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轮状病毒疫苗引入韩国5年后轮状病毒基因型的检测

Detection of Rotavirus Genotypes in Korea 5 Years after the Introduction of Rotavirus Vaccines.

作者信息

Chung Ju-Young, Kim Min-Sung, Jung Tae Woong, Kim Seong Joon, Kang Jin-Han, Han Seung Beom, Kim Sang Yong, Rhim Jung Woo, Kim Hwang-Min, Park Jae Hong, Jo Dae Sun, Ma Sang Hyuk, Jeong Hye-Sook, Cheon Doo-Sung, Kim Jong-Hyun

机构信息

Department of Pediatrics, Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea.

Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.

出版信息

J Korean Med Sci. 2015 Oct;30(10):1471-5. doi: 10.3346/jkms.2015.30.10.1471. Epub 2015 Sep 12.

Abstract

Rotavirus (RV) is one of the most important viral etiologic agents of acute gastroenteritis (AGE) in children. Although effective RV vaccines (RVVs) are now used worldwide, novel genotypes and outbreaks resulting from rare genotype combinations have emerged. This study documented RV genotypes in a Korean population of children with AGE 5 yr after the introduction of RVV and assessed potential genotype differences based on vaccination status or vaccine type. Children less than 5-yr-old diagnosed with AGE between October 2012 and September 2013 admitted to 9 medical institutions from 8 provinces in Korea were prospectively enrolled. Stool samples were tested for RV by enzyme immunoassay and genotyped by multiplex reverse-transcription polymerase chain reaction. In 346 patients, 114 (32.9%) were RV-positive. Among them, 87 (76.3%) patients were infected with RV alone. Eighty-six of 114 RV-positive stool samples were successfully genotyped, and their combinations of genotypes were G1P[8] (36, 41.9%), G2P[4] (12, 14.0%), and G3P[8] (6, 7.0%). RV was detected in 27.8% of patients in the vaccinated group and 39.8% in the unvaccinated group (P=0.035). Vaccination history was available for 67 of 86 cases with successfully genotyped RV-positive stool samples; RotaTeq (20, 29.9%), Rotarix (7, 10.4%), unvaccinated (40, 59.7%). The incidence of RV AGE is lower in the RV-vaccinated group compared to the unvaccinated group with no evidence of substitution with unusual genotype combinations.

摘要

轮状病毒(RV)是导致儿童急性胃肠炎(AGE)的最重要病毒病原体之一。尽管有效的RV疫苗(RVV)目前已在全球范围内使用,但新的基因型以及由罕见基因型组合导致的疫情仍有出现。本研究记录了在引入RVV 5年后韩国AGE儿童群体中的RV基因型,并根据疫苗接种状况或疫苗类型评估了潜在的基因型差异。前瞻性纳入了2012年10月至2013年9月期间韩国8个省份9家医疗机构收治的5岁以下诊断为AGE的儿童。通过酶免疫测定法检测粪便样本中的RV,并通过多重逆转录聚合酶链反应进行基因分型。在346例患者中,114例(32.9%)为RV阳性。其中,87例(76.3%)患者仅感染了RV。114份RV阳性粪便样本中的86份成功进行了基因分型,其基因型组合为G1P[8](36份,41.9%)、G2P[4](12份,14.0%)和G3P[8](6份,7.0%)。接种疫苗组患者中RV检出率为27.8%,未接种疫苗组为39.8%(P = 0.035)。86例成功进行基因分型的RV阳性粪便样本中有67例有疫苗接种史;RotaTeq(20例,29.9%)、Rotarix(7例,10.4%)、未接种疫苗(40例,59.7%)。与未接种疫苗组相比,RV疫苗接种组中RV AGE的发病率较低,且没有证据表明出现了不寻常基因型组合的替代情况。

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