摘要
目的了解上海市门诊腹泻婴幼儿中腺病毒(HAd V)的流行病学特征。方法收集2012年1月1日至2016年12月31日每周三在复旦大学附属儿科医院(我院)门诊就诊、≤5岁、病程≤14 d的急性腹泻患儿临床病毒检测后的剩余粪便标本,以系统抽样,采用PCR法检测HAd V、星状病毒、轮状病毒和诺如病毒,并通过基因测序和进化树分析确定HAd V的型别。结果共1 010例样本进入本文分析,2012至2014年每年144例,2015年265例,2016年313例;男628例;0~6、~12、~24、~36、~48和~60月龄分别为246、578、79、45、18和44例。(1)5年HAd V总检出率为5.2%(53/1 010),2012至2016年依次为6.9%(10/144)、10.4%(15/144)、5.6%(8/144)、4.5%(12/265)和2.6%(8/313),不同年份差异无统计学意义。(2)不同性别、不同月龄患儿和不同月份HAd V检出率差异均无统计学意义。(3)53例共检测到10种HAd V型别,肠道腺病毒(EAd V)包括HAd V 41型(31/53,58.5%)和40型(3.8%),非肠道腺病毒(NEAd V)包括HAd V 31型(11.3%)、1型(5.7%)、3型(5.7%)、2型(3.8%)、5型(3.8%)、6型(3.8%)、4型(1.9%)和7型(1.9%)。各年份均以HAd V 41型为主。(4)HAd V单一感染占73.6%(39/53),EAd V、NEAd V单一感染分别为49.1%(26/53)和24.5%(13/53);14例为HAd V和其他腹泻病毒混合感染,主要为HAd V与轮状病毒(13.2%,7/53)或诺如病毒(9.4%,5/53)的两两混合感染。结论上海地区门诊腹泻婴幼儿中HAd V流行型别多样,常年散在流行,且主要为单独感染引发婴幼儿腹泻。
Objective To characterize the molecular epidemiology of human adenoviruses （ HAdVs） and understand theirassociation with acute diarrhea in outpatient children in Shanghai.Methods Fecal samples were collected from children under fiveyears who were admitted to Children＇s Hospital of Fudan University as outpatients and diagnosed as acute diarrhea （Duration ofdiarrhea ≤14 days） from January 2012 to December 2016. All selected stool samples were subjected to reverse transcriptase PCR（RT？PCR） or PCR to detect group A rotavirus （RVA）, human calicivirus （HuCV）, human astrovirus （HAstV） and HAdV.Results A total of 1 010 fecal specimens were prospectively enrolled in this study with annual total of 144, 144, 144, 265 and313 samples collected respectively from 2012 to 2016. Among the enrolled patients, 628 of them were boys and 382 were girls.Among them, 246 individuals aged 0 to 6 months, 578 individuals aged 7 to 12 months, 79 individuals aged 13 to 24 months,45 individuals aged 25 to 36 months, 18 individuals aged 37 to 48 months and 44 individuals aged 49 to 60 months. ①HAdVinfections were detected in 5. 2%（ 53 / 1010） specimens and the detection rate was 6. 9%（ 10 / 144）, 10. 4%（ 15 / 144）, 5. 6%（8 / 144）, 4.5%（12 / 265） and 2.6%（8 / 313） respectively from 2012 to 2016. And they did not achieve statistical significance（χ2= 13.436,P= 0.09）. ②There was no significant difference of HAdV detection rate among different gender groups, age groupsand each month. ③Of the 53 HAdV？positive samples, 62. 3% （ 33 / 53） were classified as EAdV including HAdV 41 （ 31 / 53,58.5%） and ？40 （ 3. 8%, 2 / 53） while the others were NEAdV including HAdV？31 （ 11. 3%）, ？1 （ 5. 7%）, ？3 （ 5. 7%）,？2（3.8%）, ？5 （3.8%）, ？6 （3.8%）, ？4 （1.9%） and ？7 （1.9%）. HAdV 41 was the most prevalent HAdV genotype in each year.④Among the HAdVs positive specimens, 49.1%（26 / 53） were EAdV mono？infections and 24.5%（13 / 53） were NEAdV mono？infections while others were mixed infection with other diarrhea viruses. Among the mixed？infection cases, HAdVs mixed with RV（13.2%, 7 / 53） or NoV （9.4%, 5 / 53） were the most patterns.Conclusion These results clearly indicated the high diversity of the HAdVs genotypes detected in outpatient children with acute diarrhea and most of them were HAdV monoinfection cases.
出处
《中国循证儿科杂志》
CSCD
北大核心
2017年第5期352-356,共5页
Chinese Journal of Evidence Based Pediatrics
关键词
门诊
婴幼儿
腹泻
腺病毒
型别
Outpatient
Infants
Diarrhea
Human adenovirus
Genotype
