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目的了解广州市腹泻监测病例中诺如病毒分子流行病学特征。方法 2014-2015年选取广州市两家医院的门诊科室作为监测哨点,每间哨点医院每周采集5岁以下和5岁及以上腹泻病例粪便样本各3份,将采集的标本送至广州市疾病预防控制中心检测诺如病毒。阳性标本进行基因序列测定并进行同源性分析。通过中国传染病疫情和突发公共卫生事件网络直报系统收集2014-2015年广州市报告的诺如病毒感染引起的暴发疫情数据,开展流行病学分析。结果共收集腹泻标本732份,诺如病毒阳性136份,阳性率为18.58%。各年龄组诺如病毒阳性率不同(χ2=20.39,P=0.001),其中5岁以下年龄组最高(24.21%)。基因分型结果显示GⅡ组133份(97.80%),GⅠ组3份(2.20%)。分别对2014年(4份)及2015年(5份)阳性标本进行测序,结果提示,2014年诺如病毒流行株以GⅡ.4 Sydney_2012变异株(75.00%)为主,2015年以GⅡ.17变异株(55.60%)为主。2014-2015年共报告诺如病毒感染性腹泻暴发疫情23起,其中14(60.80%)起由GⅡ组引起。结论广州市诺如病毒感染性腹泻流行毒株仍以GⅡ组为主,其中2014年优势毒株为GⅡ.4 Sydney_2012变异株,2015优势毒株为GⅡ.17变异株。
Objective To understand the epidemiological characteristics of norovirus in Guangzhou diarrhea surveillance cases. Methods From 2014 to 2015, outpatient departments of two hospitals in Guangzhou were selected as the monitoring sentinel sites. Each sentinel hospital collected 3 samples of fecal samples from patients aged 5 and under and diarrhea aged 5 and above every week. The collected samples were sent to Guangzhou City Center for Disease Control and Prevention testing Norovirus. Positive specimens were sequenced and analyzed for homology. Epidemiological data of outbreaks caused by norovirus infection reported in Guangzhou in 2014-2015 were collected through the network reporting system of infectious diseases and public health emergencies in China. Results A total of 732 samples of diarrhea were collected, norovirus was positive 136, the positive rate was 18.58%. The positive rate of norovirus in each age group was different (χ2 = 20.39, P = 0.001), of which the age group under 5 years old was the highest (24.21%). Genotyping results showed 133 (97.80%) in GII and 3 (2.20%) in GⅠ. The positive samples of 2014 (4 copies) and 2015 (5 copies) were sequenced, respectively. The results showed that the 2014 Norovirus epidemic strain was mainly GⅡ.4 Sydney_2012 variant (75.00%), and 2015 was GⅡ.17 Mutant (55.60%) based. A total of 23 outbreaks of Norovirus infectious diarrhea were reported in 2014-2015, of which 14 (60.80%) were caused by GII. Conclusion The prevalence of norovirus genital infectious diarrhea in Guangzhou is still dominated by GⅡ. Among them, the dominant genotype in 2014 was GⅡ.4 Sydney_2012 variant and the 2015 dominant genotype was GⅡ.17 variant.