2011-2020年成都某哨点医院5岁以下儿童病毒性腹泻病原谱分析

Pathogen spectrum analysis of viral diarrhea in children under 5 years old in a sentinel hospital in Chengdu from 2011 to 2020

目的了解2011—2020年成都地区5岁以下儿童病毒性腹泻病原谱,为病毒性腹泻防控提供依据。方法采集成都地区2011—2020年感染性腹泻患儿粪便样本2520份,用ELISA、逆转录巢式多重PCR、RT-PCR和PCR方法对轮状病毒、诺如病毒、札如病毒、人星状病毒和肠道腺病毒进行检测,采用SPSS 20.0软件进行统计学分析。结果2520份样本中检出病毒性腹泻阳性样本1213份,阳性率为48.13%。其中男性患儿阳性检出率为49.64%(779/1569),女性患儿阳性检出率为45.64%(434/951),男女性别间阳性率差异无统计学意义。病毒性腹泻检出率呈现随着年龄先增加后下降的趋势,其中12~17月组检出率最高为63.12%(380/602)。轮状病毒在秋冬季高发,诺如病毒在秋季高发,肠道腺病毒在5月和10—12月分别出现了两个感染高峰。存在单一病原感染和混合感染,混合感染率为6.79%(171/2520);诺如病毒和轮状病毒的检出率位居前2位,其中诺如病毒检出率高于轮状病毒。诺如病毒以GⅡ型为优势株;轮状病毒自2012年起以G9P[8]为流行株。结论2011—2020年成都地区哨点医院5岁以下儿童病毒性腹泻的主要病原体为诺如病毒和轮状病毒。

Objective To investigate the pathogen spectrum of viral diarrhea among children under 5 years old in Chengdu district from 2011 to 2020,so as to provide evidence for the prevention and control of viral diarrhea.Methods A total of 2520 stool samples were collected from children with infectious diarrhea from 2011 to 2020 in Chengdu area.Rotavirus,norovirus,sapovirus,human astrovirus and adenovirus were detected by ELISA,multiplex reverse transcriptase nested PCR,RT-PCR and PCR.Statistical analysis was performed by SPSS 20.0 software.Results From 2520 stool samples,1213 were tested positive for viral diarrhea with a positive rate of 48.13%.The positive rates among male and female children were 49.64%(779/1569)and 45.64%(434/951),respectively.There was no statistically significant difference between the positive rates.The positive rate of viral diarrhea showed a trend of increasing followed by decreasing along with age increment.The positive rate in the 12-17 months old group was 63.12%(380/602).The incidence peak of rotavirus was in autumn and winter while the peak of norovirus was in autumn.The two incidence peaks of adenovirus infection was in May and October-to-December period.The single pathogen infection and mixed infection existed,and the mixed infection rate was 6.79%(171/2520).The detection rates of norovirus and rotavirus was ranked in the top two,and the detection rate of norovirus was higher than that of rotavirus.The dominant strain of norovirus was G II type while rotavirus G9P[8]has been the epidemic strain since 2012.Conclusions Norovirus and rotavirus were the main pathogens of viral diarrhea in children under 5 years old in the sentinel hospitals of Chengdu from 2011 to 2020.