低收入和中等收入国家与腺病毒 40/41 相关的小儿急性胃肠炎。
Pediatric acute gastroenteritis associated with adenovirus 40/41 in low-income and middle-income countries.
机构信息
Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont.
Tufts Medical School, Boston, Massachusetts.
出版信息
Curr Opin Infect Dis. 2020 Oct;33(5):398-403. doi: 10.1097/QCO.0000000000000663.
PURPOSE OF REVIEW
To review the roles of enteric adenovirus types 40 and 41 and nonenteric adenoviruses in the global burden of pediatric diarrhea.
RECENT FINDINGS
Large studies using highly sensitive, type-specific molecular diagnostics have demonstrated a substantial and previously under-estimated burden of pediatric diarrheal disease because of enteric infections with adenovirus types 40/41. However, the true epidemiology of adenovirus 40/41 remains incompletely understood. Similarly, additional adenovirus types may also be implicated as agents of community-acquired pediatric gastroenteritis but current data are too limited to elucidate their epidemiological role(s), if any.
SUMMARY
Efforts at global diarrhea control in low-income and middle-income countries will require combating pediatric gastroenteritis because of enteric adenovirus infections. Future research in these settings using type-specific molecular diagnostics or strain genotyping to fully characterize the epidemiology of adenovirus 40/41 infections, identify non-40/41 adenoviruses significantly associated with gastroenteritis, and develop vaccines effective at preventing adenovirus diarrhea is warranted.
目的综述
回顾肠道腺病毒 40 型和 41 型以及非肠道腺病毒在全球儿科腹泻负担中的作用。
最近的发现
使用高度敏感、型特异性分子诊断方法的大型研究表明，由于腺病毒 40/41 引起的肠道感染，儿科腹泻疾病的负担很大，此前被低估。然而，腺病毒 40/41 的真实流行病学仍不完全清楚。同样，其他腺病毒类型也可能与社区获得性小儿胃肠炎有关，但目前的数据还太有限，无法阐明其流行病学作用（如果有的话）。
总结
在低收入和中等收入国家开展全球腹泻控制工作，需要对抗由肠道腺病毒感染引起的小儿胃肠炎。在这些环境中，未来的研究需要使用型特异性分子诊断或菌株基因分型来全面描述腺病毒 40/41 感染的流行病学，确定与胃肠炎显著相关的非 40/41 腺病毒，并开发有效预防腺病毒腹泻的疫苗。
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