商晓春, 帅慧群, 赵雪琴, 周晓红. 2012-2019年浙江省杭州市哨点医院5岁以下儿童病毒性腹泻病原学和流行病学特征分析[J]. 疾病监测, 2020, 35(9): 809-814. DOI: 10.3784/j.issn.1003-9961.2020.09.009
引用本文: 商晓春, 帅慧群, 赵雪琴, 周晓红. 2012-2019年浙江省杭州市哨点医院5岁以下儿童病毒性腹泻病原学和流行病学特征分析[J]. 疾病监测, 2020, 35(9): 809-814. DOI: 10.3784/j.issn.1003-9961.2020.09.009
Xiaochun Shang, Huiqun Shuai, Xueqin Zhao, Xiaohong Zhou. Etiological and epidemiological characteristics of viral diarrhea in children under 5 years old in a sentinel hospital in Hangzhou, Zhejiang, 2012–2019[J]. Disease Surveillance, 2020, 35(9): 809-814. DOI: 10.3784/j.issn.1003-9961.2020.09.009
Citation: Xiaochun Shang, Huiqun Shuai, Xueqin Zhao, Xiaohong Zhou. Etiological and epidemiological characteristics of viral diarrhea in children under 5 years old in a sentinel hospital in Hangzhou, Zhejiang, 2012–2019[J]. Disease Surveillance, 2020, 35(9): 809-814. DOI: 10.3784/j.issn.1003-9961.2020.09.009

2012-2019年浙江省杭州市哨点医院5岁以下儿童病毒性腹泻病原学和流行病学特征分析

Etiological and epidemiological characteristics of viral diarrhea in children under 5 years old in a sentinel hospital in Hangzhou, Zhejiang, 2012–2019

  • 摘要:
    目的分析2012 — 2019年浙江省杭州市及其周边县市5岁以下儿童病毒性腹泻的病原谱和流行病学特征,为病毒性腹泻防控提供参考依据。
    方法2012 — 2019年收集浙江大学医学院附属儿童医院门急诊和肠道门诊5岁以下腹泻患儿的粪便标本,采用实时荧光定量PCR方法检测诺如病毒(NV)、轮状病毒(RV)、札如病毒(SAV)、肠道腺病毒(EADV)和星状病毒(ASV)的核酸。 采用SPSS 19.0软件分析病原检出结果。
    结果共收集1 350份标本,阳性标本594份,总检出率为44.00%。 阳性病例以单病毒感染为主(84.51%,502/594),双重和三重感染分别占14.31%和1.18%,双重感染以NV和RV为主(54.12%,46/85)。 NV检出率最高,为23.41%,其次为RV(19.11%),SAV、EADV和ASV的检出率均<5%(分别为4.22%、2.96%、1.63%)。 不同月龄组腹泻患儿间病毒核酸检出率差异有统计学意义(χ2=256.140,P<0.001),12~月龄组患儿的检出率最高,为73.77%(239/324),0~月龄组最低,为17.18% (73/425)。 各病毒在不同月龄组患儿间的检出率差异均有统计学意义。 病毒总检出率的季节性差异有统计学意义(χ2=188.495,P<0.001),冬季(12月至次年2月)检出率最高,为70.31%(225/320)。 NV、RV和SAV在不同季节的检出率差异有统计学意义(χ2=90.284,P<0.001;χ2=188.068,P<0.001;χ2=29.066,P<0.001),NV在秋季(9 — 11月)的检出率最高,RV和SAV均冬季检出率最高。 2012 — 2019年各年度检出率在奇数年份高于前一偶数年份,总体呈上升趋势(趋势χ2= 13.532,P<0.001)。 NV和ASV的检出率年度变化呈上升趋势(趋势χ2= 23.636,P<0.001;趋势χ2=18.073,P=0.003)。 RV、SAV、EADV的检出率年度变化趋势不规则(趋势χ2= 3.173,P=0.075;趋势χ2= 1.803,P=0.179;趋势χ2=0.007,P=0.932)。
    结论5岁以下儿童病毒性腹泻主要病原为NV和RV,秋冬季为高发期,12~35月龄为高发年龄段,需在秋冬季加强病毒性腹泻的防控。

     

    Abstract:
    ObjectiveTo analyze the pathogenic spectrum and epidemiological characteristics of viral diarrhea in children under 5 years old in Hangzhou and its surrounding areas of Zhejiang province from 2012 to 2019 and provide evidence for the prevention and control of viral diarrhea.
    MethodsFrom 2012 to 2019, stool samples were collected from children aged <5 years with diarrhea in the outpatient and emergency department of Children's Hospital of Zhejiang University School of Medicine for the nucleic acid detections of norovirus (NV), rotavirus (RV), sapovirus (SAV), enteric adenovirus (EADV) and astrovirus (ASV) by real-time fluorescent quantitative PCR (quantitative real-time PCR). Statistical software SPSS 19.0 was used to analyze the results.
    ResultsA total of 1 350 stool samples were collected, in which 594 were positive for the viruses. The overall infection rate was 44.00%. A majority of the samples were single virus positive (84.51%, 502/594), while 14.31% and 1.18% of the samples were positive for two and three viruses, respectively. NV and RV co-infections accounted for 54.12%, (46/85). The infection rate of NV was highest (23.41%), followed by that of RV (19.11%). The detection rates of SAV, EADV and ASV were less than 5% (4.22%, 2.96% and 1.63%, respectively). There were significant differences in the virus detection rate among children with diarrhea among different age groups ( χ2=256.140, P<0.001). The age group 12-23-months had the highest detection rate (73.77%, 239/324), but the age group under 6-months had the lowest detection rate (17.18%, 73/425). There were significant differences in the detection rate of each virus among different age groups. The overall virus detection rate exhibited significant seasonal differences ( χ2=188.495, P<0.001), and peaked (70.31%, 225/320) in winter (i.e., December - February). The differences in the detection rates of NV, RV and SAV among different seasons were significant ( χ2=90.284, P<0.001; χ2=188.068, P<0.001; χ2=29.066, P<0.001), and the detection rate of NV peaked in autumn (September - November), while the detection rates of RV and SAV peaked in the winter. Between 2012 and 2019, the detection rate was higher in odd-numbered years than in previous even-numbered years, and the overall detection rate showed an upward trend (trend χ2=13.532, P<0.001). The annual changes in the detection rates of NV and ASV also showed upward trends (trend χ2=23.636, P<0.001; trend χ2=18.073, P=0.003). The changes in annual detection rates of RV, SAV and EADV were irregular (trend χ2=3.173, P=0.075; trend χ2=1.803, P=0.179; trend χ2=0.007, P=0.932).
    ConclusionThe main pathogens of viral diarrhea in children under 5 years old were NV and RV. The incidences of infections in infants and young children aged 12–35 months were high in autumn and winter. It is necessary to strengthen the prevention and control of viral diarrhea in autumn and winter.

     

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