2020—2022年云南省5岁以下病毒性腹泻住院患儿哨点监测结果分析

Surveillance of viral diarrhea among pediatric inpatients under 5 years old in sentinel hospitals in Yunnan province,2020-2022

目的了解2020—2022年云南省哨点医院5岁以下诊断为腹泻的住院患儿腹泻病毒的感染状况。方法2020—2022年共采集粪便标本612份。采用ELISA、荧光PCR以及巢式PCR法对A组轮状病毒(rotavirus,RVA)、诺如病毒(norovirus,NV)、札如病毒(sapovirus,SaV)、人星状病毒(human astrovirus,HAtV)和肠道腺病毒(adenovirus,EAdV)进行检测,RVA阳性标本进行分型。结果阳性标本266份(混合感染47份),阳性率43.46%。检出率依次是RVA(28.76%,176/612)、NV(11.93%,73/612)、EAdV(4.74%,29/612)、HAtV(3.43%,21/612)和SaV(2.94%,18/612)。2020—2021年RVA以G9P[8]为主,2022年为G8P[8];NV均以GII为主。不同性别仅NV阳性率差异有统计学意义。12~23月龄总检出率最高,48~59月龄最低,各月龄组间差异有统计学意义;第一季度检出率最高,第二季度次之,四个季度间差异有统计学意义(P<0.05)。结论云南省监测哨点5岁以下病毒性腹泻住院患儿中RVA检出率最高,NV次之。2022年RVA优势流行株由G9P[8]变为G8P[8]。

Objective To understand the infection status of viruses causing gastroenteritis among pediatric inpatients under 5 years old with diagnosis of diarrhea in sentinel hospitals in Yunnan province from 2020 to 2022.Methods A total of 612 stool specimens were collected.Group A rotavirus(RVA),norovirus(NV),sapovirus(SaV),human astrovirus(HAtV)and enteric adenovirus(EAdV)were detected by ELISA,fluorescent PCR and nested PCR.Molecular typing was performed on positive samples of RVA.Results A total of 266 positive specimens(including 47 mixed infections)were detected with a positive rate of 43.46%.The detection rates were 28.76%for RVA(176/612),11.93%for NV(73/612),4.74%for EAdV(29/612),3.43%for HAtV(21/612)and 2.94%for SaV(18/612).The predominant type of RVA from 2020 to 2021 was G9P[8],and G8P[8]in 2022 while type GII was consistantly dominant type of NV.The statistically significant difference in genders was observed only in the positive rate of NV infections.The overall virus detection rate was the highest in children of 12-23 months old and the lowest in 48-59 months old.The difference in detection rates in age groups were statistically significant.The detection rate in the first season was the highest,followed by the second quarter.The difference of detection rates of the four seasons statistically significant.Conclusions The detection rate of RVA was the highest among inpatients under 5 years old with viral diarrhea in sentinel hospitals in Yunnan province from 2020 to 2022,followed by NV.The dominant strains of RVA changed from G9P[8]into G8P[8]in 2022.