2023—2024年山东省青岛市病毒性腹泻病原谱及流行特征

Pathogen spectrum and epidemiological characteristics of viral diarrhea in Qingdao

  • 摘要:
    目的 分析2023—2024年山东省青岛市引发病毒性腹泻的病原体构成及其流行特征,以期为该疾病的科学防控提供数据支持。
    方法 本研究共纳入青岛市4家三甲医院腹泻患者的粪便样本619份,经核酸提取后,采用荧光定量反转录聚合酶链反应技术对轮状病毒A组、诺如病毒GⅠ/GⅡ群、腺病毒、星状病毒、人副肠孤病毒和札如病毒6种腹泻病毒进行检测,结果阳性的样本再进行靶基因扩增及双向测序,通过基本局部比对搜索工具比对确定基因型。
    结果 2023—2024年青岛市引发病毒性腹泻的病毒总体阳性率为31.99%(185/619),其中13份为混合感染(2.10%)。6种病毒的检出率依次为:诺如病毒阳性率8.89%(55/619),轮状病毒阳性率12.12%(75/619),腺病毒阳性率6.62%(41/619),星状病毒阳性率1.62%(10/619),人副肠孤病毒阳性率1.94%(12/619),札如病毒阳性率0.81%(5/619)。诺如病毒和轮状病毒感染具有明显的季节性,冬春季感染人数较多,各年龄组中以0~<4岁感染人数最多。基因分型分析显示,诺如病毒以GII.4型为主,轮状病毒主要为G8P8基因型,腺病毒以C2和F41基因型为主,星状病毒以基因1型为主,人副肠孤病毒以1A型为主,札如病毒以GII基因组为主(包括1例GII.8和1例GII.N)A。
    结论  2023—2024年,轮状病毒和诺如病毒是青岛市病毒性腹泻主要病原体,且感染具有明显季节性和年龄分布特征,冬春季高发,0~<4岁年龄组为发病主体人群。建议针对0~<4 岁婴幼儿加强轮状病毒和诺如病毒疫苗的主动接种策略,并在冬春高发季采取公共卫生干预措施,以降低病毒传播风险。

     

    Abstract:
    Objective To understand the pathogen spectrum and epidemiological characteristics of viral diarrhoea in Qingdao, Shandong province, during 2023-2024 and provide data support for the effective prevention and control of viral diarrhoea.
    Methods A total of 619 stool samples were collected from diarrhoea patients in 4 grade III hospitals in Qingdao. By nucleic acid extraction, rotavirus A, norovirus GⅠ/GⅡ, adenovirus, astrovirus, parechoviruss, and Sapovirus, were detected with fluorescence quantitative RT-PCR. For the positive samples, target gene amplifications and bi-directional sequencing were performed, and the genotypes were determined by BLAST comparison.
    Results In thye 619 stool samples, 31.99% were positive for viruses (185/619), of which 13 were multi virus positive (2.10%). The detection rate was 8.89% for norovirus (55/619), 12.12% for rotavirus (75/619), 6.62% for adenovirus (41/619), 1.62% for astrovirus (10/619), 1.94% for human parechovirus (12/619), and 0.81% for Sapovirus (5/619). The incidences of norovirus, rotavirus and adenovirus infections showed obvious seasonality, with more infections occurring in winter and spring. In all the age groups, the infection incidence was highest in age group 0-<4 years. Genotyping analysis showed that norovirus GII.4, rotavirus G8P8, adenovirus C2 and F41, astrovirus 1, human parechovirus 1A and Sapovirus GII (GII.8 and GII.NA) were predominant.
    Conclusion During 2023-2024, rotavirus and norovirus were the main pathogens causingviral diarrhoea in Qingdao. The infections showed obvious seasonality, mainly occurring in winter and sprin, and age distribution, mainly occurring in age group 0-<4 years. It is suggested to strengthen the active immunization of rotavirus and norovirus in infants and children aged 0-<4 years and the public health interventions in winter and spring to reduce the risk for virus transmission.

     

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