台湾北部住院儿童中轮状病毒疫苗效果不佳对急性肠胃炎的长期影响。

Long-term impact of suboptimal rotavirus vaccines on acute gastroenteritis in hospitalized children in Northern Taiwan.

机构信息

Saint Paul's Hospital, Taoyuan, Taiwan.

Division of Pediatric Gastroenterology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.

出版信息

J Formos Med Assoc. 2018 Aug;117(8):720-726. doi: 10.1016/j.jfma.2017.09.009. Epub 2017 Oct 12.

DOI:10.1016/j.jfma.2017.09.009

PMID:29032020

Abstract

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.

METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

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。

方法

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）。

结果

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。