文章摘要
匡小舟,肖文佳,滕峥,潘浩,袁政安,吴凡,张曦.上海市2014-2017年5岁以下住院儿童病毒性腹泻病原学特征分析[J].中华流行病学杂志,2019,40(8):895-899
上海市2014-2017年5岁以下住院儿童病毒性腹泻病原学特征分析
Pathogenic characteristics of viral gastroenteritis among pediatric inpatients under five years old during 2014-2017
投稿时间:2019-03-05  
DOI:10.3760/cma.j.issn.0254-6450.2019.08.005
中文关键词: 婴幼儿;住院;病毒;急性腹泻
英文关键词: Infants and young children;Hospitalized;Viral;Acute gastroenteritis
基金项目:上海市第四轮公共卫生三年行动计划高端海外研修团队培养计划(GWTD2015S01);国家传染病防治科技重大专项(2017ZX10103009-003)
作者单位E-mail
匡小舟 上海市疾病预防控制中心 200336  
肖文佳 上海市疾病预防控制中心 200336  
滕峥 上海市疾病预防控制中心 200336  
潘浩 上海市疾病预防控制中心 200336  
袁政安 上海市疾病预防控制中心 200336  
吴凡 上海市疾病预防控制中心 200336
上海市预防医学研究院 200336 
wufan@shmu.edu.cn 
张曦 上海市疾病预防控制中心 200336 zhangxi@scdc.sh.cn 
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中文摘要:
      目的 了解目标人群中病毒病原谱及其分子流行病学特征,为病毒性腹泻的防控、用药和疫苗的研发及使用提供科学依据。方法 采集2014-2017年上海市某儿科医院<5岁腹泻住院患儿的粪便标本,并收集患儿的人口学、临床和流行病学信息。采用ELISA、荧光PCR以及巢式PCR方法对轮状病毒、杯状病毒、星状病毒和肠道腺病毒进行核酸检测和分子分型。结果 共采集粪便标本1 018份(男性患儿671份,女性患儿347份),病毒阳性检出率高达40.57%,每年秋、冬季节达到检出高峰,检出率较高为杯状病毒(24.75%)和A组轮状病毒(13.95%)。在0~6月龄的婴幼儿中病毒检出率最低(32.20%)。约有65%的病毒感染患儿曾使用抗生素治疗,且抗生素的入院前使用率在病毒感染和病毒阴性人群中差异无统计学意义(P>0.05)。G9P[8]基因型为轮状病毒的主导流行株,且轮状病毒在<5岁各年龄组中普遍易感。结论 上海市<5岁腹泻住院患儿中杯状病毒的阳性检出率高于轮状病毒,提示需要密切关注婴幼儿腹泻的病原谱及病毒型别的变迁,在治疗中应合理使用抗生素,并加强疫苗研发用于疾病防控。
英文摘要:
      Objective To conduct a viral pathogen surveillance program on pediatric inpatients less than five years old with acute gastroenteritis in Shanghai and to better understand the pathogenic spectrum and molecular features in the target population, for setting up programs on control, prevention, medication and vaccine applications of the diseases. Methods Fecal samples were collected from inpatients less than 5 years old who were admitted to a pediatric hospital for having acute gastroenteritis. Information related to demographic, clinical and epidemiological features of the patients was also collected. Laboratory assays including ELISA, real-time PCR and nested PCR, were performed to detect the presence of pathogens as rotavirus, calicivirus, astrovirus and adenovirus. Results A total of 1 018 samples were collected (male 671 and 347 female), with the positive detection rate as 40.57% which peaked from autumn till winter, annually. Calicivirus and rotavirus A presented with the highest detection rates (24.75% and 13.95% respectively). The lowest detection rate was found in the 0-6 month-olds (32.20%). 65% of the patients with positive virus had received antibiotic treatment prior to the hospitalization. However, no statistically significant difference was seen, regarding the rates of antibiotic medication in the virus positive or negative populations (P>0.05). Data from the Rotavirus genotype analysis revealed that G9P[8] genotype was the predominant strain, and causing majority of rotavirus infections in all the age groups. Conclusions Among the inpatients under 5 years of age in Shanghai, the positive detection rate for Calicivirus was higher than that for rotavirus group A, suggesting the necessity to carefully monitor the changes regarding the pathogenic spectrum and subtypes of the virus. Antibiotics should also be attentively administered, together with the development of suitable vaccine.
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