Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China.
BMC Infect Dis. 2021 Jul 29;21(1):713. doi: 10.1186/s12879-021-06403-1.
In addition to rotavirus and norovirus, human adenovirus (HAdV) and classic human astrovirus (classic HAstV) are important pathogens of acute diarrhea in infants and young children. Here, we present the molecular epidemiology of HAdV and classic HAstV in children with acute diarrhea in Shanghai.
Fecal specimens were collected from 804 outpatient infants and young children diagnosed with acute diarrhea in Shanghai from January 2017 to December 2018. All of the samples were screened for the presence of HAdV and classic HAstV. HAdV and classic HAstV were detected using traditional PCR and reverse-transcription PCR, respectively. All of the HAdV and classic HAstV positive samples were genotyped by phylogenetic analysis.
Among the 804 fecal samples, 8.58% (69/804) of samples were infected with either HAdV or classic HAstV, and five were co-infected with two diarrhea viruses. The overall detection rates of HAdV and classic HAstV were 3.47% (28/804) and 5.22% (42/804), respectively. Four subgroups (A, B, C, and F) and seven genotypes (HAdV-C1, -C2, -B3, -C5, -A31, -F40, and -F41) of HAdV were detected. Subgroup F had the highest constituent ratio at 64.29% (18/28), followed by non-enteric HAdV of subgroup C (21.43%, 6/28) and subgroup B 10.71% (3/28). HAdV-F41 (60.71%, 17/28) was the dominant genotype, followed by HAdV-C2 (14.29%, 4/28) and HAdV-B3 (10.71%, 3/28). Two genotypes of classic HAstV (HAstV-1 and HAstV-5) were identified in 42 samples during the study period; HAstV-1 (95.24%, 40/42) was the predominant genotype, and the other two strains were genotyped as HAstV-5. No significant differences were found between boys and girls in the detection rates of HAdV (P = 0.604) and classic HAstV (P = 0.275). Over half of the HAdV infections (82.14%, 23/28) and classic HAstV infections (66.67%, 28/42) occurred in children less than 36 months. Seasonal preferences of HAdV and classic HAstV infections were summer and winter, respectively. In this study, the common clinical symptoms of children with acute diarrhea were diarrhea, vomiting, fever and abdominal pain.
Our findings indicate that HAdV and classic HAstV play important roles in the pathogenesis of acute diarrhea in children in Shanghai. Systematic and long-term surveillance of HAdV and classic HAstV are needed to monitor their prevalence in children and prevent major outbreak.
除了轮状病毒和诺如病毒，人类腺病毒（HAdV）和经典人类星状病毒（经典 HAstV）也是婴幼儿急性腹泻的重要病原体。在此，我们介绍了上海地区儿童急性腹泻中 HAdV 和经典 HAstV 的分子流行病学。
从 2017 年 1 月至 2018 年 12 月，收集了上海 804 名门诊婴幼儿急性腹泻患者的粪便标本。所有样本均采用传统 PCR 和逆转录 PCR 检测 HAdV 和经典 HAstV。所有 HAdV 和经典 HAstV 阳性样本均通过系统发育分析进行基因分型。
在 804 份粪便样本中，8.58%（69/804）的样本感染了 HAdV 或经典 HAstV，5 份样本同时感染了两种腹泻病毒。HAdV 和经典 HAstV 的总检出率分别为 3.47%（28/804）和 5.22%（42/804）。检测到四个亚组（A、B、C 和 F）和七种基因型（HAdV-C1、-C2、-B3、-C5、-A31、-F40 和 -F41）的 HAdV。亚组 F 的构成比最高，为 64.29%（18/28），其次是非肠道型 HAdV 的亚组 C（21.43%，6/28）和亚组 B（10.71%，3/28）。优势基因型为 HAdV-F41（60.71%，17/28），其次是 HAdV-C2（14.29%，4/28）和 HAdV-B3（10.71%，3/28）。在研究期间，42 份样本中鉴定出两种经典 HAstV 基因型（HAstV-1 和 HAstV-5）；HAstV-1（95.24%，40/42）是主要基因型，另外两个菌株被鉴定为 HAstV-5。HAdV（P=0.604）和经典 HAstV（P=0.275）的检出率在男孩和女孩之间无显著差异。超过一半的 HAdV 感染（82.14%，23/28）和经典 HAstV 感染（66.67%，28/42）发生在 36 个月以下的儿童。HAdV 和经典 HAstV 感染的季节性偏好分别为夏季和冬季。在本研究中，急性腹泻患儿的常见临床症状为腹泻、呕吐、发热和腹痛。
我们的研究结果表明，HAdV 和经典 HAstV 在上海儿童急性腹泻的发病机制中起重要作用。需要对 HAdV 和经典 HAstV 进行系统和长期监测，以监测其在儿童中的流行情况并预防大规模爆发。
