天津市秋冬季腹泻患儿星状病毒调查

Investigation on astrovirus among hospitalized children with diarrhea in autumn and winter in Tianjin

目的了解天津市秋冬季腹泻患儿的星状病毒感染情况及其分型特点。方法采用逆转录聚合酶链反应(RTPCR)技术,于2014年9月—2015年2月收集天津市儿童医院住院部1 127例疑似病毒性腹泻的婴幼儿粪便样品中的星状病毒核酸进行检测,并将部分阳性株的PCR产物进行测序,采用序列分析软件分析测序结果,推断其毒株型别,同时收集患儿的临床资料进行综合分析。结果 1 127份腹泻粪便样品中,星状病毒RT-PCR阳性99份,检出率为8.78%。感染星状病毒的患儿多为1岁以下,患儿年龄中位数为3.00月龄,且1月检出率最高。99例阳性星状病毒患儿中,有52例与其他病毒混合感染,混合感染率为4.61%,其中以诺如病毒合并星状病毒最常见。26份PCR阳性产物送往测序,经Genbank Blast及系统进化树分析,所有星状病毒均为人类星状病毒1型。结论星状病毒是天津市秋冬季婴幼儿病毒性腹泻的重要病原体,本次调查期间星状病毒以人类星状病毒1型毒株流行为主,此外存在一定比例的混合感染。

Objective To determine the prevalence and the molecular characterization of astrovirus among children with diarrhea in autumn and winter in Tianjin. Methods A total of 1 127 stool samples collected from infants and children suspected with viral diarrhea hospitalized in Tianjin Children ＇s Hospital between September 2014 and February 2015 were examined for the presence of astrovirus by reverse transcriptase polymerase chain reaction（RT-PCR） technology, and then the positives were subjected to molecular genetic analysis by sequencing method. The sequencing results was obtained by sequence analysis software, which were used to infer the strain type, clinical data was also collected and analyzed. Result Astrovirus were detected in 99 samples（99/1 127,8.78%）. Among the astrovirus-positive samples, the majority of children were under one years old, and the median（range） age of the children was 3.00 months old. The highest detection rate was presented in January.A total of 52 positive samples were co-infected with other virus, the rate of the co-infection was 4.61%, with double infection and triple infection, the most common type was NV with HAst V. A total of 26 astrovirus-positive cases were subjected to molecular genetic analysis and the type identified in samples was HAst V-1 in 100.00% of the cases. Conclusion Astrovirus is a major pathogens of infantile viral diarrhea among hospitalized children with diarrhea in autumn and winter in Tianjin, and HAst V-1 is a predominant genotype between September 2014 and February 2015. Co-infection were observed in a certain proportion.