2016—2019年上海市奉贤区哨点医院≤14岁少儿病毒性腹泻监测结果分析

Analysis on surveillance results of viral diarrhea among children under 14 years old in sentinel hospital of Fengxian District in Shanghai from 2016-2019

目的 分析上海市奉贤区哨点医院少儿病毒性腹泻病原谱和流行病学特征,为病毒性腹泻防控提供参考依据。方法 收集2016—2019年在上海市奉贤区哨点医院儿科门诊就诊的腹泻患儿粪便标本,采用实时荧光定量聚合酶链式反应(polymerase chain reaction,PCR)技术对轮状病毒、诺如病毒、札如病毒、肠道腺病毒、星状病毒及其他病毒进行核酸检测。结果 共采集粪便标本263份(男性152份,女性111份),病毒总检出率为34.60%(91份),其中诺如病毒、轮状病毒、札如病毒、肠道腺病毒和星状病毒检出率分别为12.93%(34份)、8.75%(23份)、5.32%(14份)、4.56%(12份)和3.04%(8份)。不同季节病毒总检出率比较,差异有统计学意义(χ^(2)=43.67,P<0.05),秋、冬季节达到高峰,不同季节诺如病毒、轮状病毒、肠道腺病毒及星状病毒检出率比较,差异均有统计学意义(χ^(2)=34.297、31.245、9.517、12.015,均P<0.05)。诺如病毒在秋季(9—11月)检出率最高,轮状病毒和肠道腺病毒均在冬季(12月—次年2月)检出率最高,星状病毒在春季(3—5月)检出率最高。病毒总阳性率在37~<49月龄组最高,为75.00%。结论 上海市奉贤区少儿病毒性腹泻以诺如病毒和轮状病毒为主,流行季节为秋、冬季,37~<49月龄为高发年龄段,少儿病毒性腹泻防控工作应针对不同年龄、季节采取特异性防控措施。

Objective To analyze the pathogenic spectrum and epidemiological characteristics of viral diarrhea among children in sentinel hospital of Shanghai Fengxian District,provide evidence for prevention and control of viral diarrhea. Methods The stool specimens of patients were collected from the children in the pediatric clinic of sentinel hospital in Fengxian District of Shanghai from 2016 to 2019. The real time quantitative fluorescence polymerase chain reaction(PCR) was used to detect the presence of pathogens as rotavirus,norovirus,sapovirus,intestinal adenovirus and astrovirus. Results A total of 263 samples were collected(152 of male and 111 of female),and the overall detection rate was 34.60%(91 samples).The detection rate of norovirus,rotavirus,sapovirus,intestinal adenovirus and astrovirus was 12.93%(34 samples),8.75%(23 samples),5.32%(14 samples),4.56%(12 samples) and 3.04%(8 samples),respectively. There was statistically significant difference in the overall detection rate of virus among different season(χ^(2)=43.67,P<0.05),and it peaked in autumn and winter. The differences in the detection rates of rotavirus,norovirus,intestinal adenovirus and astrovirus among different seasons were statistically significant (χ^(2)=34.297,31.245,9.517,12.015,all P<0.05). The detection rate of norovirus was the highest in autumn(September to November),the detection rates of rotavirus and adenovirus were the highest in winter(December to February of the next year),and the detection rate of astrovirus was the highest in spring(March to May). The total positive rate of virus was the highest in 37-<49 month-old age group(75.00%).Conclusion Norovirus and rotavirus are the main pathogens of viral diarrhea in children in Shanghai Fengxian District from 2016 to 2019,the infection peak occurs in autumn and winter,37-<49 month-old is the high-incidence age group,and the specific prevention and control measures according to the difference on age and season should be taken on viral diarrhea of children.