2019年我国5岁以下腹泻住院患儿A组轮状病毒感染的流行特征分析

Epidemiological characteristics of group A rotavirus infection in hospitalized children under 5 years of age with diarrhea in China in 2019

目的了解2019年我国5岁以下腹泻住院患儿A组轮状病毒(group A rotavirus,RVA)感染的流行特征,为A组轮状病毒监测提供参考。方法收集2019年我国20省监测哨点医院的5岁以下腹泻住院儿童粪便标本及临床信息。根据《全国病毒性腹泻监测方案》中轮状病毒检测方法进行RVA核酸检测及基因分型。结果采集病毒性腹泻标本共5395份,检测5038份,1247份腹泻标本呈现RVA核酸阳性(1247/5038,24.75%)。RVA在福建省的阳性率最低(30/319,9.40%),在河南省的阳性率最高(182/338,53.85%);RVA在男性和女性患儿中的阳性率分别为25.24%(762/3019)和24.02%(485/2019),RVA感染无明显的性别分布特征(χ^(2)=0.96,P=0.326);RVA以12~17月龄患儿为主要易感对象(342/1033,33.11%),48~59月龄患儿RVA的阳性率较低(35/227,15.42%),RVA感染呈现明显的年龄分布特征(χ^(2)=86.78,P<0.001);RVA感染具有明显的城乡差别(χ^(2)=20.92,P<0.001)和季节特征(χ^(2)=411.42,P<0.001)。RVA基因分型结果显示G9P[8]型(994/1122,88.59%)是主要的流行优势株。结论2019年我国5岁以下腹泻住院患儿RVA感染的主要基因型为G9P[8]型,且RVA感染具有明显的年龄、地域和季节特征。

Objective To understand the epidemiological characteristics of group A rotavirus(RVA)infection in hospitalized children under 5 years of age with diarrhea in 2019,and to provide reference for the surveillance of RVA.Methods Stool samples and clinical information of hospitalized children under 5 years of age with diarrhea were collected from sentinel hospitals in 20 provinces in 2019.RVA nucleic acid detection and genotyping were performed according to the rotavirus detection method in the National Viral Diarrhea Surveillance Program.Results A total of 5395 viral diarrhea samples were collected,5038 were tested,and 1247 diarrhea samples showed RVA positive results(1247/5038,24.75%).The positive rate of RVA in Fujian province was the lowest(30/319,9.40%),and the positive rate of RVA was the highest in Henan province(182/338,53.85%).The positive rate of RVA in male and female children was 25.24%(762/3019)and 24.02%(485/2019),respectively.There was no significant gender distribution of RVA infection(χ^(2)=0.96,P=0.326).Children aged 12 to 17 months were mainly susceptible to RVA(342/1033,33.11%),and the positive rate of RVA in children aged 48 to 59 months was lower(35/227,15.42%).RVA infection showed significant age distribution characteristics(χ^(2)=86.78,P<0.001).RVA infection had significant difference between urban and rural areas(χ^(2)=20.92,P<0.001)and seasonal characteristics(χ^(2)=411.42,P<0.001).RVA genotyping showed that G9P[8]type(994/1122,88.59%)was the dominant epidemic strain.Conclusions In 2019,the main genotype of RVA infection in hospitalized children under 5 years of age with diarrhea was G9P[8],and RVA infection had significant age,region and season characteristics.