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轮状病毒疫苗接种对老年人急性肠胃炎病毒病因的间接影响。

Indirect impact of rotavirus vaccination on viral causes of acute gastroenteritis in the elderly.

机构信息

UCD National Virus Reference Laboratory, University College Dublin, Dublin 4, Ireland.

UCD National Virus Reference Laboratory, University College Dublin, Dublin 4, Ireland.

出版信息

J Clin Virol. 2021 Apr;137:104780. doi: 10.1016/j.jcv.2021.104780. Epub 2021 Feb 20.

DOI:10.1016/j.jcv.2021.104780
PMID:33647802
Abstract

BACKGROUND

Rotavirus is considered a childhood infection causing acute gastroenteritis however, it also causes disease in adults which may be underestimated due to less frequent testing in this age-group.

OBJECTIVES

To determine if paediatric rotavirus vaccination, introduced into Ireland in December 2016, affected the viral aetiology in those aged ≥65 yrs presenting with gastroenteritis in the pre- and post-vaccination years. Additionally, rotavirus genotypes in this age-group will be described.

METHODS

Faecal samples from 2015 to 2019 for the investigation of gastroenteritis were tested by real-time (RT-) PCR for norovirus, adenovirus, rotavirus, Rotarix, astrovirus and sapovirus. Rotaviruses were genotyped by multiplex real-time RT-PCR or hemi-nested RT-PCR and a proportion confirmed by sequencing.

RESULTS

22,593 samples from adults aged ≥65 yrs were tested and 2566 (11 %) had ≥1 virus detected. Of 2566 positive samples, norovirus was detected in 82 %, rotavirus 9 %, sapovirus 6 %, astrovirus 3 % and adenovirus 1 %. Rotavirus and norovirus infections decreased between pre and post-vaccine year groups p < 0.001, whereas sapovirus, astrovirus and adenovirus remained unchanged. Between 2015-16 and 2018-19, G2P[4] increased and G4P[8] decreased, p < 0.001. In 2015-2019 there were 37 rotavirus outbreaks. Five geriatric outbreaks were genotyped and caused by G4P[8] (n = 1), G1P[8] (n = 1), G2P[4] (n = 2) and G12P[8] (n = 1).

CONCLUSION

Rotavirus causes acute gastroenteritis in older people. Paediatric vaccination may have contributed to a decline in infections in the elderly; nevertheless, rotavirus continued to circulate in older people following vaccine introduction. Genotype distribution changed between the pre- and post-vaccine era however genotypes in outbreak and endemic settings were comparable.

摘要

背景

轮状病毒被认为是一种导致儿童急性肠胃炎的病原体,但它也会导致成年人患病,由于在该年龄段进行的检测较少,因此可能被低估。

目的

确定 2016 年 12 月在爱尔兰引入的小儿轮状病毒疫苗是否会影响接种疫苗前后≥65 岁人群因肠胃炎就诊的病毒病因。此外,还将描述该年龄段的轮状病毒基因型。

方法

使用实时(RT-)PCR 对 2015 年至 2019 年的肠胃炎粪便样本进行诺如病毒、腺病毒、轮状病毒、罗特律克斯、星状病毒和肠病毒检测。通过多重实时 RT-PCR 或半巢式 RT-PCR 对轮状病毒进行基因分型,并对一部分进行测序以确认。

结果

共检测了 22593 名≥65 岁的成年人样本,有 2566 名(11%)样本检测出≥1 种病毒。在 2566 例阳性样本中,检测到诺如病毒 82%、轮状病毒 9%、肠病毒 6%、星状病毒 3%和腺病毒 1%。轮状病毒和诺如病毒感染在疫苗接种前后年份组之间下降(p<0.001),而肠病毒、星状病毒和腺病毒则保持不变。在 2015-16 年至 2018-19 年期间,G2P[4]增加,G4P[8]减少,p<0.001。在 2015-2019 年期间,共有 37 起轮状病毒暴发。对 5 起老年暴发的病毒进行了基因分型,结果为 G4P[8](n=1)、G1P[8](n=1)、G2P[4](n=2)和 G12P[8](n=1)。

结论

轮状病毒会导致老年人急性肠胃炎。小儿疫苗接种可能导致老年人感染减少;然而,在疫苗引入后,轮状病毒仍在老年人中传播。在疫苗接种前后的时期,基因型分布发生了变化,但暴发和流行地区的基因型相似。

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