中国七个地区1998-2005年急性腹泻住院患儿中星状病毒感染研究

Astrovirus infection among hospitalized children with acute diarrhea in seven regions of China, 1998-2005

目的研究中国5岁以下腹泻住院患儿中星状病毒感染的流行病学特点,确定流行毒株血清型。方法选择国内7个地区收集5岁以下腹泻住院患儿粪便标本,应用酶联免疫或PCR方法检测星状病毒,对星状病毒阳性标本应用RT-PCR方法分型并经测序确证。结果1998-2005年在7个地区的凋查点共收集1668份急性腹泻粪便标本,检测出星状病毒阳性标本91份,平均检出率为5．5％;病例全年均有发生,发病高峰主要集中在10月份到次年1月份;95％患儿年龄在2岁以下,其中以9-11月龄儿童发病最多,检出率为7.4％,12-17月龄、6-8月龄、0-6月龄儿童的检出率依次为6．1％、5.6％、5．6％。确定型别的49份标本中45份为HAstV-1型,1例为HAstV-3型,2例为HAstV-5型,1例为HAstV-8型。结论星状病毒是中国婴幼儿病毒性腹泻的重要病原之一,流行毒株以1型为主,同时存在多个型别的散在流行。

Objective To study the epidemiology and strain variations of astrovirus infection among children under 5 years of age, hospitalized for acute diarrhea in China. Methods Inpatients under 5 years of age with acute diarrhea in hospitals of seven provinces between 1998 and 2005 were enrolled in the study Stool specimens were collected and tested for astrovirus using the Dako Amplified IDEIATM Astrovirus kits or reverse-transcription polymerase chain reaction （RT-PCR）. Genetic identities of the strains were determined using RT-PCR with serotype-specific primers and confirmed by sequencing of the RT-PCR products. Results A total of 1668 diarrheal stool samples tested for both rotavirus and calicivirus negative were examined. The detection rate of astrovirus infection was 5.5% （91/1668） and the diarrhea cases caused by astrovirus infection could be found in any season of the year but mainly occurred in cold season from October to next January. Astrovirus detection .rates were： 7.4% among infants aged 9-11 months followed by 6.1% in 12-17 month-olds, and 6-8 months 5.6% ＆ 0-2 months 5.6 % before 8 months. Over 95% of astrovirus infections occurred in children before 2 years of age. Among 49 strains typed, serotype 1 （45/91） was most commonly seen while serotype 5 was in two cases and serotype 3 and 8 were detected in only one case respectively. Conclusion Astrovirus seemed an important etiologic agent in young children with acute diarrhea in China and Serotype 1 was the most prevalent one.