河南省哨点医院2009～2015年5岁以下腹泻儿童轮状病毒分子流行病学特征研究

Molecular Epidemiological Research of Rotavirus below Five Years Old Children with Diarrhea in Sentinel Surveillance Hospital of Henan Province

为分析2009年~2015年河南省5岁以下腹泻儿童A组、B组、C组轮状病毒的感染状况及分子流行病学特征,本研究采集了河南省两个监测哨点医院5岁以下儿童腹泻病例的粪便样本(每份3~5ml)2 317份,双抗体夹心法检测A组轮状病毒;巢式多重RT-PCR进行基因分型,二步法多重RT-PCR检测B/C组轮状病毒,同时对阳性病例流行病学资料进行统计分析。2 317份腹泻样本共检出阳性样本869份,总阳性率35.0%,混合感染率2.5%。其中A组轮状病毒746份,阳性率32.2%;B组轮状病毒44份,阳性率1.9%;C组轮状病毒79份,阳性率3.4%;混合感染样本58份,混合感染率2.5%。A组轮状病毒阳性率的季节性特征显著,监测年度存在9~11月份(秋季)和3~5月份(春季)两个较显著高峰。A组轮状病毒G分型以G1、G2、G3、G9为主;P分型以P[8]、P[4]为主;型别组合以G1P[8]、G3P[8]、G2P[4]、G9P[8]为主,还存在G13P[8]、G234P[8]、G39P[8]、G389P[6][8]混合感染型别。河南省5岁以下腹泻患儿中以A组轮状病毒感染为主,B/C组轮状病毒感染率较低,且存在与A组混合感染模式;秋季和春季为高发季节,秋季高于春季且存在混合感染病例;大部分感染病例无发热、呕吐、脱水症状,出现发热、腹泻、呕吐、脱水等临床症状的病例多以轻症为主。

To investigate the infectious status and etiological characteristics of rotavirus from infants and children below five years old from 2009 to 2015in henan province,2,317 stool samples（each 3~5ml）were collected from infants and children below five years old in two sentinel hospitals and detected group A rotavirus pathogens by double antibody sandwich ELISA method.Viral RNA were extracted from positive samples and made G/P gene typing with two-step nested multiplex RT-PCR while rotavirus（groupB,C）were detected by two-step RT-PCR.The results showed that 869 positive samples were detected from2,317 diarrhea samples,the total positive rate was 35% ：group A rotavirus 746 cases,positive rate was32.2%;rotavirus group B 44 cases,positive rate was 1.9%;group C rotavirus 79 cases,positive rate was3.4%.The mixed infection rate was 2.5%（58samples）.There were two seasonal positive rate peaks of rotavirus A with autumn（9~11months）and spring（3~5months）.G typing of group A rotavirus were mainly G1,G2,G3,G9;P typing were mainly P[4],[8];gene type combination were composed mainly of G9P[8],G2P[4],G3P[8],G1P[8]with existing mixed infection type such as G13P[8],G234P[8],G39P[8],G389P[6][8].There existed higher infection rate of rotavirus（group A rotavirus dominated,group B/C detection rate was lower and existed mixed infection mode with group A）in acute diarrhea children below five years old in henan province,mainly in autumn and spring annually with higher positive rate in autumn than spring.most infected cases have no fever,vomiting,dehydration symptoms and the cases with clinical symptoms often showed mild degrees.