2009-2010年湖南省哨点医院婴幼儿病毒性腹泻病原学研究

Etiological Study on Viral Diarrhea Among Infants and Young Children in Surveillance Hospitals of Hunan Province from 2009 to 2010

目的了解湖南省哨点医院2009-2010年常见腹泻病毒的病原学特征,为病毒性腹泻的综合防治提供科学依据。方法收集湖南省哨点医院2009-2010年5岁以下住院腹泻患儿的粪便标本,采用Dako公司酶免疫试剂盒检测轮状病毒,采用逆转录-聚合酶联反应(RT-PCR)进行分型鉴定;采用聚合酶链反应(PCR)检测腺病毒;逆转录-聚合酶链反应(RT-PCR)法检测星状病毒和杯状病毒,对部分PCR阳性标本进行测序加以验证。结果检测2009-2010年湖南省哨点医院婴幼儿腹泻标本759份,其中轮状病毒占22.79%(173/759)、杯状病毒占9.22%(70/759)、腺病毒占4.61%(35/759)、星状病毒占0.79%(6/759)、混合感染占2.50%(19/759)。173份轮状病毒G血清型与P基因型以G1、G3、P[4]型为优势株。四种病毒主要是感染2岁以下婴幼儿,且有明显的季节特征。测序结果证实12份阳性标本的PCR产物均为其所对应的病毒。结论轮状病毒是2009-2010年湖南省婴幼儿病毒性腹泻的最主要病原,杯状病毒、腺病毒和星状病毒也是本省婴幼儿病毒性腹泻的重要病原。

Objective To investigate the etiological characteristics of common diarrhea viruses in sentinel hospitals of Hu- nan Province from 2009 to 2010, and to provide the scientific reference for comprehensive prevention and treatment of viral diar- rhea. Methods A total of 759 stool specimens were collected from children less than 5 years old with an acute gastroenteritis admitted to surveillance hospitals of Hunan Province from 2009 to 2010. Dako- IDEIATM kits were used for detection of rota- virus, and the strain characterization of rotavirus was carried out with reverse transcription- polymerase chain reactions （RT- PCR）. The detection of calicivirus, adenovirus and astrovirus was done by multiple RT - PCR. Part of the PCR products （DNA） which were positive for samples of ealicivirus, adenovirus and astrovirus were analyzed by nucleotide sequencing, respectively. Results Rotavirus was detected in 22.79 % （173/759） of all cases, calicivirus detected in 9.22 % （70/759）, adenovirus detect- ed in 4.61% （35/759）, and astrovirus detected in 0.79% （6/759）, respectively. Mix infections were found in 2.50% （19/759） of all samples. Among 173 rotavirus positive samples, serotypes G1, G3 and P[4] were the most predominant strains. The four types of diarrhea viruses mostly attacked the children less than 2 years old, and moreover, the seamnal variations of viral diarrhea were obvious. Sequence analysis showed that the 12 positive strains were confirmed as the corresponding virus. Conclusions Rotavirus was the main pathogen for viral diarrhea in surveillance hospitals of Hunan Province from 2009 to 2010, followed by calicivirus, adenovirus and astrovirus.