2018-2019年昆明市住院新生儿轮状病毒感染及基因型分析

Rotavirus infection and genotype analysis of hospitalized newborns in Kunming from 2018 to 2109

目的分析2018-2019年昆明地区住院新生儿轮状病毒(RV)感染情况、临床表现及基因型特征。方法选取2018-2019年昆明某三级甲等医院住院的5092例新生儿为研究对象,通过乳胶法检测粪便RV抗原,巢式逆转录PCR(RT-PCR)方法进行RV基因分型,同时收集临床表现及流行病学信息进行分析。结果5092例住院新生儿中检出粪便RV抗原阳性136例,总检出率为2.67%。社区感染占64.71%(88/136),医院感染占35.29%(48/136)。新生儿RV感染全年均可发生,12月至次年2月为感染高峰季节。30.15%(41/136)的新生儿为无症状感染,69.85%(95/136)有临床症状,最常见的临床症状为腹泻(60.29%,82/136),其次为发热(14.71%,20/136),4.41%(6/136)的患儿以发热为唯一或首发症状,9.56%(13/136)表现为便血、喂养不耐受及新生儿坏死性小肠结肠炎等其他症状。足月儿腹泻发生率高于早产儿,早产儿其他症状发生率高于足月儿(P<0.05)。新生儿RV主要流行基因型为G9P[8](76.41%,68/89),其次为G2P[4](21.35%,19/89),少见的G2P[8]及G8P[8]型各检出1例。主要基因型在不同症状及分类的新生儿中分布比较,差异无统计学意义(P>0.05)。结论昆明市住院新生儿RV感染率较低,主要基因型为G9P[8]。

Objective To analyze the rotavirus(RV)infection,clinical manifestations,and genotype characteristics of hospitalized newborns in Kunming from 2018 to 2019.Methods A total of 5092 neonates hospitalized in a tertiary grade A hospital from 2018 to 2019 were selected as the research objects.The fecal RV antigen was detected by latex agglutination test,and the nested reverse transcription PCR(RT-PCR)method was used for RV genotyping.At the same time,clinical manifestations and epidemiological information were collected.Results A total of 136 fecal RV antigen-positive newborns were detected in the 5092 hospitalized newborns,and the total detection rate was 2.67%.Community infections accounted for 64.71%(88/136),and hospital infections accounted for 35.29%(48/136).Neonatal RV infection occurred throughout the year.The epidemic peak season was from December to February of the following year.30.15%(41/136)of newborns had asymptomatic infections,69.85%(95/136)had clinical symptoms,and the most common clinical symptoms were diarrhea(60.29%,82/136),followed by fever(14.71%,20/136),4.41%(6/136)of neonates had a fever as the only or first symptom,and 9.56%(13/136)showed hematochezia,feeding intolerance and necrotizing enterocolitis,etc.Full-term infants were more likely to have diarrhea symptoms than preterm infants,and the incidence of other symptoms in preterm infants was higher than full-term infants(P<0.05).The mainprevalent genotype of neonatal RV was G9P[8](76.41%,68/89),followed by G2P[4](21.35%,19/89).The rare G2P[8]and G8P[8]were detected in one case each.There was no statistically significant difference in the distribution of main genotypes among newborns with different symptoms(P>0.05).Conclusion The RV infection rate of hospitalized newborns in Kunming is relatively low.The main prevalent genotype of neonatal RV is G9P[8].