2005-2022年甘肃省麻疹风疹实验室网络运转情况分析

Performance of measles and rubella laboratory network in Gansu,2005−2022

目的评价2005—2022年甘肃省麻疹风疹实验室网络运转状况。方法汇总2005—2022年甘肃省麻疹风疹实验室网络病例诊断、病原学检测、病毒基因分型、监测指标完成情况、职能考核等结果数据,综合网络运转情况进行统计分析。采用酶联免疫吸附试验(ELISA)方法检测疑似麻疹、风疹血清学标本的IgM抗体,采用实时荧光定量聚合酶链式反应(qRT-PCR)方法检测疑似麻疹、风疹咽拭子标本的病毒核酸。结果甘肃省麻疹风疹实验室网络共包括16家实验室,其中省级实验室1家,市、州级实验室14家,县级实验室1家,各级实验室按职责和检测内容分工有序、各司其职。2005—2022年,网络实验室采用ELISA方法共检测疑似麻疹血清学标本24338份,麻疹IgM阳性率为38.76%;检测疑似风疹血清学标本18092份,风疹IgM阳性率为19.82%。采用qRT-PCR方法,共检测疑似麻疹咽拭子标本13050份,麻疹病毒核酸阳性率为28.76%;共检测疑似风疹咽拭子标本12569份,风疹病毒核酸阳性率为11.39%。从4791份麻疹咽拭子标本中共分离到574株麻疹毒株,分离率为11.98%,全部上送国家麻疹风疹实验室测序分型,毒株型别为H1a基因型;从1635份风疹咽拭子标本中共分离到720株风疹毒株,分离率为44.04%,上送国家麻疹风疹实验室测序分型714株,其中1E基因型333株,2B基因型381株。网络实验室每年开展质量控制和技术培训,各实验室职能考核成绩良好。结论甘肃省麻疹风疹实验室网络运转良好,并通过持续技术提升提高了实验室诊断敏感性和监测能力,同时通过严格的质量控制保证了实验室数据准确高效,为甘肃省麻疹消除和风疹防控提供有力的技术保障,为后续麻疹风疹的消除工作提供了数据支持。

Objective To evaluate the performance of measles and rubella laboratory network in Gansu province from 2005 to 2022.Methods The information about the performance of measles and rubella laboratory network in Gansu from 2005 to 2022,including case diagnosis,etiological test,virus genotyping,achievement in surveillance and assessment results,were collected for a statistical analysis.IgM antibodies were detected in suspected measles and rubella serological specimens using enzyme-linked immunosorbent assay(ELISA),and viral nucleic acid was detected in suspected measles and rubella pharyngeal swab specimens using real-time fluorescence quantitative polymerase chain reaction(qRT PCR).Results The network consisted of 16 laboratories,including 1 laboratory at provincial level,14 laboratories at prefectural(municipal)level,1 laboratory at county level.The laboratories at all levels were classified according to their responsibilities and functions.From 2005 to 2022,ELISA was used to for the IgG detections of measles and rubella viruses.A total of 24338 serum samples of measles cases were detected by the laboratory network,and the measles virus IgM positive rate was 38.76%.A total of 18092 serum samples of rubella cases were detected by the laboratory network,and the rubella virus IgM positive rate was 19.82%.From 2005 to 2022,the nucleic acid detections of measles and rubella viruses in throat swabs of the cases were performed by qRT-PCR.A total of 13050 throat swabs of suspected measles case were tested by the laboratory network and the positive rate of measles virus nucleic acid was 28.76%.And 12569 throat swabs of suspected rubella case were tested by the laboratory network,and the positive rate of rubella virus nucleic acid was 11.39%.A total of 4791 throat swabs were collected for measles virus detection,from which 574 strains(11.98%)of measles virus were isolated and all were sent to the national measles and rubella laboratory for sequencing and genotyping and identified as genotype H1a.A total of 1635 throat swabs were collected for rubella virus detection,from which 720 strains of rubella virus were isolated(44.04%),and 714 strains were sequenced and genotyped at the national measles and rubella laboratory,in which 333 strains were identified as genotype 1E and 381 strains were identified as genotype 2B.Quality control and technical training were carried out every year for the laboratory network,and the assessment results of all laboratories were good.Conclusion The performance of measles and rubella laboratory network in Gansu was well,and the improvements in diagnosis sensitivity and surveillance capacity ofthe laboratory network had been made.At the same time,strict quality control had ensured the accuracy and efficiency of laboratory data,providing a strong technical guarantee for measles elimination and rubella prevention and control and data support for the subsequent measles and rubella elimination in Gansu.