目的 了解和掌握湖南省新晃县5岁住院腹泻儿童流行特征和病毒性腹泻病原谱构成。方法 收集新晃县哨点医院2009-2011年5岁住院腹泻患儿的粪便标本,采用Dako公司酶免疫试剂盒检测轮状病毒,采用反转录-聚合酶链反应(reverse transcription-polymerase chain reaction,RT-PCR)进行分型鉴定; 采用PCR检测腺病毒; RT-PCR法检测星状病毒和杯状病毒。结果 2009-2011年新晃县哨点医院共登记住院患者数47 305例,其中5岁儿童住院数9714例,5岁以下腹泻儿童住院数1506例,占5岁住院儿童总数的15.50%;采样检测1063份标本,轮状病毒、腺病毒、杯状病毒和星状病毒的阳性率分别为 18.38%、4.04%、8.84%和0.47%,4种病毒检测阳性率差异有统计学意义(2=251.623,P=0.000);A组轮状病毒P分型2009、2010年以P为主,2011年以P为主;G分型2009、2011年以G为主,2010年以G为;不同性别病例检测轮状病毒差异有统计学意义 (2=5.657,P=0.017);不同年龄病例标本检测结果除杯状病毒阳性率差异有统计学意义外,其余3种病毒的阳性率差异均无统计学意义;轮状病毒、腺病毒、杯状病毒不同月份的阳性检出率差异有统计学意义。结论 轮状病毒是新晃县5岁住院腹泻儿童病毒性腹泻的主要病原体,杯状病毒、腺病毒也占有一定的比例,星状病毒感染较少。
Objective To understand the epidemiological characteristics of diarrhea and related pathogens in hospitalized children in Xinhuang, Hunan province. Methods Stool samples were collected from the diarrhea children aged 5 years in sentinel hospitals in Xinhuang from 2009 to 2011. Rotavirus was detected with immunoreagent kit by DAko and its subtyping/identification was conducted with reverse transcription-polymerase chain reaction(RT-PCR). Adenovirus was detected with PCR, and astrovirus and calicivirus were detected with RT-PCR. Results From 2009 to 2011, the registered hospitalized patients number was 47 305 in Xinhuang, in which 9714 were children aged 5 years and 1506 of them were affected by diarrhea(15.50% of the child patients). Totally 1063 stool samples were detected. The positive rate was 18.38% for rotavirus,4.04% for adenovirus,8.84% for calicivirus and 0.47% for astrovirus. The differences had statistical significance(2=251.623,P=0.000). The major subtype of rotavirus A was P in 2009 and 2010, P in 2011, G in 2009 and 2011, and G in 2010. The gender specific difference in detection of rotavirus had statistical significance(2=5.657,P=0.017);Except calicivirus, the age specific differences in the positive rates of other 3 viruses had no statistical significance, but the time specific differences in positive rates of rotavirus, adenovirus and calicivirus had statistical significance. Conclusion The major pathogen to cause diarrhea in children aged 5 years was rotavirus in Xinhuang, followed by calicivirus and adenovirus. Astrovirus infection was rare.