2022—2023年平凉市5岁以下儿童病毒性腹泻病原监测分析

Pathogen Surveillance of Viral Diarrhea under 5 Years Old Children in Pingliang from 2022 to 2023

目的:了解甘肃省平凉市病毒性腹泻病原学构成及其流行特征,为病毒性腹泻疫情的科学有效防控及临床治疗提供参考依据。方法:以甘肃医学院附属医院为哨点医院,2022年9月—2023年8月采集以腹泻症状(日排便次数≥3次,呈水样便或稀水便)收住入院的214例5岁以下患儿的粪便或肛拭子标本,通过实时荧光PCR方法进行病毒学检测,并对实验结果进行统计分析。结果:214份标本中,病原体阳性标本105份,总阳性检出率为49.07%,检出率从高到低依次为A组轮状病毒(26.17%)、诺如病毒(20.09%)、肠道腺病毒(6.07%)、札如病毒(5.61%)和星状病毒(4.21%)。A组轮状病毒和诺如病毒分别以G9P[8]型和GII型为优势毒株,分别占83.93%和95.35%;不同月龄患儿病毒阳性检出率比较,差异有统计学意义(χ^(2)=69.134,P<0.05),其中13~24月龄组病毒阳性检出率最高(87.50%),0~6月龄组病毒阳性检出率最低(18.92%)。不同性别患儿病毒阳性检出率比较,差异无统计学意义(P>0.05)。结论:2岁以下婴幼儿是平凉市5岁以下儿童病毒性腹泻感染的高发群体,13~24月龄是A组轮状病毒和诺如病毒的高发年龄。A组轮状病毒在第1季度高发,诺如病毒在第3季度高发。今后应持续加强病毒性腹泻监测工作,针对性地开展预防控制措施,为科学防控病毒性腹泻提供依据。

OBJECTIVE To understand the pathogenic composition and epidemic characteristics of viral diarrhea in Pingliang,and to provide reference for scientific and effective prevention and control of viral diarrhea epidemic and clinical treatment.METHODS Stool samples of hospitalized children under 5 years old with diarrhea were collected from sentinel hospitals in Pingliang from 2022 to 2023,and virology detection was performed by real-time fluorescent PCR method,and the experimental results were statistically analyzed.RESULTS In 214 samples the total positive detection rate was 49.07%syn-position followed by group A Rotavirus(26.17%),Norovirus(20.09%),Intestinal Adenovirus(6.07%),Zaruvirus(5.61%)and Astrovirus(4.21%).The dominant strains of group A Rotavirus and Norovirus were G9P[8]and GII(83.93%and 95.35%).There was statistically significant difference in the positive rate of the virus between different age groups(χ^(2)=69.134,P<0.05).The positive rate of the virus in 13 to 24 months age group was the highest(87.50%),and that in 0 to 6 months age group was the lowest(18.92%).There was no statistically significant difference in virus detection rates between different genders(P>0.05).CONCLUION Infants under 2 years old were high incidence group of viral diarrhea infection in children aged 0~5 years old in Pingliang,the high incidence age of group A Rotavirus and Norovirus was 13~24 months old.The group A Rotavirus had a high incidence in the first quarter,while Norovirus had a high incidence in the third quarter.In the future,it should continue to strengthen the surveillance of viral diarrhea,and carry out targeted prevention and control measures to provide a basis for scientific prevention and control of viral diarrhea.