Saint Paul's Hospital, Taoyuan, Taiwan.
Division of Pediatric Gastroenterology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Formos Med Assoc. 2018 Aug;117(8):720-726. doi: 10.1016/j.jfma.2017.09.009. Epub 2017 Oct 12.
BACKGROUND/PURPOSE: Rotavirus vaccines were launched in Taiwan since early 2006. Our study was aimed to figure out long-term extended molecular epidemiology in acute gastroenteritis (AGE) in hospitalized young children after rotavirus vaccination in Taiwan.
During the 10-year period from January 2007 to December 2016, fecal samples from children under 5 years old with AGE hospitalized in Chang Gung Children's Hospital (CGCH) were examined for enteric pathogens and they were divided into two time intervals: early post-vaccine (Jan. 2007 to Dec. 2011; EPV) and late post-vaccine (Jan. 2012 to Dec. 2016; LPV).
In total, 837 patients with AGE were enrolled with complete study. In the EPV period, 106 (26.7%) rotavirus and 65 (16.4%) norovirus infections were identified as major pathogens. In the LPV period, 79 (17.9%) rotavirus and 98 (22.2%) norovirus infections were diagnosed. Statistical analyses showed a significantly decreased prevalence of rotavirus infection (P = 0.002) and a significantly increased prevalence of norovirus (P = 0.034) and enteric bacterial infections (P < 0.001). A substantial decrease of rotavirus G1 (P = 0.079) in the LPV period and norovirus GII.4 prevailed through the decade.
In Taiwan, under a suboptimal rotavirus vaccination policy, there was a marked decrease in the rate of rotavirus AGE of hospitalized young children. Significantly increased norovirus infection has replaced rotavirus as the leading cause. Expansion of rotavirus vaccine coverage, development of a norovirus prevention strategy, and sustained bacterial infection control are important for AGE containment in children in Taiwan.
背景/目的：台湾自 2006 年初开始使用轮状病毒疫苗。本研究旨在探讨台湾轮状病毒疫苗接种后住院幼儿急性肠胃炎（AGE）的长期扩展分子流行病学。
在 2007 年 1 月至 2016 年 12 月的 10 年期间，对长庚儿童医院（CGCH）住院的 5 岁以下儿童的 AGE 粪便样本进行肠道病原体检测，并将其分为两个时间间隔：疫苗接种后早期（2007 年 1 月至 2011 年 12 月；EVP）和疫苗接种后晚期（2012 年 1 月至 2016 年 12 月；LVP）。
共纳入 837 例 AGE 患儿，EVP 期 106 例（26.7%）轮状病毒和 65 例（16.4%）诺如病毒为主要病原体，LVP 期 79 例（17.9%）轮状病毒和 98 例（22.2%）诺如病毒感染。统计分析显示轮状病毒感染率显著下降（P=0.002），诺如病毒（P=0.034）和肠细菌感染率显著升高（P<0.001）。LVP 期轮状病毒 G1 显著减少（P=0.079），诺如病毒 GII.4 流行贯穿整个十年。
在台湾，在轮状病毒疫苗接种政策不佳的情况下，住院幼儿轮状病毒 AGE 的发生率显著下降。诺如病毒感染显著增加，取代轮状病毒成为主要病原体。扩大轮状病毒疫苗接种范围、制定诺如病毒预防策略和持续控制细菌感染对台湾儿童 AGE 的控制非常重要。
