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.

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）。