Bereciartu Alesio, Bok Karin, Gómez Jorge
Viral Gastroenteritis Laboratory, National Institute of Infectious Diseases, ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina.
J Clin Virol. 2002 Aug;25(2):197-203. doi: 10.1016/s1386-6532(02)00010-0.
Gastroenteritis is one of the most common diseases affecting children and rotavirus is the major etiological agent worldwide. Although the role of rotaviruses as a causal agent of gastroenteritis has been previously established in Argentina, little is known about the frequency of other gastrointestinal viruses.
The present study was designed to determine the frequency of calicivirus in comparison with rotavirus, astrovirus and adenovirus type 40/41 in our country.
Sixty six diarrhea patients (10%) =3 years of age, were randomly selected from a previous series (9/1997-8/1998) and virus frequency determined using RT-PCR and/or commercial EIAs. In addition, we sequenced the RNA polymerase region of calicivirus-positive samples to characterize Argentine strains.
We detected at least one viral agent in 48.5% (32/66) of the patients. Rotavirus, calicivirus, astrovirus, and enteric adenovirus were found in 17, 16, 5, and 2 children, respectively. Sequence analysis of 4 calicivirus positive samples allowed us to identify a strain clustered to Lorsdale virus, one strain clustered with Manchester virus and two strains clustered with London/92 virus.
Our data suggest that calicivirus and rotavirus are major agents of gastroenteritis in children younger than 3 years of age in Buenos Aires, Argentina. Unfortunately, viral diagnosis is seldom available in Argentine hospitals and coproculture results are mostly negative. Our data supports the need to develop rapid and sensitive tests for calicivirus diagnosis. The introduction of affordable viral diagnosis in our pediatric hospitals will improve patient care by reducing the unnecessary use of antibiotics.
胃肠炎是影响儿童的最常见疾病之一,轮状病毒是全球主要的病原体。尽管轮状病毒作为胃肠炎病原体的作用此前已在阿根廷得到证实,但对于其他胃肠道病毒的感染频率知之甚少。
本研究旨在确定我国杯状病毒与轮状病毒、星状病毒及40/41型腺病毒相比的感染频率。
从先前的一组病例(1997年9月至1998年8月)中随机选取66例3岁以下腹泻患者(占10%),采用逆转录聚合酶链反应(RT-PCR)和/或商业酶免疫分析(EIA)测定病毒感染频率。此外,我们对杯状病毒阳性样本的RNA聚合酶区域进行测序,以鉴定阿根廷毒株。
我们在48.5%(32/66)的患者中检测到至少一种病毒病原体。分别在17例、16例、5例和2例儿童中发现了轮状病毒、杯状病毒、星状病毒和肠道腺病毒。对4份杯状病毒阳性样本的序列分析使我们能够鉴定出一株与洛兹代尔病毒聚类的毒株、一株与曼彻斯特病毒聚类的毒株以及两株与伦敦/92病毒聚类的毒株。
我们的数据表明,杯状病毒和轮状病毒是阿根廷布宜诺斯艾利斯3岁以下儿童胃肠炎的主要病原体。不幸的是,阿根廷医院很少能进行病毒诊断,粪便培养结果大多为阴性。我们的数据支持开发快速、灵敏的杯状病毒诊断检测方法的必要性。在我们的儿科医院引入价格可承受的病毒诊断方法将通过减少抗生素的不必要使用来改善患者护理。