2017-2019 年儿童诺如病毒胃肠炎的分子流行病学研究。
A molecular epidemiological study of pediatric norovirus gastroenteritis, 2017-2019.
机构信息
Department of Infection, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China (Xu H-M, Email:
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Oct 15;23(10):1027-1032. doi: 10.7499/j.issn.1008-8830.2107003.
OBJECTIVES
To study the molecular epidemiological characteristics of norovirus in children with acute gastroenteritis from 2017 to 2019.
METHODS
A retrospective analysis was performed on the medical data of children with acute gastroenteritis who were admitted to Children's Hospital of Chongqing Medical University from January 2017 to December 2019. A total of 1 458 stool samples were collected from the children, and viral RNA was extracted. Reverse transcription polymerase chain reaction was used for gene amplification, sequencing, and genotype identification of the VP1 region of capsid protein in norovirus.
RESULTS
Among the 1 458 stool samples, 158 (10.8%) were positive for norovirus. There was no significant difference in the positive detection rate of norovirus between different years (>0.05). Boys had a norovirus detection rate of 12.2% (105/860), which was significantly higher than that in girls (8.9%, 53/598) (=0.043). The children aged 12 to <18 months had the highest norovirus detection rate (16.9%, 51/301). August, September, and October were the epidemic peak season. A total of 23 norovirus-positive samples were also positive for rotavirus. The norovirus detected were mainly GII type (97.5%, 154/158), and only 4 cases were GI type (2.5%, 4/158). The sequencing of the VP1 region of capsid protein in the positive samples showed that GII.4 (69.6%, 110/158) was the dominant genotype, among which 99 (62.7%, 99/158) were GII.4 Sydney 2012, followed by GII.3 (15.2%, 24/158), GII.2 (10.1%, 16/158), GII.6 (1.9%, 3/158), and GII.17 (0.6%, 1/158). GI.3 (1.3%, 2/158), GI.2 (0.6%, 1/158), and GI.5 (0.6%, 1/158) were rarely detected.
CONCLUSIONS
Norovirus GII.4 Sydney 2012 was the major epidemic strain in the children with norovirus gastroenteritis from 2017 to 2019. Although norovirus infection can exist throughout the year, August to October is the peak period. During this period, norovirus surveillance and key population protection are strengthened to help prevent and control norovirus diarrhea.
目的
研究 2017 年至 2019 年儿童急性胃肠炎诺如病毒的分子流行病学特征。
方法
对 2017 年 1 月至 2019 年 12 月重庆医科大学附属儿童医院收治的急性胃肠炎患儿的临床资料进行回顾性分析。采集患儿粪便标本 1458 份，提取病毒 RNA，采用逆转录聚合酶链反应对诺如病毒衣壳蛋白 VP1 区进行基因扩增、测序和基因型鉴定。
结果
1458 份粪便标本中诺如病毒阳性 158 份，阳性检出率为 10.8%，不同年份诺如病毒阳性检出率比较差异无统计学意义（>0.05）。男童诺如病毒阳性检出率为 12.2%（105/860），高于女童的 8.9%（53/598）（=0.043）。12 至<18 个月龄儿童诺如病毒阳性检出率最高（16.9%，51/301）。8、9、10 月为流行高峰季节。共 23 份诺如病毒阳性样本同时检测出轮状病毒阳性。检测出的诺如病毒主要为 GII 型（97.5%，154/158），仅 4 份为 GI 型（2.5%，4/158）。阳性样本 VP1 区测序结果显示，GII.4（69.6%，110/158）为优势基因型，其中 99 份（62.7%，99/158）为 GII.4 Sydney 2012 型，其次为 GII.3（15.2%，24/158）、GII.2（10.1%，16/158）、GII.6（1.9%，3/158）和 GII.17（0.6%，1/158）。GI.3（1.3%，2/158）、GI.2（0.6%，1/158）和 GI.5（0.6%，1/158）检出率较低。
结论
2017 年至 2019 年重庆医科大学附属儿童医院儿童诺如病毒胃肠炎以 GII.4 Sydney 2012 为主要流行株。虽然诺如病毒感染全年均可存在，但 8 至 10 月为流行高峰。在此期间，加强诺如病毒监测和重点人群保护，有助于预防和控制诺如病毒腹泻。
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