2018-2021年广东省深圳市光明区病毒感染性腹泻病原谱及流行病学特征分析

Etiological and epidemiological characteristics of viral infectious diarrhea in Guangming district of Shenzhen,Guangdong,2018−2021

目的分析广东省深圳市光明区导致感染性腹泻的常见病毒流行病学特点,为辖区病毒感染性腹泻防控策略制定与实施提供参考。方法收集2018年1月至2021年12月450例其他感染性腹泻病例的粪便标本和临床资料,检测肠道腺病毒(EAdV),轮状病毒(RV),诺如病毒GⅠ、GⅡ组(NoV GⅠ,NoV GⅡ),星状病毒(AstV)及札如病毒(SV)5种病毒,并分析其病毒流行特征。结果450例其他感染性腹泻病例中,150例(33.3%)检出上述5种腹泻相关病毒(共178株)。病毒混合(2种或以上)感染27例,占检出病例18.0%(27/150)。NoV检出率为18.0%(81/450)、RV检出率为9.8%(44/450),高于SV的4.4%、EAdV的3.8%、AstV的3.6%,差异具有统计学意义(P<0.05);NoV及RV是引起病毒感染性腹泻病的主要病原。病例年龄呈双峰分布,峰值在0~5岁及16~45岁。81.0%(17/21)的混合感染病例为11~45岁;NoV GⅡ病例多集中于第一、四季度,RV多集中于第一季度。腹泻病患症状评分与病毒阳性检出率间呈正相关(r=0.935,P<0.05)。结论有关部门应关注对EAdV、RV、NoV(GⅠ、GⅡ组)、AstV及SV 5种感染性腹泻相关病毒的监测,在高发季节对重点人群落实逢泻必检,提升哨点监测敏感性。

Objective To understand the etiological and epidemiological characteristics of common viral infectious diarrhea in Guangming district of Shenzhen and provide reference data for the development and implementation of viral infectious diarrhea prevention strategy.Methods From January 2018 to December 2021,the clinical data and stool samples were collected from 450 cases of viral infectious diarrhea and detections of enteric adenovirus,rotavirus,norovirus GⅠ,GⅡ,astrovirus and Sapovirus were conducted.The spread characteristics of the viruses were analyzed.Results In 450 cases of viral infectious diarrhea,the 178 strains of the viruses mentioned above were detected in 150 cases(33.3%),and two or more viruses were detected in 27 cases(18.0%).The detection rate of norovirus was 18.0%(81/450)and the detection rate of rotavirus was 9.8%(44/450),which were significantly higher than those of Sapovirus(4.4%),enteric adenovirus(3.8%)and astrovirus(3.6%),the differences were significant(P<0.05).Norovirus and rotavirus were the main viruses causing viral infectious diarrhea in Guangming district.The age-specific incidence of the infections showed two peaks,one was in age group 0−5 years and another one was in age group 16−45 years.Up to 81.0%(17/21)of co-infections occurred in age group 11−45 years.For seasonal distribution,norovirus GⅡinfections mainly occurred in the first and fourth quarters,and rotavirus infections mainly occurred in the first quarter.There was a positive correlation between the symptom score of diarrhea patients and the positive detection rate of the virus(r=0.935,P<0.05).Conclusion It is necessary to pay attention to the surveillance the 5 viruses causing infectious diarrhea.Screening should be carried out in diarrhea cases in high-risk seasons and in key populations to improve the sensitivity of sentinel surveillance.