State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Center of Clinical Laboratory, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Pediatr Infect Dis J. 2013 Jul;32(7):e285-90. doi: 10.1097/INF.0b013e31828c3de4.
Acute diarrhea is a leading cause of childhood morbidity and mortality worldwide, but there have been few reports on the causative viruses associated with acute diarrhea among outpatient children in developing countries. This study was conducted to identify the viral agents in outpatient children with acute diarrhea in southeastern China.
Eight hundred eleven outpatient children 5 years or younger with acute diarrhea were enrolled. Five enteric viruses were determined by enzyme-linked immunosorbent assay and multiplex reverse transcription-polymerase chain reaction for each stool specimen.
At least 1 virus was detected in 353 (43.5%) of the subjects. The proportions of rotavirus, norovirus, sapovirus, adenovirus and astrovirus were 25.5%, 18.1%, 4.4%, 2.7% and 1.2%, respectively. G3P[8] was the most prevalent rotavirus strain. Mixed infections were observed in 65 cases, among which the most prevalent coinfection was rotavirus with other viruses (58 cases, 89.2%). Rotavirus and norovirus infections showed marked and opposing seasonal patterns. Mixed infection was significantly more common in children older than 1 year (12.2%) than in those younger than 1 year (7.1%) (P = 0.026). Clinically, rotavirus infection presented with a longer duration (4.3 ± 6.7 days) and higher frequency (5.9 ± 2.0 times/d) of diarrhea than any other viral infection. Vomiting was more common for mixed infections than for single infections (P = 0.010).
All the 5 common etiologies were detected in this study, with rotavirus and norovirus being the 2 leading agents. Mixed viral infections were common in outpatient children with acute diarrhea, and rotavirus seemed to play a major role in mixed infections.
急性腹泻是全世界导致儿童发病和死亡的主要原因，但发展中国家的门诊儿童急性腹泻相关病原体的研究报告较少。本研究旨在明确中国东南部门诊儿童急性腹泻的病毒病因。
共纳入 811 例 5 岁及以下急性腹泻门诊患儿，采用酶联免疫吸附试验和多重反转录聚合酶链反应检测每份粪便标本中的 5 种肠道病毒。
至少有 1 种病毒在 353 例（43.5%）患儿中被检出。轮状病毒、诺如病毒、星状病毒、腺病毒和肠道病毒的检出率分别为 25.5%、18.1%、4.4%、2.7%和 1.2%。G3P[8]是最常见的轮状病毒株。共发现 65 例混合感染，其中最常见的是轮状病毒与其他病毒的混合感染（58 例，89.2%）。轮状病毒和诺如病毒感染呈明显的相反季节性。1 岁以上患儿混合感染明显多于 1 岁以下患儿（12.2%比 7.1%，P=0.026）。临床方面，轮状病毒感染腹泻持续时间更长（4.3±6.7 天），腹泻频次更高（5.9±2.0 次/d）。混合感染较单一感染更易发生呕吐（P=0.010）。
本研究发现了所有 5 种常见病原体，其中轮状病毒和诺如病毒是主要病原体。门诊儿童急性腹泻中混合病毒感染较常见，轮状病毒似乎在混合感染中起主要作用。
