2016-2017年乌鲁木齐市5岁以下婴幼儿轮状病毒感染状况及病原学分析

Etiological analysis of rotavirus infection in infants in Urumqi

目的调查2016-2017年新疆维吾尔自治区(新疆)乌鲁木齐市<5岁婴幼儿轮状病毒(RV)流行趋势和病原学特征,为婴幼儿RV防控提供依据。方法收集2016年1月1日至2017年12月31日乌鲁木齐市儿童医院因腹泻住院的597例婴幼儿患者的流行病学资料和粪便标本,用酶联免疫吸附试验(ELISA)检测RV抗原,并用反转录–聚合酶链式反应(RT-PCR)检测RV核酸和基因分型。结果 A群RV抗原阳性率为32.5%(194/597),对阳性病例标本进一步进行基因分型分析,检测出G1~4型、G9型等,以G9型最为常见,阳性检出率为11.6%(69/597)。检出P[4]型、P[6]型、P[8]型等,以P[8]型最多,阳性检出率为22.7%(44/194)。G、P基因型组合中G3P[8](31.4%)、G9P[8](25.3%)、G2P[4](18.0%)、G1P[8](8.8%)检出较多。13~18月龄组RV阳性率最高(40.0%)、0~6月龄组RV阳性率最低(23.4%),不同月龄组间RV阳性率差异有统计学意义(χ~2=13.698,P=0.033)。2016年和2017年RV阳性率分别为35.8%(108/302)、29.2%(86/295)(χ~2=2.971,P=0.085)。城市患儿RV阳性率为32.8%(173/527),高于农村患儿30.0%(21/70)(χ~2=0.225,P=0.635)。结论乌鲁木齐市婴幼儿对RV普遍易感,RV毒株基因型呈多样性,以G3P[8]型为主,居住城市、年龄为1~2岁组婴幼儿是接种疫苗防控的重点人群。

Objective To understand the infection status of rotavirus in children under 5 years old in Urumqi from 2016 to 2017,analyze its etiological characteristics and provide evidence for the prevention and control of rotavirus infection. Methods The epidemiological data and stool samples were collected from 597 infants hospitalized in Urumuqi Children’s Hospital due to diarrhea from January 1, 2016 to December 31, 2017. Enzyme-linked immunosorbent assay(ELISA) was conducted to detect rotavirus antigen, and reverse transcription polymerase chain reaction(RT-PCR) was used for rotavirus nucleic acid detection and genotyping. The test results and epidemiological data were analyzed. Results The positive rate of group A rotavirus antigen was 32.5%(194/597). In genotyping of the rotavirus strains isolated from positive cases, genotype G1, G2, G3, G4 and G9 were detected, G9 was predominant(11.6%, 69/597), and genotype P[4], P[6] and P[8] were detected, and the detection rate of P[8] was highest(22.7%, 44/194). In the combinations of G and P genotypes, G3 P[8](31.4%),G9 P[8](25.3%), G2 P[4](18.0%) and G1 P[8](8.8%) were detected more frequently. The positive rate of rotavirus was highest in age group 13–18 months(40.0%) and lowest in age group 0–6 months(23.4%). The infection rate of rotavirus varied with age group, the differences were significant(χ~2=13.698,P=0.033). The positive rate of rotavirus was 35.8% in2016(108/302) and 29.2% in 2017(86/295)(χ~2=2.971, P=0.085). The rotavirus positive rate in urban children was 32.8%(173/527), higher than that in rural children(30.0%, 21/70)(χ~2=0.225, P=0.635). Conclusion Infants and young children in Urumqi are generally susceptible to rotavirus, and RV strains had diverse genotypes, mainly G3 P[8] type. Urban children aged 1–2 years are the key population for vaccination in the prevention and control of rotavirus infection.