上海地区儿童腹泻病轮状病毒感染的研究

Study on rotavirus infection in children with diarrhea in Shanghai

目的 了解上海地区腹泻儿童中轮状病毒感染的情况。方法 收集复旦大学儿科医院1 999年 1 1月至 2 0 0 1年 1 2月住院的腹泻病儿童粪便标本 1 2 30份 ,采用聚丙烯酰胺凝胶电泳(PAGE)法和酶联免疫吸附法 (ELISA)检测轮状病毒。结果 1 2 30份粪便标本中 ,493份检测到A组轮状病毒RNA基因组 ,阳性检出率为 40 1 % ,未发现B组及C组轮状病毒。其中RNA长型有397份 ( 80 5 % ) ,短型有 5 5份 ( 1 1 2 % ) ,混合型有 1 8份 ( 3 7% ) ,RNA部分降解未能分型有 2 3份( 4 7% )。对 471份有明确编号的轮状病毒阳性标本来源的患儿分析显示 ,平均发病年龄 1 4 2个月 ,社区感染 32 0例 ( 67 9% ) ,院内感染 1 5 1例 ( 32 1 % ) ,5岁以下儿童占 464例 ( 98 7% ) ,3个月至2岁儿童 369例 ( 78 3% )。 3年冬季 1 1月份与 1 2月份轮状病毒阳性检出率均达到 5 0 %以上。结论 A组轮状病毒是上海地区 5岁以下住院儿童腹泻病的主要病原 ,3月龄至 2岁婴幼儿是轮状病毒的易感人群 ,以冬季 1 1月份至 1 2月份为流行高峰 ,基因组以长型为主。

Objective To investigate the status of rotavirus infection among children with diarrhea in Shanghai.Methods Stool samples were collected from 1230 hospitalized children with community-acquired and nosocomially acquired diarrhea in Children's Hospital Affiliated to Fu Dan University between November 1999 and December 2001.Polyacrylamide gel electrophoresis (PAGE) was used to detect rotavirus genomic RNA and identify electropherotypes of group A rotavirus RNAs.Results Out of 1230 samples investigated,493 (40.1%) were group A rotavirus gene positive by PAGE,among which 397 (80.5%) showed long electropherotypes,55 (11.2%) showed short electropherotypes,18(3.7%) showed mixed electropherotypes,suggesting the children were co-infected by rotaviruses of different electropherotypes,and 23(4.7%) failed in typing due to degradation of some of the genomic RNA fragments.No group B or group C rotavirus was found.Among 471 cases of rotavirus-positive patients with detailed clinical data,the mean age was 14.2 months old;320(67.9%) were community-acquired infection,151(32.1%) were nosocomial infection;98.7% (465) were ≤5 years of age,79.2%(373) aged 3 months to 2 years.Rotavirus positive rates were above 50% in November and December during the three years.Conclusion It shows that group A rotavirus is the major pathogen for diarrhea among hospitalized children aged under 5 years in Shanghai.Rotaviral diarrhea is more prevalent among children of 3 to 24 months old.Winter epidemics is observed in Shanghai.