五岁以下住院儿童中星状病毒相关性肠胃炎的特征分析
Characterization of astrovirus-associated gastroenteritis in hospitalized children under five years of age.
作者信息
Zaraket Hassan, Abou-El-Hassan Hadi, Kreidieh Khalil, Soudani Nadia, Ali Zainab, Hammadi Moza, Reslan Lina, Ghanem Soha, Hajar Farah, Inati Adlette, Rajab Mariam, Fakhouri Hassan, Ghanem Bassam, Baasiri Ghassan, Melhem Nada M, Dbaibo Ghassan
机构信息
Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon.
Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107-2020, Beirut, Lebanon.
出版信息
Infect Genet Evol. 2017 Sep;53:94-99. doi: 10.1016/j.meegid.2017.05.016. Epub 2017 May 20.
PURPOSE
The aim of this study was to determine the incidence and genetic diversity of astrovirus (AstV) detected in children hospitalized for gastroenteritis (GE).
METHODS
A multi-center, hospital-based surveillance study was conducted across Lebanon to investigate the incidence of AstV among diarrheal hospitalizations. Viral RNA was extracted from stool samples collected between 2011 and 2013 from children, below the age of 5years, hospitalized for GE at six medical centers across Lebanon. Demographic and clinical data were collected and analyzed. RNA of eligible samples (n=739) was screened by two AstV-specific PCR assays followed by genotype-specific PCR. Sanger sequencing and phylogenetic analysis were performed for genotypic characterization.
RESULTS
Overall, 5.5% (41/739) of rotavirus-negative stool samples collected from hospitalized children <5years old tested positive for AstV infection. AstV infections were detected all year long. Diarrhea, dehydration, vomiting and fever were the most common symptoms associated with AstV infections. Children aged 48-59months had the highest incidence of AstV. Using the Vesikari Scoring System to assess clinical severity, 85.4% of children with AstV had a score>11, indicating severe GE. Genotype-specific PCR identified 22 classical and 4 MLB-like AstV specimens. Further sequencing and phylogenetic analysis of orf1b and orf2 genes revealed that AstV classical 1-3, 5, 6, and 8, MLB-1, VA-1 and -2 genotypes circulated in Lebanon. Recombination between classical AstV strains was detected in several cases as evident by the lack of congruency in the tree topologies of the orf1b and orf2. Two cases of mixed infections between classical and non-classical genotypic strains were recorded.
CONCLUSION
High genetic diversity was detected among AstVs in Lebanon. AstVs are associated with 5.5% of non-rotavirus GE-associated hospitalizations in children under five years in Lebanon.
目的
本研究旨在确定因肠胃炎（GE）住院的儿童中星状病毒（AstV）的感染率及基因多样性。
方法
在黎巴嫩开展了一项基于医院的多中心监测研究，以调查腹泻住院患者中AstV的感染率。从2011年至2013年期间在黎巴嫩六个医疗中心因GE住院的5岁以下儿童的粪便样本中提取病毒RNA。收集并分析人口统计学和临床数据。通过两种AstV特异性PCR检测方法对符合条件的样本（n = 739）的RNA进行筛查，随后进行基因型特异性PCR。进行桑格测序和系统发育分析以进行基因型鉴定。
结果
总体而言，从5岁以下住院儿童中收集的轮状病毒阴性粪便样本中有5.5%（41/739）检测出AstV感染呈阳性。全年均检测到AstV感染。腹泻、脱水、呕吐和发烧是与AstV感染相关的最常见症状。48 - 59个月大的儿童AstV感染率最高。使用韦西卡里评分系统评估临床严重程度，85.4%的AstV感染儿童评分>11，表明患有严重GE。基因型特异性PCR鉴定出22个经典型和4个MLB样AstV样本。对orf1b和orf2基因进行进一步测序和系统发育分析表明，AstV经典型1 - 3、5、6和8、MLB - 1、VA - 1和 - 2基因型在黎巴嫩流行。在几例病例中检测到经典AstV菌株之间的重组，orf1b和orf2的树形拓扑结构缺乏一致性即明显表明了这一点。记录到两例经典型和非经典型基因型菌株混合感染的病例。
结论
在黎巴嫩检测到AstV具有高度的基因多样性。在黎巴嫩，AstV与5岁以下儿童中5.5%的非轮状病毒GE相关住院病例有关。
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