):1629-1630.
[13]陈玲霞,姬莉莉,刘建荣,等.2011-2013年北京怀柔地区病毒性腹泻监测结果分析[J].现代预防医学,2014,41(13):2454-2456.
[14]杜伟平.轮状病毒和腺病毒联合检测在儿童腹泻诊断中的价值[J].延安大学学报(医学科学版),2013,11(3):53-54.
[15]谢佩言,刘萍,梁西强.西安地区住院腹泻患儿轮状病毒、腺病毒感染分析[J].成都医学院学报,2012,4(3z):469-470.
[16]肖凤娟,周浩,唐道洲,等.5岁以下住院儿童病毒性腹泻流行特征及病原学调查[J].中国公共卫生管理,2014,30(3):399-400.
[17]杨桂荣.824例儿童腹泻病原分析[J].内蒙古民族大学学报(自然科学版),2014,29(4):461-462.
[18]陈惠芳,胡婷婷,俞守义,等.广州地区5岁以内儿童病毒性腹泻病原及流行病学特点[J].中华疾病控制杂志,2014,18(4):336-338.
[19]傅益飞,孙乔,叶楚楚,等.2012年上海市浦东新区急性腹泻门诊病例病原谱特征分析[J].疾病监测,2014,29(5):349-353.
[20]刘翔,郝琼,马江涛,等.2011年宁夏地区感染性腹泻病原谱及流行特征[J].现代预防医学,2014,41(1):1-3.
[21]孙惠泉,张新星,顾文婧.等.2006~2015年苏州地区440例儿童呼吸道腺病毒感染的流行病学分析[J].中国当代儿科杂志,2017,19(1):34-38.
[22]Florescu DF,Islam MK,Mercer DF,et al.Adenovirus infections in pediatric small bowel transplant recipients[J].Transplantation,2010,90(1):198-204.