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2023 年南非西开普省甲型肝炎的分子特征。

Molecular characterisation of hepatitis A in the Western Cape province, South Africa in 2023.

机构信息

National Institute for Communicable Diseases, A Division of the National Health Laboratory Service, Johannesburg, Gauteng, South Africa.

School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, Gauteng, South Africa.

出版信息

BMC Infect Dis. 2024 Aug 21;24(1):845. doi: 10.1186/s12879-024-09738-7.

Abstract

In 2023, passive laboratory-based surveillance showed an increase in hepatitis A virus (HAV) infection. We investigated hepatitis A incidence using the notifiable medical condition surveillance system (NMCSS) data and molecularly characterised positive blood samples from the Western Cape province for 2023. All HAV IgM seropositive cases from the NMCSS from 1 January to 31 October 2023 in South Africa were investigated. HAV RNA from blood samples that had tested positive for HAV IgM from Western Cape was amplified in the VP1/P2B junction and sequenced (3500Xl Genetic Analyser). Sequences were assembled, aligned (Sequencher) and analysed (Aliview 1.27 and MEGA11). Statistical analysis was performed using Excel and the CuSum2 Threshold to determine suspected outbreaks. In 2023, the incidence of HAV IgM was 6.28/100,000 in South Africa, with the highest incidence in Western Cape province (15.86/100,000). Children aged 5 to 14 years were affected the most in the Western Cape. The positive cases in the Western Cape were above the CuSum2 threshold from January to May 2023, with the highest incidence observed in the City of Cape Town Metropolitan (14.8/100,000). Genotyping was successfully performed on 92.7% (139/150) of serum samples, for which the IB sub-genotype was detected. Three primary mutations R63K, R71S and M104I were observed in more than 49% of the samples. Most of the samples sequenced belonged to patients residing in areas close to each other within the City of Cape Town Southern, Western, and Mitchells Plain sub-districts. The CuSum2 threshold method allowed the identification of suspected HAV outbreaks in the districts within the Western Cape in 2023 while genotyping identified clusters of sub-genotype IB. Genotyping could assist with determining the common source of infection during an outbreak, especially if coupled with epidemiological and geographical data. Further active surveillance can assist in investigating the HAV risk factors for targeted public health responses.

摘要

2023 年,被动的实验室监测显示甲型肝炎病毒(HAV)感染有所增加。我们使用法定传染病监测系统(NMCSS)数据对 2023 年西开普省的甲型肝炎发病率进行了调查,并对该省的阳性血液样本进行了分子特征分析。所有南非 2023 年 1 月 1 日至 10 月 31 日 NMCSS 报告的 HAV IgM 阳性病例均进行了调查。从西开普省 HAV IgM 阳性血液样本中扩增 HAV RNA,并在 VP1/P2B 连接处进行测序(3500Xl 遗传分析仪)。对序列进行组装、比对(Sequencher)和分析(Aliview 1.27 和 MEGA11)。使用 Excel 和 CuSum2 阈值进行统计分析,以确定疑似暴发。2023 年,南非 HAV IgM 的发病率为 6.28/100,000,西开普省发病率最高(15.86/100,000)。西开普省受影响最大的是 5 至 14 岁的儿童。2023 年 1 月至 5 月,西开普省的阳性病例超过了 CuSum2 阈值,开普敦都会市区的发病率最高(14.8/100,000)。对 150 份血清样本中的 92.7%(139 份)成功进行了基因分型,检测到 IB 亚型。在超过 49%的样本中观察到 R63K、R71S 和 M104I 三个主要突变。测序的样本大多属于开普敦市南部、西部和米切尔平原分区内彼此靠近的地区的患者。CuSum2 阈值法可识别 2023 年西开普省各地区疑似 HAV 暴发,基因分型可确定 IB 亚型亚群。基因分型有助于确定暴发期间的感染源,特别是如果与流行病学和地理数据相结合。进一步的主动监测有助于调查甲型肝炎的危险因素,以便采取有针对性的公共卫生应对措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c16/11337563/383cf21fba65/12879_2024_9738_Fig1_HTML.jpg

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