新疆某医院2012-2013年婴幼儿轮状病毒感染基因型哨点监测

Sentinel surveillance of rotavirus infection among infants and children under age 5 in Urumqi of China

目的哨点监测2012-2013年新疆维吾尔自治区人民医院婴幼儿轮状病毒感染基因型情况,为轮状病毒(RV)疫苗的研制和使用提供依据。方法从新疆维吾尔自治区人民医院收集2012年8月至2013年10月5岁以下感染儿科和新生儿科住院腹泻和非腹泻患儿粪便样本203份,用ELISA方法检测轮状病毒,对阳性样本提取RV核酸,应用多重RT-PCR进行G型(VP7)和P型(VP4)基因分型。结果监测期间轮状病毒的检出率为33.5%(68/203),95.6%的RV阳性患儿≤24月龄,是RV感染的主要对象。对68份RV阳性样本进行基因分型,结果显示:感染儿科婴幼儿在2012年G型以G9(38.1%)为主要流行株,其次是G3(19.0%)、G2(14.3%)和G1(9.5%),混合感染达19.0%,1例未能分型;P型以P[8](71.4%)为主,其次是P[4](14.3%),混合感染占9.5%,1例未能分型;在2013年G型以G3(34.4%)为主,其次是G9(21.9%),G1和G2各占3.1%,混合感染型达31.3%,未能分型2例;P型同样以P[8](78.1%)为主,P[4]和P[6]各占3.1%,混合感染占15.6%。新生儿科新生儿以G9为主导(83.3%,10/12),1例为混合感染,1例未能分型;婴儿3例,2例G9,1例为G9+G3混合感染。新生儿P型以P[6]型为主(9/12),另有P[8]型2例,1例混合感染P[6+8];3例婴儿均为P[6+8]型混合感染。G/P组合基因型,感染儿科婴幼儿2012年主要以G9P[8]为主,其次为G3P[8],而2013年变为以G3P[8]为主,其次为G9P[8];新生儿科新生儿主要流行G9P[6],婴儿以混合感染为主。结论 RV仍然是本地婴幼儿腹泻的主要病原。2012-2013年婴幼儿RV G9P[8]型和G3P[8]型交替占主导流行。新生儿RV感染则以G9P[6]型为主要优势株。婴儿与新生儿间RV毒株的混合感染应引起高度关注。

Objective To monitor rotavirus（RV）genotypes among children younger than 5years old from2012 to 2013in a sentinel hospital.Methods A total of 203 stool specimens were collected from neonates,infants and children under 5years old with diarrhea or non-diarrhea hospitalized in the departments of Infection Pediatrics and neonatology at the People′s Hospital of Xinjiang Uighur Autonomous Region during August2012 to October 2013 in Xinjiang,China.RV was detected by ELISA.The nucleic acid was extracted from rotavirus-positive specimens.Rotavirus was further genotyped for G and P types by RT-PCR.Results RV positive rate was 33.5%（68/203）during the surveillance period,95.6% patients with rotavirus diarrhea were infants younger than 24 months old.In the Department of Infection Pediatrics,G-typing showed that G9（38.1%）was predominant in 2012,followed by G3（19.0%）,G2（14.3%）and G1（9.5%）;G mixed infection was up to 19%.P-typing showed that P[8]（71.4%）was the main epidemic strain,followed by P[4]（14.3%）,P mixed infection was 9.5%.In 2013,G3（34.4%）was predominant,followed by G9（21.9 %）,G2（3.1%）and G1（3.1%）;G mixed infection was up to 31.3%.P[8]（78.1%）was still the main epidemic strain in 2013,followed by P[4]（3.1%）and P[6]（3.1%）,P mixed infection was 15.6%.In the Department of Neonatology,G9（10/12）was the main epidemic strain.P-typing showed that the main strain was P[6]（9/12）,followed by 2P[8]strains and 1P[6]and [8]mixed strain,3Infants were P[6＋8]infection.The most common G/P combination was G9P[8]in the Department of Infection Pediatrics in 2012,followed by G3P[8].But in 2013,the main G/P combination changed to G3P[8].In the Neonatal Units,the main G/P combination was G9P[6];the infants were mainly mixed infection.Conclusions Rotavirus remains the most prevalent pathogen causing diarrhea among infants and children in Xinjiang,China.G3P[8]or G9P[8]are the most popular stains during 2012-2013.The main G/P combination of neonates was G9P[6].