兰州地区婴幼儿病毒性腹泻的分子流行病学研究

Molecular epidemiology of virus diarrhea among infants and young children in Lanzhou

目的通过分子流行病学调查研究兰州地区婴幼儿病毒性腹泻的病原学特点。方法采用酶联免疫吸附试验(ELISA)及逆转录聚合酶链反应(RTPCR),对2003年7月至2004年6月兰州地区收集的624例婴幼儿腹泻粪便标本随机抽取271例进行轮状病毒(RV)、杯状病毒(HuCV)及星状病毒(AstV)检测。结果在271例标本中共检出RV感染153例(56.46%),其中G394例(61.44%),G24例(2.61%),G93例(1.96%),未发现G1、G4型和混合感染;在随机抽取的69例G分型阳性标本中,检出P[8]型28例(40.58%);RV的感染对象主要为6～23月龄的婴幼儿,发病高峰在10、11月份(86.27%、73.81%)。在118例RVELISA阴性标本中检出HuCV感染13例(11.02%),其中诺如病毒(NLV)GⅡ型11例,札如病毒(SLV)2例,未检出NLVGⅡ型,发病年龄1～18个月(11.31±4.53个月);同时检出AstV感染7例(5.93%),发病年龄4～12个月(8.27±2.69)个月,其中有1例合并有SLV感染,另有1例为迁延性腹泻。HuCV和AstV感染均未表现出明显的季节性。结论RV是兰州婴幼儿病毒性腹泻的主要病原,其流行的主要血清型为G3型,HuCV和AstV亦是重要病原之一。

Objective To investigate the etiologic characteristics of virus diarrhea through molecular epidemiology among infants and young children with acute diarrhea in Lanzhou. Methods 271 cases were randomly selected from 624 stool specimens collected from both outpatients and inpatients with acute diarrhea at Department of Pediatrics of the First Hospital of Lanzhou University, from July 2003 to June 2003. Enzyme-linked immunosorbant assay （ ELISA ） and Reverse transcription-polymerase chain reaction （ RT-PCR） were used to detected rotavirus and human caliciviruses and astrovirus. Results Rotavirus was detected in 153 of 271 specimens （ 56.46%）. Genotyping of rotavirus showed that G3 was predominant （61.44% ） ,followed by G2 （2. 61% ） and G9 （1.96% ）. Both G1 and C,4 and mixed infections were not found. Only genotype P[ 8 ] （ 40. 58% ） was detected in G-positive specimens. The most common combination of G and P was P[ 8 ] G3, followed by P[ 8 ] G9. Rotavirus infection appeared in autumn and winter, but the peaks in Lanzhou were in October and November, 86. 27% and 73.81% respectively. The highest infection rates of rotavirus were 57.38% and 63.33% in 6 - 23 months old children. The infection rate of human caliciviruses （ HuCV） which occurred in 1 - 18 months-old was 11.02% （ 13/118 ）, and there were 11 cases of norovirus （ NLV ） and 2 cases of sapovirus （ SLV ） and no NLV G was found. The infection rate of astrovirus which occurred in 4 - 12 months-old was 5. 93 % （ 7/118 ）, among which one case was combined with SLV and one with persisting diarrhea. Both HuCV and AstV were not obviously seasonal. Conclusion Rotaviruses are the major etiological agent of diarrhea among infants and young children in Lanzhou and G3 is the predominant serotype. Both human caliciviruses and astrovirus are also one of the important etiological agents of virus diarrhea in Lanzhou.