摘要
目的比较住院和门诊腹泻儿童星状病毒感染的分子流行病学特点，加深对星状病毒感染与儿童腹泻关系的认识。方法收集复旦大学附属儿科医院2008年1月至2010年12月住院腹泻患儿粪便标本298份，并收集2010年8月至2011年7月门诊腹泻患儿粪便标本360份，采用反转录-PCR检测粪便标本中的星状病毒、轮状病毒、杯状病毒和腺病毒，利用基因测序和进化树分析的方法确定星状病毒的基因型。结果在298份住院腹泻患儿标本中，星状病毒的总检出率为27．2％（81／298），2008年至2010年的检出率分别为33．9％（42／124）、33．8％（25／74）和14．0％（14／100）；星状病毒感染全年分布，1月份、3月份和4月份出现高峰，95．1％（77／81）的患儿年龄在0～35月龄；星状病毒阳性的标本均存在与其他腹泻病毒的混合感染。360份门诊腹泻患儿标本中，星状病毒的检出率为1．9％（7／360），主要集中在11月份，所有患儿年龄均在O～35月龄，星状病毒单独感染者3份，其余分别为与轮状病毒（3份）和腺病毒（1份）的混合感染。住院和门诊腹泻患儿感染星状病毒的型别单一，均为I型。结论住院腹泻患儿中星状病毒的检出率高于门诊腹泻患儿，住院腹泻患儿大多为医院感染引起。星状病毒感染多与其他腹泻病毒尤其是轮状病毒共存。门诊患儿中存在星状病毒单独引起的腹泻，但比例较低，提示星状病毒可能更多以与其他病毒共感染的方式在腹泻中发挥作用。
Objective To compare the molecular epidemic characteristics of human astrovirus （HAstV） between outpatient and hospitalized children with acute diarrhea, and to investigate the relationship between HAstV infection and diarrhea in children. Methods A total of 298 cases were randomly collected from hospitalized children from January 2008 to December 2010 in Children＇s Hospital of Fudan University, and 360 specimens were collected from outpatients with acute diarrhea from August 2010 to July 2011. Reverse transcriptase polymerase chain reaction （RT-PCR） was used to detect rotavirus （RV）, human calicivirus （HuCV）, HAstV and human adenovirus （HAdV）. HAstV genotype was determined by gene sequencing and phylogenetic analysis. Results Epidemiology of HAstV in hospitalized children was as [ollows： among the included 298 samples, HAstV was detected in 27. 20//00 （81/298） of the patients, compared with 33. 9% （42/124）, 33.8% （25/74） and 14.0%（14/100）, respectively from 2008 to 2010. HAstV diarrhea occurred throughout the year and peaked in January, March, and April. 95.1% （77/81） of the infected children were 0--35 months old. All the episodes of HAstV were mixed with other diarrhea virus infection. Molecular epidemiology of HAstV in outpatient children with diarrhea was as follows： the overall incidence of HAstV was 1. 9% among the 360 cases（7/360）. The seasonal distribution of HAstV＇s gastroenteritis showed a peak in November. All the outpatient children were 0--35 months old. Three cases were single infection with HAstV and the others were coinfection with RV （3 cases） or HAdV （1 case）. All of the detected HAstV, either in inpatients or outpatients, belonged to HAstV-1. Conclusions The detection rate of HAstV in hospitalized children is significantly higher than that in outpatients. Most HAstV infections in hospitalized children are ascribed to nosocomial infections. Most episodes of HAstV infection were accompanied with other diarrhea viruses infection. HAstV single infection is seen in outpatient children while the detection rate is very low, implying that HAstV co-infection with other viruses plays a main role in diarrhea in most instances.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2016年第8期463-468,共6页
Chinese Journal of Infectious Diseases
