天水市儿童腹泻感染病原谱分析

Pathogen spectrum analysis of diarrhea infection in children in Tianshui City

目的分析2018年—2019年天水市5岁以下婴幼儿腹泻的病原构成和流行特征;为预防控制提供依据。方法收集天水2所医院腹泻患儿的粪便标本310份。采用ELISA法检测轮状病毒、RT-PCR方法检测诺如病毒、星状病毒、札如病毒和肠道腺病毒;同时分离培养检测非伤寒沙门菌、志贺菌、致泻大肠埃希菌、致病性弧菌、嗜水气单胞菌、类志贺邻单胞菌、小肠结肠炎耶尔森菌、空肠弯曲菌。结果310例患儿总的病原阳性率为49.68%。主要构成为A组轮状病毒(21.29%)、诺如病毒GⅡ型(20.97%)、肠道腺病毒(7.42%)、致泻大肠埃希菌(5.16%)。其中阳性RV中G血清型主要为G9型(95.45%)、P基因型主要为P8型(92.42%),基因型组合以G9P[8]为主(93.94%)。结论天水市5岁以下儿童感染病毒性腹泻以轮状病毒、诺如病毒为主,轮状病毒G血清型和P基因型组合以G9P[8]为主;细菌性腹泻以致泻大肠埃希菌、沙门菌为主。

Objective To investigate the pathogenic spectrum and epidemic characteristics of diarrhea in infants under 5 years old in Tianshui City from 2018 to 2019,and to provide basis for prevention and control.Methods A total of 310 fecal samples were collected from children with diarrhea from two hospitals in Tianshui.Rotavirus was detected by ELISA,and norovirus,astrovirus,zarovirus and entericadenovirus were detected by RT-PCR.At the same time,Salmonella non-typhoid,Shigella,Escherichia coli causing diarrhea,Vibrio pathogenicity,Aeromonas hydrophila,Shigera monomonas,Yersinia enterocolitis and Campylobacter jejuni were isolated and cultured.Results The total positive rate of viral pathogens was 49.68%in 310 children patients.The main pathogens were rotavirus(21.29%),norovirus GⅡ(20.97%),Entericadenovirus(7.42%),diarrhea causing Escherichia coli(5.16%).In the positive RV,the G serum type was mainly G9(95.45%),the P genotype was mainly P8(92.42%),and the genotype combination was mainly G9P[8](93.94%).Conclusion Rotavirus and norovirus were the main pathogens causing bacterial diarrhea in children under 5 years old in Tianshui City,and G9P[8]is the main genotype combination of rotavirus G serotype and P genotype.Bacterial diarrhea was mainly caused by Escherichia coli and Salmonella.