诺如病毒感染急性肠胃炎的影响因素及其基因特征

Influencing factors for Norovirus infection in acute gastroenteritis and its genetic characteristics

目的探讨诺如病毒(NoV)感染急性肠胃炎的影响因素及其基因特征。方法选取武汉市武昌医院2019年1月-2021年6月NoV感染急性肠胃炎患者102例纳入病例组,另按照性别、年龄、职业选取2周内无腹泻、呕吐的健康人群102名作为对照组,对比两组饮食、个人卫生情况,通过Logistic回归分析NoV感染性急性肠胃炎的影响因素,并检测NoV病毒感染优势基因型,分析基因特征。结果病例组生与熟食砧板不予区分、经常吃海鲜类食物、饭前便后不洗手的习惯、非正规餐饮店/流动摊点就餐、接触呕吐或腹泻患者占比高于对照组(P<0.05);生与熟食砧板不予区分、经常食用海鲜类食物、饭前便后不洗手的习惯、非正规餐饮店/流动摊点就餐、接触呕吐或腹泻患者是NoV感染性急性肠胃炎发生的影响因素(P<0.05);在102例NoV阳性标本中针对ORF1的RdRp区域扩增并分型,成功分型71份,以GⅡ.Pe和GⅡ.P12为主(P<0.05);针对ORF2的Capsid区域扩增并分型,成功分型66份,以GⅡ.4 Sydney2012和GⅡ.3为主(P<0.05);RdRp和Capsid片段均分型成功的有54份样本,以GⅡ.Pe-GⅡ.4 Sydney2012和GⅡ.P12-GⅡ.3为主(P<0.05)。结论饮食和生活习惯不良是NoV感染的重要原因,流行株几乎均为重组株,GⅡ.Pe-GⅡ.4 Sydney 2012和GⅡ.P12-GⅡ.3是主要重组株,同时出现GⅡ.Pe-GⅡ.3和GⅡ.P16-GⅡ.2的重组株。

OBJECTIVE To investigate the factors influencing norovirus(NoV) infection in acute gastroenteritis and its genetic characteristics.METHODS A total of 102 patients with NoV-infected acute gastroenteritis in Wuhan Wuchang Hospital were selected to be included in the case group between Jan.2019 and Jun.2021,and aother 102 healthy people without diarrhea or vomiting within 2 weeks were selected as the control group according to matched gender,age and occupation.The diet and personal hygiene between the two groups were compared.The influencing factors of NoV infection were analyzed by Logistic regression analysis,the dominant genotypes of NoV infection were detected,and the genetic characteristics were analyzed.RESULTS The proportions of patients with mixed usage of chopping board for raw and cooked food,frequent consumption of seafood-based foods,habit of not washing hand before eating and after toilet,eating at informal restaurants/mobile stalls,and exposure to vomiting or diarrhea people in the case group were higher than those in the control group(P<0.05).The mixed usage of chopping board for raw and cooked food,frequent consumption of seafood-based foods,habit of not washing hand before eating and after toilet,eating at informal restaurants/mobile stalls and exposure to vomiting or diarrhea people were influencing factors of NoV-infected acute gastroenteritis(P<0.05).In terms of amplification and typing of the RdRp region against ORF1 in 102 NoV-positive specimens,71 cases were successfully typed,mainly on GII.Pe and GII.P12(P<0.05).In terms of amplification and typing of Capsid region against ORF2,66 cases were successfully typed,mainly on GII.4 Sydney2012 and GII.3(P<0.05).There were 54 cases with successful typing for RdRp and Capsid fragments,mainly on GII.Pe-GII.4 Sydney2012 and GII.P12-GII.3(P<0.05).CONCLUSION Poor diet and living habits were important causes of NoV virus infection.The prevalent strains were almost all recombinant strains,GII.Pe-GII.4 Sydney 2012 and GII.P12-GII.3 were the main recombinant strains,with simultaneously appeared recombinant strains of GII.Pe-GII.3 and GII.P16-GII.2.