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2009-2014 年中国西部成都地区腹泻患儿轮状病毒 A 感染的流行特征及与疫苗株的亲缘关系分析。

Prevalence and clinical profile of rotavirus A infection among diarrhoeal children and phylogenetic analysis with vaccine strains in Chengdu, West China, 2009-2014.

机构信息

Department of Public Health Laboratory Sciences, West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, Chengdu, China.

Sichuan Center for Disease Control and Prevention, Chengdu, China.

出版信息

Trop Med Int Health. 2018 Jul;23(7):704-713. doi: 10.1111/tmi.13077. Epub 2018 Jun 1.

Abstract

OBJECTIVES

Rotaviruses are the most common cause of severe diarrhoeal disease in young children. However, little is known about the epidemiological and clinical profile of rotavirus A (RVA) in diarrhoeal children or the efficacy of Lanzhou lamb rotavirus vaccine (LLR) in Chengdu, China. This study aimed to determine the prevalence and clinical profile of RVA in diarrhoeal children and provide gene analysis information for RVA vaccination programmes.

METHODS

A total of 1121 faecal samples were collected from outpatient children with diarrhoea between 2009 and 2014. RT-PCR was performed to detect RVA infection and other gastroenteritis viruses. VP4 and VP7 genes of 13 RVA strains were sequenced to compare their similarity with vaccine strains.

RESULTS

The overall RVA infection rate was 17.48%. G1 (54.72%) and G3 (18.87%) were the predominant G genotypes; P[8] (72.36%) and P[4] (11.38%) were the main P genotypes. Sixteen genotypes were identified; G1P[8] (57.33%) and G9P[8] (12.00%) were the most prevalent. The proportion of coinfection with RVA and other gastroenteritis viruses was 18.88%. RVA was mostly detected in winter and in diarrhoeal children 1-2 years of age. The genotypes of Rotarix and RotaTeq vaccines were consistent with RVA strains prevalent in Sichuan and shared high identity.

CONCLUSIONS

RVA was one of the major aetiological agents of diarrhoeal children in Chengdu. Genotype distribution differed within each year and the gene analysis implied low efficacy of LLR. Continuous epidemiological monitoring of RVA is essential for the national vaccination programme.

摘要

目的

轮状病毒是导致婴幼儿严重腹泻病的最常见病因。然而,人们对轮状病毒 A(RVA)在腹泻患儿中的流行病学和临床特征,以及兰州羔羊轮状病毒疫苗(LLR)在中国成都的效果知之甚少。本研究旨在确定 RVA 在腹泻患儿中的流行率和临床特征,并为 RVA 疫苗接种计划提供基因分析信息。

方法

2009 年至 2014 年期间,共采集了 1121 份来自门诊腹泻患儿的粪便样本。采用 RT-PCR 检测 RVA 感染和其他胃肠炎病毒。对 13 株 RVA 株的 VP4 和 VP7 基因进行测序,以比较其与疫苗株的相似性。

结果

总 RVA 感染率为 17.48%。G1(54.72%)和 G3(18.87%)是主要的 G 基因型;P[8](72.36%)和 P[4](11.38%)是主要的 P 基因型。共鉴定出 16 种基因型;G1P[8](57.33%)和 G9P[8](12.00%)最为流行。RVA 与其他胃肠炎病毒的混合感染率为 18.88%。RVA 主要在冬季和 1-2 岁的腹泻患儿中检出。Rotarix 和 RotaTeq 疫苗的基因型与四川流行的 RVA 株一致,具有高度同源性。

结论

RVA 是成都腹泻患儿的主要病原体之一。各年基因型分布不同,基因分析表明 LLR 效果较低。对 RVA 的持续流行病学监测对于国家疫苗接种计划至关重要。

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