2012—2017年山东省5岁以下儿童病毒性腹泻病原监测结果分析

Analysis of surveillance results of viral diarrhea among children under 5 years of age in Shandong province from 2012 to 2017

目的分析山东省5岁以下儿童病毒性腹泻病原谱和流行病学特点,为病毒性腹泻防控提供参考依据。方法收集2012—2017年在山东省哨点医院就诊的所有5岁以下腹泻患儿发病3日内粪便标本共1017份,轮状病毒使用ELISA筛检,ELISA阳性标本使用RT-PCR方法进行轮状病毒G/P分型;诺如病毒(GI和GII)、札如病毒、星状病毒检测采用RT-PCR筛检,肠道腺病毒采用PCR方法检测。结果1017份粪便标本中,病毒总阳性率为51.62%(525/1017),检出至少含有1种病毒核酸421份、混合病毒感染104份,混合感染占全部感染的10.23%(104/1017)。轮状病毒、杯状病毒、肠道腺病毒和星状病毒阳性检出率分别为34.22%(348/1017)、16.91%(172/1017)、2.56%(26/1017)、9.64%(98/1017)。腹泻病毒总检出率和轮状病毒检出率在12~17月龄最高,分别为51.72%(105/203)和20.20%(41/203),2岁及以下患儿腹泻病毒阳性率为49.36%(502/1017),2岁以上患儿腹泻病原阳性率2.26%(23/1017)。病毒性腹泻高峰为每年11月份至次年4月份。轮状病毒G基因型以G9为优势型(82.76%),P基因型以P[8]型为主(80.46%),G/P组合以G9P[8]为主(83.87%)。杯状病毒中诺如病毒感染为主(87.21%)。结论2012—2017年山东省5岁以下儿童病毒性腹泻以轮状病毒为主,其次为诺如病毒,发病率处于全国的中等程度,秋冬季为流行季节。

Objective To analyze the epidemiological characteristics and pathogen types of viral diarrhea in children under 5 years of age in Shandong province,and provide reference for the prevention and control of viral diarrhea.Methods A total of 1017 fecal samples were collected from all children aged 5 years and younger with diarrhea who were admitted to the sentinel hospital of Shandong province from 2012 to 2017 within 3 days.Rotavirus antigen was detected by using an ELISA method.Rotavirus G/P typing was performed by RT-PCR;Norovirus(GI and GII),Sapovirus,and Astrovirus were detected by multiplex RT-PCR,and adenovirus was detected by PCR.Results In the 1017 fecal specimens,the overall positive rate was 51.62%(525/1017),and viral nucleic acids were detected in at least 421 samples,and mixed virus infection was found in 104 sampes.The mixed infection accounted for 10.23%(104/1017)of all infections.The positive detection rates of Rotavirus,Calicivirus,Adenovirus and Astrovirus were 34.22%(348/1017),16.91%(172/1017),2.56%(26/1017),and 9.64%(98/1017)).The total detection rate of diarrhea virus and the detection rate of Rotavirus were the highest at 12 to 17 months of age,which was 51.72%(105/203)and 20.20%(41/203),respectively.The positive rate of diarrhea in children aged 2 years and younger was 49.36%(502/1017),which was much higher than the positive rate of diarrhea in children over 2 years old(2.26%(23/1017)).The peak of viral diarrhea was found to occur between November and April of the following year.The genotype of rotavirus was dominated by G9(82.76%),the P genotype was dominated by P[8](80.46%),and the G/P combination was dominated by G9P[8](83.87%).Norovirus was the main infection in the Calicivirus(87.21%).Conclusions From 2012 to 2017,viral diarrhea in children under 5 years of age in Shandong Province was mainly caused by Rotavirus infection,followed by Norovirus.The overall prevalence of viral diarrhea in Shandong was moderate in China,and autumn and winter were the main epidemic season for viral diarrhea.