[2013年浙江省病毒性脑膜脑炎的病因及分子流行病学特征]

[Etiology and molecular-epidemiological characteristics of viral meningoencephalitis of Zhejiang province in 2013].

作者信息

Yan Juying, Miao Ziping, Lyu Huakun, Zhou Jiayue, Gong Liming, Mao Haiyan, Sun Yi, Zhang Yanjun

机构信息

Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.

Department of Infectious Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; Email:

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Mar;36(3):280-4.

PMID:25975409

Abstract

OBJECTIVE

To investigate pathogens and molecular-epidemiology characteristics of viral meningoencephalitis in the monitoring sites of Zhejiang province, 2013.

METHODS

Cerebrospinal fluid and/or stool specimens were collected from suspected patients admitted to the monitoring hospitals in southern and northern Zhejiang province. Such specimen were subject to real-time qPCR for the detection of Human enterovirus (HEV), Japanese encephalitis virus (JEV), Mumps virus (MuV), Herpes simplex virus (HSV) and Cytomegalovirus (CMV). HEVs were isolated using the RD and Hep-2 cell lines, while VP1 genes from all HEV-positive isolates or RNA-positive specimen were amplified, sequenced, for homology and evolution analysis.

RESULTS

92 (38.5%) of the 239 samples collected from 229 patients were detected as virus nucleic acid positive, including 87 HEV positive samples, 1 MuV positive, 2 HSV positive, and 2 CMV positive; of the 87 HEV positive samples, 38 were further determined to be Coxsackievirus (CV) and 49 as Echovirus (E). 56 HEV strains were isolated from 239 (23.4%) samples. From the 31 cerebral fluid specimen of nucleic acid positive yet virus isolation negative, the most specimen were identified with E9 (9 specimen), followed by CVA9 (8 specimen); the viral serotype of Zhejiang province HEV were CVA9, CVB4, CVB5, E6, E7, E9, E11, E14, E16, E25 and E30, respectively. Predominant epidemic strains identified at southern and northern Zhejiang province were CVB5 and E6 respectively. The phylogenetic analysis of VP1 gene showed that all the HEV isolates in Zhejiang province were HEV-B.

CONCLUSION

The HEV-B was the main pathogen for viral meningoencephalitis in Zhejiang province in 2013, including 11 serotypes, while E7 was the first time to be isolated in Zhejiang province. The predominant isolates were CVB5 and E6 in southern and northern Zhejiang province respectively. The positive rate of viral nucleic acid detection was significantly higher than that of viral isolation. Regular EV isolation method was exposed to the risk of missing-detection of E9 and CVA9.

摘要

目的

调查2013年浙江省监测点病毒性脑膜脑炎的病原体及分子流行病学特征。

方法

采集浙南和浙北监测医院收治的疑似患者的脑脊液和/或粪便标本。对这些标本进行实时定量聚合酶链反应，以检测人肠道病毒（HEV）、日本脑炎病毒（JEV）、腮腺炎病毒（MuV）、单纯疱疹病毒（HSV）和巨细胞病毒（CMV）。使用RD和Hep-2细胞系分离HEV，对所有HEV阳性分离株或RNA阳性标本的VP1基因进行扩增、测序，进行同源性和进化分析。

结果

从229例患者采集的239份样本中，92份（38.5%）检测为病毒核酸阳性，其中HEV阳性样本87份、MuV阳性1份、HSV阳性2份、CMV阳性2份；87份HEV阳性样本中，进一步确定38份为柯萨奇病毒（CV），49份为埃可病毒（E）。从239份样本（23.4%）中分离出56株HEV。在31份核酸阳性但病毒分离阴性的脑脊液标本中，以E9型最多（9份），其次为CVA9型（8份）；浙江省HEV病毒血清型分别为CVA9、CVB4、CVB5、E6、E7、E9、E11、E14、E16、E25和E30。浙南和浙北地区主要流行株分别为CVB5和E6。VP1基因系统进化分析显示，浙江省所有HEV分离株均为HEV-B型。