三重实时荧光PCR法检测急性胃肠炎聚集性疫情的探讨

Detection of Aggregation Epidemic of Acute Gastroenteritis by Triple Real-Time Fluorescent PCR

目的:探讨三重实时荧光PCR法在急性胃肠炎聚集性疫情中快速检测GⅠ/GⅡ型诺如病毒和A组轮状病毒的应用。方法:采集2020年11月12日一起学校急性胃肠炎聚集性疫情中的疑似病例、临床诊断病例、密切接触者标本及环境标本共373份,用三重实时荧光RT-PCR法同时检测诺如病毒(基因组GⅠ/GⅡ)和A组轮状病毒核酸,根据不同病毒核酸的检出率分析该疫情的主要病原体,分析病原体在感染者中年龄的分布影响。结果:373份标本中检出诺如病毒(基因组GⅠ/GⅡ)144份,检出率38.61%;检出A组轮状病毒2份,检出率0.54%;检出诺如病毒和A组轮状病毒混合感染6份,检出率1.61%。不同性别间诺如病毒感染阳性率比较,差异无统计学意义(P>0.05)。不同职业间诺如病毒感染阳性率比较,差异无统计学意义(P>0.05)。>45岁组人群诺如病毒感染阳性率最高,26~35岁组阳性率最低,不同年龄组人群阳性率比较,差异有统计学意义(P<0.05)。结论:诺如病毒可能是导致本次疫情的主要病原体,同时存在诺如病毒和A组轮状病毒混合感染的情况,三重实时荧光PCR法同时检测多种病毒为疫情快速处置提供了实验室依据。

Objective: To explore the application of triple real-time fluorescent PCR in the rapid detection of GI/GII norovirus and group A rotavirus in aggregation epidemic of acute gastroenteritis. Methods: A total of 373 specimens of suspected cases, clinically diagnosed cases, close contacts, and environment from an aggregation epidemic of acute gastroenteritis in a school reported on November 12, 2020 were collected, and a triple real-time fluorescent RT-PCR method was used for simultaneous nucleic acid test of norovirus(genome GI/GII) and group A rotavirus. The main pathogens of the epidemic were analyzed based on the detection rate of different viral nucleic acids, and the influence of the pathogen’s age distribution among infected persons was analyzed. Results:Noroviruses(genome GI/GII) were detected in 144 of 373 specimens, with a detection rate of 38.61%;Group A rotaviruses were detected in 2 specimens, with a detection rate of 0.54%;The mixed infection of norovirus and group A rotavirus was detected in 6specimens, with a detection rate of 1.61%. There was no significant difference in the positive rate of norovirus infection between different genders(P>0.05). There was no significant difference in the positive rate of norovirus infection among different occupations(P>0.05). The positive rate of norovirus infection was the highest in the population of >45-year-old group and the lowest in the population of 26-to 35-year-old group. There was a statistically significant difference in the positive rate among different age groups(P<0.05). Conclusion: Norovirus may be the main pathogen causing this epidemic, and there are mixed infections of norovirus and group A rotavirus. The triple real-time fluorescent PCR method to detect multiple viruses at the same time provides laboratory evidence for the rapid treatment of the epidemic.