Melhem Nada M, Zaraket Hassan, Kreidieh Khalil, Ali Zeinab, Hammadi Moza, Ghanem Soha, Hajar Farah, Haidar Amjad, Inati Adlette, Rajab Mariam, Fakhouri Hassan, Ghanem Bassam, Baasiri Ghassan, Dbaibo Ghassan
Nada M Melhem, Hassan Zaraket, Zeinab Ali, Moza Hammadi, Soha Ghanem, Farah Hajar, Amjad Haidar, Ghassan Dbaibo, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut 1107-2020, Lebanon.
World J Gastroenterol. 2016 Dec 28;22(48):10557-10565. doi: 10.3748/wjg.v22.i48.10557.
To assess the burden of norovirus (NoV) and to determine the diversity of circulating strains among hospitalized children in Lebanon.
Stool samples were collected from children presenting with acute gastroenteritis to six major hospitals in Lebanon. A total of 739 eligible stool samples, testing negative for diarrhea caused by rotavirus as a possible viral pathogen, were collected between January 2011 and June 2013. A standardized questionnaire including demographic, epidemiological and clinical observations was used at the time of hospitalization of children presenting with diarrhea. Viral RNA was extracted from stool samples followed by reverse transcription polymerase chain reaction and nucleotide sequencing of a fragment of the viral protein 1 capsid gene. Multiple sequence alignments were carried out and phylogenetic trees were constructed using the MEGA 6 software.
Overall, 11.2% of stool samples collected from children aged < 5 years tested positive for NoV genogroups I (GI) and II (GII). GII accounted for 10.6% of the gastroenteritis cases with only five samples being positive for GI (0.7%). The majority of hospitalized children showed symptoms of diarrhea, dehydration, vomiting and fever. Upon sequencing of positive samples and based on their clustering in the phylogenetic tree, 4/5 of GI gastroenteritis cases were designated GI.3 and one case as GI.4. GII.4 was predominantly detected in stool of our study participants (68%). We report a JB-15/KOR/2008 GII.4 Apeldoorn 2008-like variant strain circulating in 2011; this strain was replaced between 2012 and 2013 by a variant sharing homology with the Sydney/NSW0514/2012/AUS GII.4 Sydney 2012 and Sydney 2012/FRA GII.4 strains. We also report the co-circulation of non-GII.4 genotypes among hospitalized children. Our data show that NoV gastroenteritis can occur throughout the year with the highest number of cases detected during the hot months.
The majority of NoV-associated viral gastroenteritis cases among our participants are attributable to GII.4, which is compatible with results reported worldwide.
评估黎巴嫩住院儿童中诺如病毒（NoV）的负担，并确定流行毒株的多样性。
从黎巴嫩六家主要医院患有急性肠胃炎的儿童中收集粪便样本。在2011年1月至2013年6月期间，共收集了739份符合条件的粪便样本，这些样本作为可能的病毒病原体检测轮状病毒引起的腹泻呈阴性。在腹泻儿童住院时使用标准化问卷，包括人口统计学、流行病学和临床观察。从粪便样本中提取病毒RNA，然后进行逆转录聚合酶链反应和病毒蛋白1衣壳基因片段的核苷酸测序。使用MEGA 6软件进行多序列比对并构建系统发育树。
总体而言，从＜5岁儿童中收集的粪便样本中有11.2%检测诺如病毒基因组I（GI）和II（GII）呈阳性。GII占肠胃炎病例的10.6%，只有5份样本GI呈阳性（0.7%）。大多数住院儿童表现出腹泻、脱水、呕吐和发热症状。对阳性样本进行测序并基于它们在系统发育树中的聚类，4/5的GI肠胃炎病例被指定为GI.3，1例为GI.4。GII.4在我们研究参与者的粪便中占主导地位（68%）。我们报告了2011年一种类似JB-15/KOR/2008 GII.4阿珀尔多伦2008的变异株在传播；该毒株在2012年至2013年期间被一种与悉尼/新南威尔士州0514/2012/澳大利亚GII.4悉尼2012和悉尼2012/法国GII.4毒株具有同源性的变异株所取代。我们还报告了住院儿童中非GII.4基因型的共同传播。我们的数据表明，诺如病毒肠胃炎全年均可发生，炎热月份检测到的病例数最多。
我们研究参与者中大多数与诺如病毒相关的病毒性肠胃炎病例归因于GII.4，这与全球报告的结果一致。
