深圳市腹泻患者肠道腺病毒感染的分子流行病学特征

Molecular epidemiology of enteric adenovirus isolated from patients with diarrhea in Shenzhen during 2010-2011

目的 了解深圳地区感染性腹泻患者中肠道腺病毒的感染情况,并研究其分子流行病学特征.方法 采集深圳市2010年1月-2011年12月2083例疑似腹泻患者便标本,采用荧光PCR法检测肠道腺病毒核酸;应用特异性引物,对肠道腺病毒核酸阳性标本进一步扩增肠道腺病毒的hexon区,PCR扩增产物测序后,进行腺病毒型别鉴定和进化树分析,同时对病例的流行病学资料进行统计分析.结果 肠道腺病毒检出率为1.82％（38/2083）;其中6月龄以下、6-11月龄、1-4岁和5岁以上患者检出分别为3.55％（6/169）、0.85％（6/707）、15.70％（19/121）和0.64％（7/1086）;肠道腺病毒的感染无明显的季节变化特征,但不同月份检出率差异较大,介于0％ ～4.76％之间.对hexon区序列分析结果显示,深圳地区肠道腺病毒以41型为主要流行株,无40型肠道腺病毒的检出.结论 肠道腺病毒是深圳地区病毒性腹泻的重要病原体之一,41型肠道腺病毒是深圳地区肠道腺病毒的主要流行株,应加强对肠道腺病毒腹泻的监测.

Objective To investigate enteric adenovirus infection status and identify its molecular characteristics in Shenzhen. Methods From January 2010 to December 2011, 2083 stool samples were collected from patients with suspected diarrhea and 30 stool samples were collected from healthy people in Shenzhen. The nucleic acids extracted from the samples were detected by real-time polymerase chain reaction （real-time PCR）. The sequences of hexon of the enteric adenovirus positive samples were amplified by PCR, and then the products were sequenced after purification. The phylogenetic tree was constructed to analyze the nucleotide sequence homology between those sequences and the sequences of reference strains available in the GenBank database. Results 38 samples of 2083 were enteric adenovirus positive （ 1.82% , 38/ 2083）. The positive rates of patients under 6 months, 6-11 months, 1-4 years and above 5 years were 3.55% （6/169）, 0. 85% （6/707）, 15.70% （19/121） and 0. 64% （7/1086）, respectively. The detection rates of EAdV in different months were between 0% and 4. 76%, with great fluctuation. There was no significant seasonal features of EAdV infection. According to the analysis on the gene sequencing, type 41 was the predominant strain of enteric adenovirus in Shenzhen, while no type 40 was detected. Conclusions Enteric adenovirus may play an important role in viral diarrhea in Shenzhen and type 41 was the most predominant strain. Therefore, it is necessary to strengthen the surveillance for diarrhea caused by enteric adenovirus infection.