Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Emerg Infect Dis. 2011 Aug;17(8):1381-8. doi: 10.3201/eid1708.101533.
Approximately 179 million cases of acute gastroenteritis (AGE) occur annually in the United States. However, lack of routine clinical testing for viruses limits understanding of their role among persons seeking medical care. Fecal specimens submitted for routine bacterial culture through a health maintenance organization in Georgia, USA, were tested with molecular diagnostic assays for norovirus, rotavirus, astrovirus, sapovirus, and adenovirus. Incidence was estimated by using national health care utilization rates. Routine clinical diagnostics identified a pathogen in 42 (7.3%) of 572 specimens; inclusion of molecular viral testing increased pathogen detection to 15.7%. Community AGE incidence was 41,000 cases/100,000 person-years and outpatient incidence was 5,400/100,000 person-years. Norovirus was the most common pathogen, accounting for 6,500 (16%) and 640 (12%) per 100,000 person-years of community and outpatient AGE episodes, respectively. This study demonstrates that noroviruses are leading causes of AGE among persons seeking medical care.
据估计，每年在美国有 1.79 亿例急性肠胃炎（AGE）病例发生。然而，由于对病毒缺乏常规的临床检测，限制了人们对其在寻求医疗服务人群中作用的了解。在美国佐治亚州的一家健康维护组织，通过常规细菌培养提交的粪便标本，用分子诊断检测试剂盒进行了诺如病毒、轮状病毒、星状病毒、肠腺病毒的检测。通过使用国家卫生保健利用率来估计发病率。常规临床诊断在 572 个标本中的 42 个（7.3%）中确定了病原体；包括分子病毒检测将病原体检测率提高到了 15.7%。社区 AGE 的发病率为 41000 例/10 万人年，门诊发病率为 5400 例/10 万人年。诺如病毒是最常见的病原体，分别占社区和门诊 AGE 发作每 10 万人年 6500 例（16%）和 640 例（12%）。本研究表明，诺如病毒是寻求医疗服务人群中 AGE 的主要原因。
