2011年北京地区婴幼儿病毒性腹泻病原学研究

目的了解北京地区婴幼儿病毒性腹泻的病原学特点。方法采集2011年1月-12月5岁以下腹泻患儿的粪便标本并填写个案调查表,用ELISA试剂盒检测A组轮状病毒,采用逆转录-聚合酶链反应（RT-PCR）检测人杯状病毒和星状病毒,采用PCR检测腺病毒。结果 604例粪便标本中,A组轮状病毒检出率15.89%,人杯状病毒检出率18.71%,星状病毒检出率2.98%,腺病毒检出率4.80%,病毒混合感染27例。11月份轮状病毒检出率最高,10月份人杯状病毒检出率最高。结论 A组轮状病毒和人杯状病毒为北京地区秋冬季婴幼儿腹泻的主要病原。     

中国病毒性腹泻的病原学研究

<正> 1982～1986年收集因腹泻住院的2岁以下病儿粪便标本975份,电镜检查结果408份检出病毒(41.8％),其中轮状病毒370份(37.9％)、腺病毒27份(2.8％)、小圆病毒11份(1.1％),证实轮状病毒是婴幼儿腹泻的重要病原。     

实时荧光定量PCR检测GI型诺瓦克样病毒方法的建立

目的建立临床粪便中GI型诺瓦克样病毒的实时荧光定量PCR检测方法。方法针对诺瓦克样病毒GI型保守序列,用序列比对软件设计特异性引物与探针,建立诺瓦克样病毒实时荧光定量PCR检测方法。并用常规RT-PCR和本文建立的实时荧光定量PCR对137份临床腹泻标本进行检测。结果该方法对诺瓦克样病毒检测准确,重复性好,标准曲线的线性范围为102～107拷贝,相关系数为0.9991。并且对临床标本的检出率显著高于普通RT-PCR。结论本研究建立的实时荧光定量PCR方法可用于检测临床腹泻粪便标本中的GI型诺瓦克样病毒,从而有效预防和控制该病毒的传染。     

南京市发现感染札幌病毒致老年人腹泻

目的探讨应用分子生物学检测老年人腹泻病因的临床评价。方法随机收集2011年1~6月在南京某医院腹泻门诊就诊并临床诊断病毒性腹泻的60岁以上老年人的粪便20份,对诺如病毒、札幌病毒、轮状病毒、肠腺病毒和星状病毒进行分子生物学检测,并将检测结果与临床诊断进行比对,用于指导用药和治疗。结果 20份随机样中共检测到13份阳性,其中有5份诺如病毒,4份轮状病毒,2份肠腺病毒,1份星状病毒,1份札幌病毒,病毒感染阳性率高达65%,加上由于技术原因不能检测到的病毒,该结果说明临床判断的准确性很高。结论确定病原后采取支持疗法,病人康复,避免了抗生素的使用。另外,札幌病毒感染老年人致腹泻在南京是首次报道。     

青岛地区腹泻患儿星状病毒感染的分子流行病学特征

目的研究青岛地区婴幼儿腹泻患者星状病毒流行病学特点和基因型别。方法收集青岛地区散发儿童病毒性腹泻患者粪便标本48份,经胶体金法、RT-PCR法分别检测轮状病毒和诺如病毒后,应用RT-PCR进行星状病毒检测,并对阳性标本进行测序,鉴定型别。结果 48份粪便标本中,4份检出星状病毒(8.3%),经序列分析鉴定为HastV-1型。结论青岛地区散发病毒性腹泻患儿存在星状病毒感染,型别为HastV-1。     

一起由星状病毒1型引起的新生儿腹泻暴发的病原确证

目的 对一起新生儿急性胃肠炎暴发事件进行病原确证.方法 2008年12月至2009年2月,内蒙古自治区某妇幼医院新生儿室发生腹泻流行,高峰期采集38例患儿的45份粪标本,ELISA法检测轮状病毒、腺病毒和星状病毒病原,RT-PCR法检测星状病毒核酸,其中13份星状病毒核酸阳性标本进行测序分析和进化树分析,4份星状病毒及病毒核酸均阳性的标本进行免疫电子显微镜观察.结果 45份粪标本中,轮状病毒、腺病毒病原检测均阴性.30份标本ELISA检测星状病毒病原阳性,阳性率为66.7%;31份标本星状病毒核酸阳性,阳性率为68.9%.采用星状病毒分型引物进行分型,均为星状病毒1型.选择13株与GenBank中星状病毒1型参考株进行比较,其核苷酸序列同源性为90.9%～96.3%.13株星状病毒1型株彼此间核苷酸序列同源性为94.7%～100.0%.随机选择的4份阳性标本,免疫电子显微镜下2份有大量星状病毒颗粒.结论 此起新生儿腹泻暴发由星状病毒1型引起.     

厦门地区病毒性腹泻诺如病毒感染状况

目的了解本地区病毒性腹泻患者诺如病毒感染情况,为进一步探索诺如病毒流行规律和防控对策提供依据。方法收集2007年4月至2008年7月3个监测哨点医院病毒性腹泻患者粪便标本共323份,应用ELISA方法检测粪便标本中病毒抗原,实时荧光逆转录聚合酶链反应法(Real-Time RT-PCR)分组别检测病毒核酸,部分病毒核酸阳性的标本扩增RdRp基因片段后测序验证病毒组别。结果323例患者粪便标本中,ELISA检测抗原阳性68例,阳性率21.05%;Real-Time RT-PCR检测核酸阳性107例,阳性率33.13%;诺如病毒检出率为38.08%。诺如病毒GGⅡ组占74.77%,少数为GGⅠ组(1.87%),尚有25份(23.36%)未定型。结论厦门地区存在诺如病毒流行,以GGⅡ组毒株流行为主,而且是病毒性腹泻的主要病原。     

病毒性腹泻

病毒性腹泻是由于病毒感染胃肠道引起的急性胃肠炎,是多发病和常见病。本病虽在三十年代就有临床报道,但其病因学研究始于七十年代,1972年Kapikian报道了引起小儿腹泻的Norwalk(诺瓦克)因子,1973年Bishop等人报道了从患急性腹泻的婴幼儿十二指肠中发现了轮状病毒(也称小儿腹泻轮状病毒)。此后相继发现了与腹泻有关的病毒,如星状病毒、杯状病毒、肠道腺病毒、小圆病     

2006-2011年成都市儿童医院病毒性腹泻监测分析

目的 了解成都市哨点医院儿童病毒性腹泻的4种主要病毒在儿童重症腹泻病例中的分布情况以及毒株变迁,为病毒性腹泻的预警预测和控制提供依据.方法 成都监测点(成都市儿童医院)监测对象为5岁以下腹泻的门诊和住院患儿,收集2006 - 2011年患儿的粪便标本进行轮状病毒检测和分型,对杯状病毒、星状病毒和肠道腺病毒进行病原PCR检测.结果 成都地区2006 -2011年5岁以下儿童病毒性腹泻监测结果,轮状病毒、杯状病毒、星状病毒和肠道腺病毒阳性率分别为33.84％、26.49％、1.62％、7.44％.结论 2006-2011年轮状病毒是成都地区婴幼儿腹泻的主要病源,提示有必要长期开展病毒监测,以评估不同病毒引起腹泻的疾病负担.     

2011年和2013年武汉市病毒性胃肠炎病原监测与分析

目的监测和分析2011年和2013年武汉市婴幼儿和成人病毒性胃肠炎病原。方法用聚丙烯酰胺凝胶电泳及RT-PCR对胃肠炎患者腹泻大便样本进行轮状病毒、诺如病毒、星状病毒以及札幌样病毒检测,部分样本测序并比对同源性。用PCR检测腺病毒。结果轮状病毒、诺如病毒、星状病毒、札幌样病毒检出率分别为21.6%(296/1 368)、35.7%(488/1 368)、10.2%(140/1 368)和7.7%(105/1 368);肠道腺病毒在儿童患者中的检出率为8.2%(70/853)。诺如病毒和轮状病毒易感人群为13~24月龄和7~24月龄儿童,及40~59岁成人。轮状病毒检出高峰在秋冬季。星状病毒、札幌样病毒和腺病毒多发于2岁以下的婴幼儿,无明显季节分布。196人份A组轮状病毒基因型以G9P[8]为主(40.8%),其次为G1P[8](26.5%),G3P[8](16.3%)和G2P[4](11.7%)。经测序比对诺如病毒基因型分别为GⅡ.4型(7/12),GⅡ.3型(5/12);星状病毒为1型(8/13),8型(4/13)和5型(1/13);札幌样病毒为GI.1型(2/6),GI 2型(2/6)和GⅡ.1型(2/6)。结论 2011年和2013年武汉市婴幼儿和成人胃肠炎主要病原是诺如病毒,其次是轮状病毒。     

Epidemiological profile of rotavirus infection in the Republic of Korea: results from prospective surveillance in the Jeongeub District, 1 July 2002 through 30 June 2004

To facilitate future decisions regarding the usefulness of rotavirus vaccines in the Republic of Korea, active surveillance was conducted in a network of clinics, emergency departments, and hospitals serving Jeongeub District, Korea. Children with diarrhea underwent standard clinical evaluations, and stool specimens were collected to test for the presence of rotavirus. Parents were interviewed to collect demographic and family information. From 1 July 2002 through 30 June 2004, a total of 4106 children, representing 1 (50%) of every 2 children <5 years old in the study population, were evaluated for rotavirus diarrhea. Of the 2232 stool specimens obtained throughout the year, 460 (20.6%) were rotavirus positive; however, the monthly prevalence of rotavirus infection peaked at 49.5% in February 2004. Of the 460 rotavirus-positive stool specimens, 366 were obtained from children who visited outpatient clinics, and 94 were obtained from children who were hospitalized. By extrapolating the proportion of rotavirus-positive patients to all children with diarrhea in the surveillance system, we calculate that 882 children in Jeongeub District had rotavirus infection (which would predict that there would be 702 associated clinic visits and 180 hospitalizations). Genotyping of rotavirus strains showed that 39% of strains were type G9P[8], 24% were type G1P[8], 17% were type G3P[8], and 13% were type G2P[4]. The incidence of rotavirus diarrhea peaked at age 13-24 months, and 94% of cases occurred during the first 3 years of life. The annual incidence of all rotavirus disease-associated outcomes was 56.9 cases/1000 children <5 years old (95% confidence interval [CI], 51.9-62.2 cases/1000 children <5 years old). The incidence of rotavirus disease-associated hospitalizations was 11.6 cases/1000 children <5 years old (95% CI, 9.5-14.2 cases/1000 children <5 years old). In Korea, diarrhea is common during childhood, and the incidence of diarrhea due to rotavirus infection suggests that improved programs for the prevention and control of both rotavirus diarrhea and diarrhea due to other causes are needed.     

Hospital-based surveillance for rotavirus diarrhea in children in Yangon, Myanmar

Diarrhea is a common childhood illness in Myanmar, and rotavirus is the single most important etiological agent of diarrhea. Surveillance for rotavirus diarrhea in children <5 years of age was conducted in a tertiary pediatric hospital in Yangon, Myanmar, from January 2002 through December 2003. Stool specimens obtained from children admitted to the hospital for acute diarrhea were tested for the presence of rotavirus by use of an enzyme-linked immunosorbent assay. Diarrhea was the cause of 5671 (18%) of all hospitalizations of children <5 years of age during the 2-year study period (n = 30,869). Rotavirus was identified in 923 (53%) of the 1736 stool specimens tested, and rotavirus infection was associated with approximately 10% of all hospitalizations of children. Rotavirus diarrhea most frequently occurred in children 6-17 months of age, and it was more commonly identified in boys (62% of children with rotavirus diarrhea were boys). The seasonal pattern of rotavirus disease mimicked that of diarrheal illness due to all causes, with the peak season for rotavirus disease occurring from November through February (i.e., during the cool, dry season). During the study period, 53 of the children who were hospitalized for diarrhea died. The present study confirms the importance of the etiological role that rotavirus plays in childhood diarrhea.     

河南省2008-2014年5岁以下腹泻儿童A组轮状病毒病原学及流行病学特征研究

目的 分析2008-2014年河南省5岁以下腹泻儿童A组轮状病毒的感染状况及流行病学特征。方法 采集河南省两个监测哨点医院5岁以下儿童腹泻病例的粪便样本2 098份,双抗体夹心法ELISA检测A组轮状病毒,阳性样本抽提病毒RNA,两步巢式多重RT-PCR进行G-P基因分型,同时收集病例临床与流行病学信息进行分析。结果 2 098份腹泻样本共检出A组轮状病毒688份,总阳性率32.8%。年检出率最高46.4%(2013年),最低26.7%(2009年)。轮状病毒检出率的季节性特征显著,存在秋季和春季两个高峰。A组轮状病毒型别组合以G9P^[8]、G2P^[4]、G3P^[8]、G1P^[8]为主,还存在部分混合感染型别。感染病例集中于4个月到1岁,以无临床症状或轻症为主。结论 河南省5岁以下腹泻患儿中存在较高的A组轮状病毒感染率,病原体可分为多种基因型别,感染人群具有显著的流行病学特征。     

Rotavirus and norovirus infections in children in Sana'a, Yemen

Objectives To describe the epidemiology of rotavirus and norovirus infection among children with acute gastroenteritis in Sana’a, Yemen. Methods A cross‐sectional study from November 2007 to March 2009 of children aged 1 month to 5 years attending the emergency and outpatient departments of two hospitals in Sana’a with acute gastroenteritis. Rotavirus was detected by ELISA and genotyped by RT‐PCR. Norovirus was detected by End Point RT‐PCR and nucleotide sequencing. Results A total of 290 children (48% in the emergency department and 52% in the outpatient department of the children respectively) were enrolled. Rotavirus infections were detected in 78 (27%) and norovirus infections in 30 (10%). Rotavirus genotypes included G1P[8] (55%), G9P[8] (21%) and G2P[4] (12%) with G12 comprising 3% of strain types. The main norovirus genotype was GII.4 (27%) with >10 other genotypes detected. Conclusions Rotavirus and norovirus infections are common causes of gastroenteritis in Yemen. Rotavirus vaccines could play a significant role in the control of acute childhood diarrhoea in this setting.     

A Prospective Hospital-based Surveillance to Estimate Rotavirus Disease Burden in Bhutanese Children under 5 Years of Age

As part of efforts to develop an informed policy for rotavirus vaccination, this prospective study was conducted to estimate the burden of rotavirus diarrhea among children less than 5 years old attended to the Department of Pediatrics, Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), Thimphu, Bhutan. The duration of the study was three years, extending from February 2010 through December 2012. We estimated the frequency of hospitalization in the pediatric ward and dehydration treatment unit (DTU) for diarrhea and the number of events attributable to rotavirus infection among children under 5 years of age. During the study period, a total of 284 children (1 in 45) were hospitalized in the pediatric ward, and 2,220 (1 in 6) in the DTU with diarrhea among children residing in the Thimphu district. Group A rotavirus was detected in 32.5% and 18.8% of the stool samples from children hospitalized in the pediatric ward, respectively. Overall, 22.3% of the stool samples were rotavirus-positive, and the majority (90.8%) of them was detected in children under 2 years of age. From this study, we estimated that the annual incidence of hospitalization in the pediatric ward and DTU due to rotavirus diarrhea was 2.4/1000 (95% CI 1.7–3.4) and 10.8/1000 (95% CI 9.1–12.7) children, respectively. This study revealed that rotavirus is a major cause of diarrhea in Bhutanese children in Thimphu district and since no study has been performed previously, represents an important finding for policy discussions regarding the adoption of a rotavirus vaccine in Bhutan.     

Protective immunity after natural rotavirus infection: a community cohort study of newborn children in Guinea-Bissau,west Africa

To study the natural history of rotavirus infection and to determine the protection it confers against reinfection and diarrhea, 200 newborns in Guinea-Bissau were prospectively followed for up to 2 years. Rotavirus was detected in stool specimens collected weekly. By age 2 years, the incidence of primary rotavirus infection was 74%. In the first 3 months of life, 17% of the infections were diarrhea associated, compared with 60% at 9-11 months; after age 18 months, all infections were asymptomatic. A primary infection conferred 52% (95% confidence interval [CI], 16% to 73%) and 70% (95% CI, 29% to 87%) protection against subsequent rotavirus infection and rotavirus diarrhea, respectively. The protection was 66% (95% CI, 24% to 85%) against reinfection within the same epidemic, compared with 34% (95% CI, -29% to 67%) against reinfection in any subsequent epidemic. The high level of protection against symptomatic rotavirus infection provides an important incentive for development of a rotavirus vaccine.     

Incidence of severe rotavirus diarrhea in New Delhi, India, and G and P types of the infecting rotavirus strains

A total of 62,475 children <5 years old from a defined population of approximately 500,000 children and adults from slums in New Delhi, India, were assessed for 1 year by means of passive surveillance, to identify children who were hospitalized for diarrhea. The incidence of severe rotavirus diarrhea was estimated, and the G and P types of the infecting rotavirus strains were determined and were correlated with the clinical severity of diarrhea. Of 584 children who were hospitalized with diarrhea, 137 (23.5%) had rotavirus detected in stool specimens (incidence of rotavirus diarrhea-associated hospitalizations, 337 hospitalizations/100,000 children <5 years of age). Most cases of diarrhea (98%) occurred during the first 2 years of life, peaking at 9-11 months of age. Rotavirus-associated diarrhea occurred year-round but was predominant in winter. Among the strains that could be G-typed, G1 was the most common serotype, followed by G9 and G2; 10% of cases of diarrhea were due to mixed G-type infections. Common strains identified in the present surveillance study were P[8]G1, P[4]G2, P[8]G9, P[6]G1, P[6]G9, and P[6]G3. Children infected with G1 strains had a greater risk of developing more-severe cases of diarrhea than did children infected with other rotavirus strains (odds ratio, 2.95; 95% confidence interval, 1.3-6.67).     

上海地区婴幼儿院内感染轮状病毒致腹泻病的分子流行病学调查

目的 了解上海地区婴幼儿院内感染轮状病毒(RV)致腹泻病的分子流行病学特征.方法 采用胶体金法和套式PCR,对2006年11月至2008年1月复旦大学附属儿科医院收集的226例院内感染性腹泻患儿的粪便标本进行RV病原检测,并对阳性标本进行分型,调查患儿的临床特征.数据分析分别以构成比、阳性榆出率表示,均值采用t检验.结果 胶体会法RV阳性率为47.8%.院内感染RV腹泻以1岁以内的年龄段最高,新生儿占RV腹泻患儿的32.4%.发病高峰在10、11月份.采用套式-PCR对除新生儿外的67份RV阳性标本进行分型,G3为主要流行的血清型,占46.3%,其次为G1占23.9%、G2占3.0%、G9占1.5%,7份为混合感染,均为G1、G3混合,10份未能分型.从P分型来看,主要流行株为P[8]型,占90.0%,其次为P[4]型占6.0%,3份标本未能分型.未发现P[6]、PE9]和P[10]型.G3P[8]为主要分离株,占61.2%,其次为G1P[8],占17.9%,G1、G3P[8]混合感染占9.5%,G2P[4]、G8P[9]各1例.新生儿32份RV阳件标本中10份成功分型,均为G1P[8].院内感染RV腹泻延长住院天数、增加住院费用.结论 RV是上海地区院内感染性腹泻病的主要病原,其流行的主要血清型为G3P[8]型,但仍需加强监测G1流行株的暴发流行.