Altay Aylin, Bozdayı Gülendam, Meral Melda, Dallar Bilge Yıldız, Dalgıç Buket, Ozkan Seçil, Ahmed Kamruddin
Gazi University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
Mikrobiyol Bul. 2013 Jan;47(1):98-108. doi: 10.5578/mb.4082.
Norovirus causes severe gastroenteritis requiring hospitalization especially in children less than five years of age both in developed and developing countries. Therefore, we aimed to investigate the incidence of norovirus (NoV) in 0-5 years old children with acute gastroenteritis in two large hospitals in Ankara, Turkey. Stool samples were obtained from 1000 (413 female, 587 male) children between 0-5 years old with acute gastroenteritis who attended to the Department of Paediatrics, Ministry of Health Ankara Training and Education Hospital and affiliated hospital of Gazi University Faculty of Medicine between October 2004 and June 2011. Antigens of norovirus GI and GII genogroups in the stool specimens were detected by ELISA (RIDASCREEN® Norovirus (C1401) 3rd Generation, R-Biopharm, Germany). Norovirus GI and GII antigens were determined in a total of 141 (14.1%) samples, of them 62 (15%) were female and 79 (13.5%) were male, yielding no statistically significant difference (p> 0.05). The highest NoV positivity was detected in children between 12-23 months (17.1%), however there was no statistically significant difference between ELISA positivity and age (p> 0.05). NoV detection rate was highest in 2007 (18.4%) and in 2009 (18%), and the difference regarding ELISA positivity among the study years was not statistically significant (p> 0.05). The prevalences of norovirus infection in spring, summer, autumn and winter were 13.8%, 17.7%, 14.7% and 11.2%, respectively. Therefore no seasonal variation was found in the incidence of norovirus infection. However when the monthly prevalence was analyzed, a statistically significant difference was found (p< 0.05) between the rate of norovirus infection in july (24.2%) and december (4.1%). When evaluating the clinical symptoms, all of 141 patients (100%) had diarrhoea, while 72 (51.1%) had vomiting. Stool samples were also evaluated for the presence of parasitic and bacterial agents. Coinfection rate with parasites was detected as 3.3% (4/122; norovirus + Entamoeba histolytica in three cases, norovirus + Enterobius vermicularis in one case), while no pathogenic bacteria were isolated from norovirus positive stool samples. The prevalence rate of 14.1% for NoV GI/GII infection detected in this retrospective study including 0-5 years old children in Ankara for 2004-2011 period was thought to reflect the regional data and would contribute to national epidemiological data. We anticipate that the incidence of norovirus will increase in 0-5 year old children as a result of increasing use of rotavirus vaccine in Turkish children. It was concluded that, NoV antigen detection tests should be used in routine laboratories for appropriate diagnosis of sporadic and/or epidemic norovirus infections.
在发达国家和发展中国家，诺如病毒都会引发严重的肠胃炎，这类肠胃炎患者尤其是五岁以下儿童需要住院治疗。因此，我们旨在调查土耳其安卡拉两家大型医院中0至5岁急性肠胃炎患儿的诺如病毒（NoV）感染率。2004年10月至2011年6月期间，从安卡拉卫生培训与教育医院儿科以及加齐大学医学院附属医院就诊的1000名（413名女性，587名男性）0至5岁急性肠胃炎患儿中采集粪便样本。采用酶联免疫吸附测定法（RIDASCREEN®诺如病毒（C1401）第三代，德国R - 生物制药公司）检测粪便标本中诺如病毒GI和GII基因群的抗原。诺如病毒GI和GII抗原在总共141份（14.1%）样本中被检测到，其中62份（15%）为女性样本，79份（13.5%）为男性样本，差异无统计学意义（p>0.05）。12至23个月大的儿童中诺如病毒阳性率最高（17.1%），然而酶联免疫吸附测定法阳性率与年龄之间无统计学差异（p>0.05）。2007年（18.4%）和2009年（18%）的诺如病毒检测率最高，各研究年份之间酶联免疫吸附测定法阳性率的差异无统计学意义（p>0.05）。诺如病毒感染在春季、夏季、秋季和冬季的患病率分别为13.8%、17.7%、14.7%和11.2%。因此，未发现诺如病毒感染率存在季节性变化。然而，分析月度患病率时，发现7月（24.2%）和12月（4.1%）的诺如病毒感染率存在统计学显著差异（p<0.05）。评估临床症状时，141例患者（100%）均有腹泻，72例（51.1%）有呕吐。还对粪便样本进行了寄生虫和细菌病原体检测。寄生虫合并感染率为3.3%（4/122；3例为诺如病毒 + 溶组织内阿米巴，1例为诺如病毒 + 蠕形住肠线虫），而诺如病毒阳性粪便样本中未分离出致病细菌。这项回顾性研究涵盖了2004 - 2011年安卡拉0至5岁儿童，其中诺如病毒GI/GII感染患病率为14.1%，被认为反映了该地区的数据情况，将有助于完善国家流行病学数据。我们预计，由于土耳其儿童轮状病毒疫苗使用量增加，0至5岁儿童诺如病毒感染率将会上升。研究得出结论，常规实验室应采用诺如病毒抗原检测试验，以准确诊断散发性和/或流行性诺如病毒感染。
