海南省病毒性腹泻病原学流行特征分析

Analysis of the etiology and epidemiological characteristics of viral diarrhea

目的分析病毒性腹泻患者病原学及流行病学特点,为病毒性腹泻的预防和控制提供参考。方法搜集2015-2017年海口市中医医院就诊的腹泻患者粪便标本857份,采用荧光定量PCR检测轮状病毒和杯状病毒核酸,PCR检测肠道腺病毒核酸,星状病毒核酸检测采用RT-PCR,用SPSS22.0对检测结果与流行病学资料进行统计分析。结果 857份粪便标本病毒阳性367份,阳性率为42.82%,其中杯状病毒的阳性检出率最高,为14.12%,其他病毒分别为轮状病毒(12.25%)、肠道腺病毒(5.02%)、星状病毒(2.80%);混合感染占8.63%。1~岁年龄组病毒阳性率最高,为55.61%(114/205),其次为50~岁年龄组,为55.25%(36/64),2~岁年龄组为48.85%(64/131),各年龄组间差异有统计学意义(χ2=1.698,P=0.428)。男性病毒阳性率42.54%,女性为43.31%,差异无统计学意义(χ2=0.048,P=0.826);病毒性腹泻呈现出一定的季节性特点,流行高峰为秋冬季。其中,杯状病毒检出在1~2岁组最高,轮状病毒检出率在40~49岁组最高,两种病毒均在秋冬季较为流行。结论病毒性腹泻病原体以杯状病毒和轮状病毒为主,具有明显季节性,同时存在混合感染。病毒性腹泻防控重点人群为2岁以下儿童。

Objectives To analyze the etiology and epidemiological characteristics of viral diarrhea in order to provide reliable data for prevention and control of viral diarrhea. Methods Eight hundred and fifty-seven fecal specimens were collected from patients with diarrhea at Haikou Traditional Chinese Medicine Hospital from 2015-2017.Fluorescent quantitative PCR was used to detect rotavirus and calicivirus nucleic acids.PCR was used to detect enteric adenovirus nucleic acids.Astrovirus nucleic acids were detected with RT-PCR.Those results and epidemiological data were statistically analyzed using SPSS 22.0. Results Laboratory testing of the 857 stool specimens indicated that 367（42.82%）tested positive for a virus.A calicivirus was detected most often（14.12%）,followed by a rotavirus（12.25%）,an enteric adenovirus（5.02%）,and an astrovirus（2.80%）.The rate of mixed infections was 8.63%. Conclusion Prevention and control of viral diarrhea should target children under the age of 2.