2019年广东省部分地区感染性腹泻病原学及人轮状病毒分子流行病学特征

目的 对感染性腹泻样本进行检测鉴定,并对轮状病毒A组进行病毒分离,研究2019年广东省部分地区感染性腹泻病原学及轮状病毒分子流行病学特征。方法 2019年1月1日至2020年1月12日,采集广东省广州市、东莞市和江门市临床感染性腹泻患者粪便样本,进行多重RT-PCR扩增和微球杂交技术检测鉴定,并对轮状病毒A组阳性样本进行分离后,采用半巢式PCR试验对阳性细胞培养物进行G/P基因分型。结果 共纳入706例合格病例,病原体总检出率43.06%,病毒检出率18.13%高于细菌检出率8.36%高于寄生虫检出率1.27%。病毒病原谱以轮状病毒A组G9P8]和诺如病毒GII型感染为主,细菌病原谱以沙门菌和艰难梭菌为主,寄生虫以蓝氏贾第鞭毛虫为首。不同季度、不同年龄组病原谱构成各不相同。轮状病毒A组主要受累群体为≤5岁儿童,主要时间分布于1—4月,基因型呈现多样性,包括G2P4]、G3P8]和G9P8]。结论 2019年广东省部分地区感染性腹泻病毒类病原体高于细菌类高于寄生虫类,轮状病毒A组G9P8]、诺如GII型、沙门菌和蓝氏贾第鞭毛虫是最主要的病原体,且G9P8]型A组轮状病毒毒株在轮状病毒感染中占主导趋势。在防控病毒性和细菌性腹泻的同时,应警惕寄生虫所致腹泻并重视混合感染的病原学监测。

Etiology of infectious diarrhea and molecular epidemiology of human rotavirus in part of Guangdong, 2019

Objective To detect and identify the samples with infectious diarrhea infection, and to explore the etiology of infectious diarrhea and the molecular epidemiological characteristics of Rotavirus Group A in part of Guangdong Province in 2019 with isolated Rotavirus Group A. Methods From January 1, 2019 to January 12, 2020, stool samples were collected from patients infected with infectious diarrhea in Guangzhou, Dongguan and Jiangmen, Guangdong Province for multiplex RT-PCR reaction and bead hybridization detection technology. After isolation of Rotavirus Group A positive samples, G/P typing was performed on positive cell cultures using a semi-nested PCR assay. Results A total of 706 eligible cases were included. The detective result showed 43.06% positive rate in all pathogens, 18.13% in viruses, 8.36% in bacterium, and 1.27% in parasites. G9P
8] of Rotavirus Group A and Norovirus GII infection were predominant in viral pathogen spectrum, and Salmonella and Clostridium Difficile were dominant in bacterial pathogen spectrum, with Giardia mainly in parasite spectrum. Composition of pathogenic spectrum varied by quarter and age group. The mainly affected group of Rotavirus Group A was children under 5 years old, the main time distribution was from January to April, and the genotypes were diverse, including G2P
4], G3P
8] and G9P
8]. Conclusion In part of Guangdong Province in 2019, the proportion of viral pathogens is higher than that of bacteria and parasite. G9P
8] of Rotavirus Group A, Norovirus GII, Salmonella and Giardia are prevailing pathogens of infectious diarrhea, and the G9P
8] strains of Rotavirus Group A dominate Rotavirus infection. In addition to preventing and controlling viral and bacterial diarrhea, it should be alert for infectious diarrhea caused by parasites and for the etiological surveillance of co-infections.