2012-2016年河北省5岁以下腹泻患儿轮状病毒感染情况及流行特征分析

Infectious status and epidemiological characteristics of rotavirus among diarrhea children under 5 years old in Hebei Province,2012-2016

目的了解2012-2016年河北省5岁以下腹泻患儿轮状病毒流行病学特点和基因型别。方法收集河北省病毒性腹泻监测哨点医院2012年1月-2016年12月0~59月龄腹泻患儿粪便标本1 614份。采用ELISA方法检测轮状病毒抗原,阳性标本采用RT-PCR法进行分型鉴定。采用SPSS 20.0软件对腹泻患儿轮状病毒的感染情况及流行特征进行分析。结果 1 614份标本轮状病毒抗原阳性率为45.23%(730/1 614),男女阳性率分别为42.96%(412/959)、48.55%(318/655),男女患儿差异有统计学意义(χ2=4.906,P=0.027)。轮状病毒感染呈现明显的季节性分布,秋冬季(11月-次年3月)检出率最高。轮状病毒感染在0~59月龄均有发生,集中在3~35月龄,占全部的96.44%,且随月龄增长呈现先升高后降低趋势,不同年龄组患儿中轮状病毒阳性率差异有统计学意义(χ2=94.369,P=0.000)。730例轮状病毒阳性标本在2012-2016年均以G9血清型为主,所占比例呈逐年上升趋势,P分型以P[8]为主。G/P组合以G9P[8]为主,占70.14%,其次为G2P[4],占7.53%。结论 2012-2016年,轮状病毒是河北地区5岁以下儿童病毒性腹泻的主要病原,秋冬季高发,G9P[8]为该地区的流行株。

Objective To investigate the epidemiological characteristics and genotypes of rotavirus in diarrhea children below 5 years old in Hebei Province during 2012-2016. Methods We collected 1,614 stool samples from diarrhea children aged 0-59 months in viral diarrhea sentinel hospitals in Hebei Province from January 2012 to December 2016. Rotavirus antigen was detected by ELISA, and then the positive samples were genotyped by RT-PCR. SPSS 20.0 software was used to analyze the infectious status and epidemiological characteristics of rotavirus in diarrhea children. Results The positive rate of rotavirus antigen was 45.23% （730/1,614）. The rotavirus infection rates of males and females were 42.96% （412/959） and 48.55% （318/655） , showing a statistically significant difference （χ2 = 4.906, P= 0.027）. Rotavirus infection showed a clearly seasonal distribution, and the detection rate of rotavirus diarrhea was found to be the highest in autumn and winter （ from November to next March）. Rotavirus infection occurred in children ranging in age from 0 to 59 months, but 96.44% of the cases were children aged 3-35 months. It tended to firstly increase then decrease with the increasing age. There were statistically significant differences in the positive rate of rotavirus antigen among children from different age groups （χ2= 94. 369, P= 0.000 ）. Among the 730 samples positive for rotavirus antigen during 2012-2016, the predominant genotype was G9 and its proportion showed an increasing tendency year-by-year. P [ 8 ] was found as predominant genotype. The major rotavirus strain was G9P[ 8] （70.14%）, followed by G2P [ 4] （7.53%）. Conclusions Rotavirus was the main pathogen causing viral diarrhea among children under 5 years old in Hebei Province during 2012- 2016. The incidence of rotavirus-related diarrhea peaked in fall and winter, and genotype G9P[ 8] was identified as the most prevalent strain.