2015-2017年云南省轮状病毒感染情况及基因分型分析
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摘要
目的分析2015-2017年云南省5岁以下腹泻患儿A组轮状病毒感染情况、基因分型变迁、临床表现及流行病学特征。方法选取2015年1月至2017年12月期间在云南省病毒性腹泻监测哨点医院进行诊疗的5岁以下腹泻患儿为研究对象,采集其诊疗当天24h内或发病3d内的粪便标本,采用巢式RT-PCR方法检测轮状病毒并进行基因分型,同时收集临床表现及流行病学资料信息进行分析。结果 2015、2016和2017年云南省5岁以下腹泻患儿粪便A组轮状病毒阳性率分别为34.85%、33.33%和29.42%,总阳性率为32.51%。2015-2017年各月份均有轮状病毒感染检出,每年各月份间轮状病毒阳性率差异均有统计学意义(χ~2_(2015)=85.106,χ~2_(2016)=111.812,χ~2_(2017)=107.946,P<0.05),均以1-3和10-12月阳性率较高,不同年份比较轮状病毒阳性率差异均无统计学意义(χ2=3.196,P>0.05)。轮状病毒G基因分型以G9居多,其次为G2;P分型以P[8]居多,型别以G9P[8]为主,占62.76%,G2P[4]和G1P[8]分别占19.77%和9.89%,并存在G39P[8]及G249P[4][8]混合感染。2015-2017年G1、G2、G3型占比均呈现下降趋势,G9呈上升趋势,G9P[8]为优势流行株。轮状病毒感染临床表现以腹泻为主,并可出现恶心、呕吐等症状,部分患儿可伴有脱水、发热及呼吸道症状。患儿中男、女性比例为1.33:1,年龄以3-6个月居多,占34.90%～36.84%,5岁组较少,占3.01%～3.92%;农村、城市籍患儿分别占28.86%～29.32%和70.59%～71.14%,差异有统计学意义(P<0.05)。结论云南省5岁以下腹泻患儿A组轮状病毒感染率较高,以3个月-2岁儿童为主,且农村多于城市。每年的1-3和10-12月为A组轮状病毒感染发病高峰期,G9P[8]为优势流行株。患者临床表现以腹泻为主,可伴恶心、呕吐等症状。
Objective To analyze the prevalence of infection with group A rotavirus in fecal specimens from children under 5 years of age in Yunnan Province from 2015 to 2017,changes in genotypes,clinical manifestations,and epidemiological characteristics. Methods Subjects were children under 5 years of age who were seen at a sentinel hospital for surveillance of viral diarrhea in Yunnan Province from January 2015 to December 2017.Stool samples were collected within 24 hours of the visit or within 3 days of onset to detect and genotype rotavirus.Information on clinical manifestations and epidemiological data were also collected. Results Children under 5 years of age in Yunnan Province tested positive for group A rotavirus at a rate of 34.85%in 2015,33.33%in 2016,and 29.42%in 2017.From 2015-2017,group A rotavirus was detected at a rate of 32.51%.A rotavirus infection was detected every month.The rate of rotavirus detection differed significantly in different months of each year(χ~2=85.106,111.812,107.946,P<0.05),and the rate of rotavirus detection was higher in January to March and October to December.The rate of rotavirus detection did not differ statistically in different years(χ~2=3.196,P>0.05).The most prevalent G genotype was G9,followed by G2.The most prevalent P genotype was P[8].The most prevalent type was G9 P[8](62.76%),followed by G2 P[4](19.77%)and G1 P[8](9.89%).Co-infection with the G and P genotypes-G39 P[8]and G249 P[4][8]-was also noted.From2015-2017,G1,G2,and G3 tended to decrease while G9 tended to increase markedly.G9 P[8]tended to increase,becoming the most prevalent rotavirus genotype in Yunnan Province.The main clinical manifestation of infection with group A rotavirus was diarrhea;nausea and vomiting were also noted as clinical manifestations.In addition,some patients also had dehydration,a fever,and respiratory symptoms.The ratio of male/female children infected with group A rotavirus was 1.33:1.By age group,infection with group A rotavirus was most prevalent(34.90-36.84%)in infants 3-6 months of age and least prevalent(3.01-3.92%)in children 4-5 years of age.Of the children infected with group A rotavirus,29.32%resided in a rural area while 70.59%resided in an urban area.The rate of rotavirus detection differed significantly in the 2 groups of children(P<0.05). Conclusion The rate of infection with group A rotavirus was higher in children under 5 years of age in Yunnan Province.Infection with group A rotavirus mainly affected children 3 months to 2 years of age,and children residing in urban areas were more often infected than those residing in rural areas.Infection peaked from January to March and from October to December.The most prevalent rotavirus genotype was G9 P[8].The main clinical manifestation of infection with group A rotavirus was diarrhea;nausea and vomiting were also noted as clinical manifestations.
Objective To analyze the prevalence of infection with group A rotavirus in fecal specimens from children under 5 years of age in Yunnan Province from 2015 to 2017,changes in genotypes,clinical manifestations,and epidemiological characteristics. Methods Subjects were children under 5 years of age who were seen at a sentinel hospital for surveillance of viral diarrhea in Yunnan Province from January 2015 to December 2017.Stool samples were collected within 24 hours of the visit or within 3 days of onset to detect and genotype rotavirus.Information on clinical manifestations and epidemiological data were also collected. Results Children under 5 years of age in Yunnan Province tested positive for group A rotavirus at a rate of 34.85%in 2015,33.33%in 2016,and 29.42%in 2017.From 2015-2017,group A rotavirus was detected at a rate of 32.51%.A rotavirus infection was detected every month.The rate of rotavirus detection differed significantly in different months of each year(χ~2=85.106,111.812,107.946,P<0.05),and the rate of rotavirus detection was higher in January to March and October to December.The rate of rotavirus detection did not differ statistically in different years(χ~2=3.196,P>0.05).The most prevalent G genotype was G9,followed by G2.The most prevalent P genotype was P[8].The most prevalent type was G9 P[8](62.76%),followed by G2 P[4](19.77%)and G1 P[8](9.89%).Co-infection with the G and P genotypes-G39 P[8]and G249 P[4][8]-was also noted.From2015-2017,G1,G2,and G3 tended to decrease while G9 tended to increase markedly.G9 P[8]tended to increase,becoming the most prevalent rotavirus genotype in Yunnan Province.The main clinical manifestation of infection with group A rotavirus was diarrhea;nausea and vomiting were also noted as clinical manifestations.In addition,some patients also had dehydration,a fever,and respiratory symptoms.The ratio of male/female children infected with group A rotavirus was 1.33:1.By age group,infection with group A rotavirus was most prevalent(34.90-36.84%)in infants 3-6 months of age and least prevalent(3.01-3.92%)in children 4-5 years of age.Of the children infected with group A rotavirus,29.32%resided in a rural area while 70.59%resided in an urban area.The rate of rotavirus detection differed significantly in the 2 groups of children(P<0.05). Conclusion The rate of infection with group A rotavirus was higher in children under 5 years of age in Yunnan Province.Infection with group A rotavirus mainly affected children 3 months to 2 years of age,and children residing in urban areas were more often infected than those residing in rural areas.Infection peaked from January to March and from October to December.The most prevalent rotavirus genotype was G9 P[8].The main clinical manifestation of infection with group A rotavirus was diarrhea;nausea and vomiting were also noted as clinical manifestations.
引文
[1] Gutierrez L,Nguyen TH.Interactions between rotavirus andnatural organic matter isolates with different physicochemicalcharacteristics[J].Langmuir,2013,29(47):14460-8.
[2] 何艳明,梁秉绍,姚淑雯,等.2171例腹泻患儿轮状病毒和腺病毒检出率及流行特征[J].实用医学杂志,2017,33(11):1872-5.
[3] 杨黎明,方玉才.小儿轮状病毒肠炎患者的流行及临床调查[J].中华实验和临床病毒学杂志,2011,25(5):371-3.
[4] Zhan F,Zhou X,Xing D.Rapid and sensitive electrochemilumi-nescence detection of rotavirus by magnetic primer based reversetranscription-polymerase chain reaction[J].Anal Chim Acta,2013(761):71-7.
[5] 鄢小琼.2015年重庆地区儿童轮状病毒腹泻分子流行病学研究[D].重庆:重庆医科大学,2016.
[6] Fernandes F,Dias MM,Vidigal J,et al.Production of rotaviruscore-like particles in Sf9cells using recombinase-mediated cas-sette exchange[J].J Biotechnol,2014(171):34-8.
[7] Girard A,Roques E,Massie B,et al.Flagellin in fusion with hu-man rotavirus structural proteins exerts an adjuvant effect whendelivered with replicating but non-disseminating adenovectorsthrough the intrarectal route[J].Mol Biotechnol,2014,56(5):394-407.
[8] Mok HF,Hamilton AJ.Exposure factors for wastewater-irriga-ted Asian vegetables and a probabilistic rotavirus disease burdenmodel for their consumption[J].Risk Anal,2014,34(4):602-13.
[9] Dhama K,Saminathan M,Karthik K,et al.Avian rotavirus en-teritis-an updated review[J].Vet Q,2015,35(3):142-58.
[10] Cui H,Bai S,Huo Z,et al.A cluster of rotavirus enteritis inpediatric liver recipients[J].Transpl Infect Dis,2015,17(3):477-80.
[11] Kaneko K,Kimata T,Tsuji S,et al.Genetic predisposition tohyperuricaemia in rotavirus gastro-enteritis[J].Paediatr IntChild Health,2015,35(2):165-5.
[12] Moura-Alvarez J,Chacon JV,Scanavini LS,et al.Enteric viru-ses in Brazilian turkey flocks:single and multiple virus infectionfrequency according to age and clinical signs of intestinal disease[J].Poult Science,2013,92(4):945-55.
[13] Kang B,Kim DH,Hong YJ,et al.Comparison between febrileand afebrile seizures associated with mild rotavirus gastroenteritis[J].Seizure,2013,22(7):560-4.
[14] Alkan F,Gulyaz V,Timurkan MO,et al.A large outbreak ofenteritis in goat flocks in Marmara,Turkey,by G8P
[1]group Arotaviruses[J].Arch Virol,2012,157(6):1183-7.
[15] Stelzmueller I,Dunst KM,Hengster P.A cluster of rotavirusenteritis in adult transplant recipients[J].Transpl Int,2005,18(04):470-4.
[16] Turner A,Ngwira B,Witte D,et al.Surveillance of rotavirusgastro-enteritis in children in Blantyre,Malawi[J].Paediatr IntChild Health,2013,33(1):42-5.
[17] Asano KM,Gregori F,Souza SP,et al.Bovine rotavirus in tur-keys with enteritis[J].Avian Dis,2011,55(4):697-700.
[18] Koo BS,Lee HR,Jeon EO,et al.An unusual case of concomi-tant infection with chicken astrovirus and group A avian rotavirusin broilers with a history of severe clinical signs[J].J Vet Sci2013,14(2):231-3.
[19] Medici MC,Abelli LA,Guerra P,et al.Case report:detectionof rotavirus RNA in the cerebrospinal fluid of a child with rotavir-us gastroenteritis and meningism[J].J Med Virol,2011,83(9):1637-40.
[20] Yassin MA,Kirby A,Mengistu AA,et al.Unusual norovirusand rotavirus genotypes in Ethiopia[J].Paediatr Int ChildHealth,2012,32(1):51-5.
[21] Adeyi OA,Costa G,Elmagd KM,et al.Rotavirus infection in a-dult small intestine allografts:a clinicopathological study of a co-hort of 23patients[J].Am J Transplant,2010,10(12):2683-9.
[22] Gutierrez L,Nguyen TH.Interactions between rotavirus andnatural organic matter isolates with different physicochemicalcharacteristics[J].Langmuir,2013,29(47):14460-8.
[23] Periz J,Celma C,Jing B,et al.Rotavirus mRNAS are releasedby transcript-specific channels in the double-layered viral capsid[J].Proc Natl Acad Sci USA,2013,110(29):12042-7.
[24] Xue B,Jin M,Yang D,et al.Effects of chlorine and chlorine di-oxide on human rotavims infectivity and genome stability[J].Water Res,2013,47(10):3329-38.
[2] 何艳明,梁秉绍,姚淑雯,等.2171例腹泻患儿轮状病毒和腺病毒检出率及流行特征[J].实用医学杂志,2017,33(11):1872-5.
[3] 杨黎明,方玉才.小儿轮状病毒肠炎患者的流行及临床调查[J].中华实验和临床病毒学杂志,2011,25(5):371-3.
[4] Zhan F,Zhou X,Xing D.Rapid and sensitive electrochemilumi-nescence detection of rotavirus by magnetic primer based reversetranscription-polymerase chain reaction[J].Anal Chim Acta,2013(761):71-7.
[5] 鄢小琼.2015年重庆地区儿童轮状病毒腹泻分子流行病学研究[D].重庆:重庆医科大学,2016.
[6] Fernandes F,Dias MM,Vidigal J,et al.Production of rotaviruscore-like particles in Sf9cells using recombinase-mediated cas-sette exchange[J].J Biotechnol,2014(171):34-8.
[7] Girard A,Roques E,Massie B,et al.Flagellin in fusion with hu-man rotavirus structural proteins exerts an adjuvant effect whendelivered with replicating but non-disseminating adenovectorsthrough the intrarectal route[J].Mol Biotechnol,2014,56(5):394-407.
[8] Mok HF,Hamilton AJ.Exposure factors for wastewater-irriga-ted Asian vegetables and a probabilistic rotavirus disease burdenmodel for their consumption[J].Risk Anal,2014,34(4):602-13.
[9] Dhama K,Saminathan M,Karthik K,et al.Avian rotavirus en-teritis-an updated review[J].Vet Q,2015,35(3):142-58.
[10] Cui H,Bai S,Huo Z,et al.A cluster of rotavirus enteritis inpediatric liver recipients[J].Transpl Infect Dis,2015,17(3):477-80.
[11] Kaneko K,Kimata T,Tsuji S,et al.Genetic predisposition tohyperuricaemia in rotavirus gastro-enteritis[J].Paediatr IntChild Health,2015,35(2):165-5.
[12] Moura-Alvarez J,Chacon JV,Scanavini LS,et al.Enteric viru-ses in Brazilian turkey flocks:single and multiple virus infectionfrequency according to age and clinical signs of intestinal disease[J].Poult Science,2013,92(4):945-55.
[13] Kang B,Kim DH,Hong YJ,et al.Comparison between febrileand afebrile seizures associated with mild rotavirus gastroenteritis[J].Seizure,2013,22(7):560-4.
[14] Alkan F,Gulyaz V,Timurkan MO,et al.A large outbreak ofenteritis in goat flocks in Marmara,Turkey,by G8P
[1]group Arotaviruses[J].Arch Virol,2012,157(6):1183-7.
[15] Stelzmueller I,Dunst KM,Hengster P.A cluster of rotavirusenteritis in adult transplant recipients[J].Transpl Int,2005,18(04):470-4.
[16] Turner A,Ngwira B,Witte D,et al.Surveillance of rotavirusgastro-enteritis in children in Blantyre,Malawi[J].Paediatr IntChild Health,2013,33(1):42-5.
[17] Asano KM,Gregori F,Souza SP,et al.Bovine rotavirus in tur-keys with enteritis[J].Avian Dis,2011,55(4):697-700.
[18] Koo BS,Lee HR,Jeon EO,et al.An unusual case of concomi-tant infection with chicken astrovirus and group A avian rotavirusin broilers with a history of severe clinical signs[J].J Vet Sci2013,14(2):231-3.
[19] Medici MC,Abelli LA,Guerra P,et al.Case report:detectionof rotavirus RNA in the cerebrospinal fluid of a child with rotavir-us gastroenteritis and meningism[J].J Med Virol,2011,83(9):1637-40.
[20] Yassin MA,Kirby A,Mengistu AA,et al.Unusual norovirusand rotavirus genotypes in Ethiopia[J].Paediatr Int ChildHealth,2012,32(1):51-5.
[21] Adeyi OA,Costa G,Elmagd KM,et al.Rotavirus infection in a-dult small intestine allografts:a clinicopathological study of a co-hort of 23patients[J].Am J Transplant,2010,10(12):2683-9.
[22] Gutierrez L,Nguyen TH.Interactions between rotavirus andnatural organic matter isolates with different physicochemicalcharacteristics[J].Langmuir,2013,29(47):14460-8.
[23] Periz J,Celma C,Jing B,et al.Rotavirus mRNAS are releasedby transcript-specific channels in the double-layered viral capsid[J].Proc Natl Acad Sci USA,2013,110(29):12042-7.
[24] Xue B,Jin M,Yang D,et al.Effects of chlorine and chlorine di-oxide on human rotavims infectivity and genome stability[J].Water Res,2013,47(10):3329-38.