2021—2022年成都市病毒性腹泻病原学监测分析

Pathogenic Surveillance on the Viral Diarrhea in Chengdu from 2021 to 2022

目的分析2021—2022年成都市病毒性腹泻病原学监测结果,总结肠道病毒流行规律,为肠道传染病的防控提供参考依据。方法在成华区、金牛区、金堂县和彭州市各选择2所医院作为监测哨点,各哨点自2021年4月起采集24 h排便3次及以上并伴有大便性状改变(呈稀便、水样便等),或24 h呕吐2次及以上的患者标本并开展病原学监测,监测病毒包括诺如病毒(NV)GⅠ、GⅡ型、轮状病毒(RV)A、B和C组、人星状病毒(AstV)、肠道腺病毒(AdV)、札如病毒(SaV)。实验室检测方法包括荧光PCR、多病原检测和普通PCR检测。整理分析2021—2022年肠道病毒病原学监测数据。运用SPSS 19.0软件进行统计分析,计数资料描述采用频数和率,组间比较采用Pearsonχ^(2)检验,检验水准为α=0.05,双侧检验。结果2021—2022年成都市腹泻/呕吐病人标本检测病毒总阳性率为29.84%,其中RVA、NVGⅡ和AdV的阳性率最高,分别为11.90%、9.26%和8.73%。检出1种病毒型别的占比77.41%,同时检出2种病毒型别的占比16.90%,同时检出3种病毒型别的占比4.52%,同时检出4种病毒型别的占比1.18%。不同月份的腹泻病毒的检出率不同,总体阳性检出率最高在2月,为54.32%,之后呈逐月下降趋势。男性病毒检出阳性率为27.75%,女性病毒检出阳性率为32.27%,差异有统计学意义(χ^(2)=4.15,P=0.042)。5岁及以下病毒检出阳性率为37.12%,其他年龄组病毒检出阳性率为23.52%,差异有统计学意义(χ^(2)=37.48,P<0.001)。不同职业病毒检出阳性率排前3位的是幼托儿童(41.46%)、散居儿童(36.32%)和学生(34.20%)。结论近两年来,轮状病毒、诺如病毒和肠道腺病毒是成都市病毒性腹泻的优势病原体,建议今后尤其应加强对这三类病毒的监测,开展有针对性的预防控制措施。

Objective To analyze the pathogenic monitoring results of viral diarrhea in Chengdu from2021 to 2022,and to provide a basis for formulating scientific prevention and control measures.Methods Two hospitals in Chenghua District,Jinniu District,Jintang County and Pengzhou City were selected as monitoring sentinels.From April 2021,samples of patients with three or more defecations in 24 hours,accompanied by changes in stool characteristics(loose stool,watery stool,etc.),or vomiting twice in 24 hours were collected at each sentinel point,and pathogen monitoring was carried out.Surveillance viruses included Norovirus(NV)GⅠ,GⅡ,rotavirus(RV)A,B,C,human astrovirus(AstV)Intestinal adenovirus(AdV),Zaru virus(SaV).Methods of Laboratory testing included fluorescence PCR,multi pathogen detection and conventional PCR detection.The pathogenic surveillance data of Enterovirus from 2021 to 2022 were analyzed.Statistical analysis was conducted by using SPSS 19.0 software,with counting data was described by using frequency and rate,and comparison among groups was tested by using Pearsonχ^(2)inspections,with an inspection level ofα=0.05,bilateral test.Results The total positive rate of virus detected in samples of diarrhea/vomiting patients in Chengdu from 2021 to 2022 was 29.84%,with the highest positive rates of RVA,NVGⅡ,and AdV being 11.90%,9.26%,and 8.73%,respectively.The proportion of one virus type detected was 77.41%,while the proportion of two virus types detected at the same time was 16.90%.The proportion of three virus types detected at the same time was 4.52%,and the proportion of four virus types detected at the same time was1.18%.The detection rate of diarrhea virus varies in different months,with the highest overall positive detection rate being 54.32%in February,and then showing a decreasing trend month by month.The positive rate of virus detection in male was 27.75%,while the positive rate of virus detection in female was 32.27%,with a statistically significant difference(χ^(2)=4.15,P=0.042).The positive rate of virus detection was 37.12%in children aged 5 and below,and 23.52%for those aged other years,with a statistically significant difference(χ^(2)=37.48,P<0.001).Among all professions,preschool children,scattered children and students had the highest positive rates of virus detection,with 41.46%,36.32%,and 34.20%,respectively.Conclusions In recent two years,rotavirus,orovirus and enteroadenovirus are the dominant pathogens of viral diarrhea in Chengdu.It is suggested that the surveillance of these three Viroid should be strengthened in the future,and the targeted prevention and control measures should be carried out.