文章摘要
严菊英,缪梓萍,吕华坤,周佳悦,龚黎明,茅海燕,孙逸,张严峻.浙江省2013年病毒性脑膜脑炎病原学及分子流行病学特征[J].中华流行病学杂志,2015,36(3):280-284
浙江省2013年病毒性脑膜脑炎病原学及分子流行病学特征
Etiology and molecular-epidemiological characteristics of viral meningoencephalitis of Zhejiang province in 2013
投稿时间:2014-09-25  
DOI:10.3760/cma.j.issn.0254-6450.2015.03.019
中文关键词: 病毒性脑膜脑炎;人类肠道病毒;进化分析
英文关键词: Viral meningoencephalitis;Human enterovirus;Phylogenetic analysis
基金项目:国家科技重大专项(2012ZX10004-210-002); 浙江省科技厅项目(2012C33063)
作者单位E-mail
严菊英 310051 杭州, 浙江省疾病预防控制中心微生物所  
缪梓萍 传染病预防控制所 zpmiao@cdc.zj.cn 
吕华坤 传染病预防控制所  
周佳悦 310051 杭州, 浙江省疾病预防控制中心微生物所  
龚黎明 310051 杭州, 浙江省疾病预防控制中心微生物所  
茅海燕 310051 杭州, 浙江省疾病预防控制中心微生物所  
孙逸 310051 杭州, 浙江省疾病预防控制中心微生物所  
张严峻 310051 杭州, 浙江省疾病预防控制中心微生物所  
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中文摘要:
      目的 分析2013年浙江省监测点病毒性脑膜脑炎病原学及分子流行病学特征。方法 从浙南和浙北监测点医院采集疑似病毒性脑膜脑炎患者脑脊液和/或粪便样本,用荧光定量PCR方法检测样本中人类肠道病毒(HEV)、流行性乙型脑炎病毒(JEV)、腮腺炎病毒(MuV)、单纯疱疹病毒(HSV)和巨细胞病毒(CMV)核酸,采用人横纹肌瘤细胞(RD)和人喉表皮样癌细胞(Hep-2)分离HEV,对HEV阳性分离物或核酸阳性样本扩增VP1基因并测序,然后进行同源性与进化分析。结果 在229例患者共计239份样本中检测到病毒核酸阳性92份(38.5%),其中HEV阳性87份,MuV、HSV和CMV阳性分别为1、2和2份;87份HEV中柯萨奇病毒(CV)38份和埃可病毒(E)49份;239份样本中分离到56株(23.4%)HEV;在31份HEV核酸阳性但病毒分离阴性的脑脊液样本中,检出最多的为E9(9份),其次为CVA9(8份);HEV血清型分别为CVA9、CVB4、CVB5、E6、E7、E9、E11、E14、E16、E25和E30;浙南监测点优势流行株为CVB5,浙北为E6。VP1区进化分析显示,浙江省HEV均为B组EV。结论 2013年浙江省监测点病毒性脑膜脑炎的主要病原为HEV-B,涉及11个血清型,首次在浙江省分离到E7;浙南优势流行株为CVB5,浙北为E6;核酸检出率明显高于病毒分离率,采用常规EV分离法存在漏检E9和CVA9的风险。
英文摘要:
      Objective To investigate pathogens and molecular-epidemiology characteristics of viral meningoencephalitis in the monitoring sites of Zhejiang province,2013. Methods Cerebrospinal fluid and/or stool specimens were collected from suspected patients admitted to the monitoring hospitals in southern and northern Zhejiang province. Such specimen were subject to real-time qPCR for the detection of Human enterovirus (HEV),Japanese encephalitis virus(JEV),Mumps virus(MuV),Herpes simplex virus(HSV) and Cytomegalovirus (CMV). HEVs were isolated using the RD and Hep-2 cell lines,while VP1 genes from all HEV-positive isolates or RNA-positive specimen were amplified,sequenced,for homology and evolution analysis. Results 92(38.5%) of the 239 samples collected from 229 patients were detected as virus nucleic acid positive,including 87 HEV positive samples,1 MuV positive,2 HSV positive,and 2 CMV positive; of the 87 HEV positive samples,38 were further determined to be Coxsackievirus (CV) and 49 as Echovirus (E). 56 HEV strains were isolated from 239(23.4%) samples. From the 31 cerebral fluid specimen of nucleic acid positive yet virus isolation negative,the most specimen were identified with E9 (9 specimen),followed by CVA9 (8 specimen); the viral serotype of Zhejiang province HEV were CVA9,CVB4,CVB5,E6,E7,E9,E11,E14,E16,E25 and E30,respectively. Predominant epidemic strains identified at southern and northern Zhejiang province were CVB5 and E6 respectively. The phylogenetic analysis of VP1 gene showed that all the HEV isolates in Zhejiang province were HEV-B. Conclusion The HEV-B was the main pathogen for viral meningoencephalitis in Zhejiang province in 2013,including 11 serotypes,while E7 was the first time to be isolated in Zhejiang province. The predominant isolates were CVB5 and E6 in southern and northern Zhejiang province respectively. The positive rate of viral nucleic acid detection was significantly higher than that of viral isolation. Regular EV isolation method was exposed to the risk of missing-detection of E9 and CVA9.
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