2020至2022年新生儿轮状病毒感染流行病学特征分析

Analysis of Epidemiological Characteristics of Neonatal Rotavirus Infection from 2020 to 2022

目的研究新生儿轮状病毒(rotavirus,RV)感染流行病学特征,为临床疾病治疗、预防及医院制定RV感染的防治策略提供参考。方法回顾性收集2020年1月至2022年12月入住云南省某三甲儿童医院新生儿科患儿临床资料,使用A群轮状病毒检测试剂(胶体金法)检测粪便RV抗原,应用SPSS 26.0对RV感染新生儿的临床及流行病学数据进行比较分析。结果16761例新生儿患者中有261例检出RV感染,感染率为1.56%,其中2020年至2022年感染率分别为1.97%(124/6298),1.01%(57/5660),1.67%(80/4803)。男性患儿RV感染率为1.39%,女性为1.79%,两者RV感染率,差异有统计学意义(P<0.05)。日龄≤7 d的新生儿RV感染率明显低于日龄8~28 d的新生儿,2者差异有统计学意义(P<0.05)。2020年至2022年新生儿春、夏、秋、冬RV感染率分别为2.64%(102/3866),1.58%(71/4502),0.63%(28/4450),1.52%(60/3943),RV感染率,差异有统计学意义(P<0.05)。患儿不同来源地区感染率排名前四的州(市)分别是迪庆州7.14%(3/42),普洱市2.82%(2/71),红河州2.31%(8/346),文山州2.19%(3/137)。新生儿RV感染中社区感染占62.07%(162/261),医院内感染占37.93%(99/261)。有22.22%(58/261)的患儿为无症状感染,77.78%(203/261)的患儿有腹泻、发热和呕吐等RV感染相关临床症状。不同民族(χ^(2)=7.945,P<0.05)、不同RV抗原检测结果(χ^(2)=5.007,P<0.05)的新生儿RV感染有无症状,差异有统计学意义。结论住院新生儿RV感染率总体较低,以晚期新生儿RV感染最为常见,经济水平相对落后的地区感染率较高。建议提高对新生儿RV感染的重视,加强对照护者的健康教育,并制定综合防治措施,从源头上控制新生儿轮状病毒感染。

Objective To study the epidemiological characteristics of neonatal rotavirus(RV)infection,and to provide the guidance for the treatment and prevention of clinical diseases and the formulation of prevention and treatment strategies for RV infection in hospitals.Methods The clinical data of newborns admitted to a 3A children’s hospital in Yunnan Province were retrospectively collected from January 2020 to December 2022.The RV antigen in feces was detected by group A rotavirus detection reagent(colloidal gold method),and the clinical and epidemiological data of neonatal RV infection were compared and analyzed by SPSS 26.0.Results There were 261 cases of RV infection in 16761 newborn patients,and the infection rate was 1.56%,of which the infection rates in 2020-2022 were 1.97%(124/6298),1.01%(57/5660)and 1.67%(80/4803)respectively.The RV infection rate of male children was 1.39%,while that of female children was 1.79%,and the difference between them was statistically significant(P<0.05).The infection rate of rotavirus in newborns aged≤7 days was significantly lower than that in newborns aged 8~28 days,and the difference was statistically significant(P<0.05).From 2020 to 2022,the neonatal RV infection rates in spring,summer,autumn and winter were 2.64%(102/3866),1.58%(71/4502),0.63%(28/4450)and 1.52%(60/3943)respectively,and the difference was statistically significant(P<0.05).The top four states(cities)of neonatal RV infection rates in different origin areas were 7.14%(3/42)in Diqing,2.82%(2/71)in Pu’er,2.31%(8/346)in Honghe and 2.19%(3/137)in Wenshan.Community infection accounted for 62.07%(162/261)and hospital infection accounted for 37.93%(99/261).There were 22.22%(58/261)children with asymptomatic infection,and 77.78%(203/261)children with RV infection-related clinical symptoms such as diarrhea,fever and vomiting.There are differences between the different nationalities(χ^(2)=7.945,P<0.05)and different RV antigen test results(χ^(2)=5.007,P<0.05)in the presence or absence of symptoms of RV infection in newborns.Conclusion RV infection rate of hospitalized newborns is generally low,especially in late newborns,and the infection rate is higher in areas with relatively backward economic level.It is suggested that more attention should be paid to RV infection in newborns,health education for caregivers should be strengthened and comprehensive prevention measures should be formulated to control the neonatal rotavirus infection from the source.