CAJ | 학술논문

目的监测2009至201 1年上海地区儿童诺如病毒腹泻的流行病学及流行株的基因型特征.方法 2009年1月至2011年12月我们连续采集2 288份门诊急性腹泻患儿的粪便标本,采用实时荧光RT-PCR检测诺如病毒GⅠ和GⅡ基因组,对部分GⅡ基因组阳性标本经RT-PCR扩增诺如病毒部分衣壳蛋白(VP1)和多聚酶蛋白(RdRp)序列,对核苷酸序列进行基因分型.结果在2 288份门诊急性腹泻患儿的粪便标本中,531份(23.2％)标本系诺如病毒阳性,GⅠ和GⅡ基因组阳性标本分别有4份(0.75％)和527份(99.25％).诺如病毒每月检出率7.7％～ 47.3％,每年7至10月份检出率高于年平均检出率.4岁以下儿童累积病例数占95.2％,4岁以下腹泻患儿的诺如病毒检出率明显高于≥4岁儿童(24.4％ vs.10.7％,x2=10.66,P＜0.05).239株诺如病毒的VP1分型包括7种基因型,依次为:154株(64.4％)为GⅡ.4[9株为2009(New Orleans),145株为2006b变异株],66株(27.6％)为GⅡ.3,7株(2.9％)为GⅡ.2,6株(2.5％)为GⅡ.6,4株(1.7％)为GⅡ.12,GⅡ.7和GⅡ.14各1株(0.4％).244株RdRp分型包括7种基因型,依次为:189株(77.5％)为GⅡ.4[14株为2009(New Orleans)变异株,175株为2006b变异株],47株(19.3％)为GⅡ.12,GⅡ.16、GⅡ.b和GⅡ.g各2株(0.8％),GⅡ.2和GⅡ.6各1株(0.4％).GⅡ.4-2010变异株自2010年6月被首次检测到,随后散发流行.198株诺如病毒的VP1和RdRp同时测序分型,56株(28.3％)存在不同的RdRp/ VP1基因型组合,以GⅡ.12/GⅡ.3(69.6％)和GⅡ.4/GⅡ.3(8.9％)常见.结论诺如病毒是上海地区儿童腹泻常见的病原,诺如病毒腹泻全年流行.上海地区诺如病毒流行株具有多种基因型,存在不同基因型间重组株.GⅡ.4-2006b型变异株仍然为优势流行株,并未被新的变异株GⅡ.4-2009(New Orleans)所取代.
목적 감측2009지201 1년상해지구인동낙여병독복사적류행병학급류행주적기인형특정.방법 2009년1월지2011년12월아문련속채집2 288빈문진급성복사환인적분편표본,채용실시형광RT-PCR검측낙여병독GⅠ화GⅡ기인조,대부분GⅡ기인조양성표본경RT-PCR확증낙여병독부분의각단백(VP1)화다취매단백(RdRp)서렬,대핵감산서렬진행기인분형.결과 재2 288빈문진급성복사환인적분편표본중,531빈(23.2％)표본계낙여병독양성,GⅠ화GⅡ기인조양성표본분별유4빈(0.75％)화527빈(99.25％).낙여병독매월검출솔7.7％～ 47.3％,매년7지10월빈검출솔고우년평균검출솔.4세이하인동루적병례수점95.2％,4세이하복사환인적낙여병독검출솔명현고우≥4세인동(24.4％ vs.10.7％,x2=10.66,P＜0.05).239주낙여병독적VP1분형포괄7충기인형,의차위:154주(64.4％)위GⅡ.4[9주위2009(New Orleans),145주위2006b변이주],66주(27.6％)위GⅡ.3,7주(2.9％)위GⅡ.2,6주(2.5％)위GⅡ.6,4주(1.7％)위GⅡ.12,GⅡ.7화GⅡ.14각1주(0.4％).244주RdRp분형포괄7충기인형,의차위:189주(77.5％)위GⅡ.4[14주위2009(New Orleans)변이주,175주위2006b변이주],47주(19.3％)위GⅡ.12,GⅡ.16、GⅡ.b화GⅡ.g각2주(0.8％),GⅡ.2화GⅡ.6각1주(0.4％).GⅡ.4-2010변이주자2010년6월피수차검측도,수후산발류행.198주낙여병독적VP1화RdRp동시측서분형,56주(28.3％)존재불동적RdRp/ VP1기인형조합,이GⅡ.12/GⅡ.3(69.6％)화GⅡ.4/GⅡ.3(8.9％)상견.결론 낙여병독시상해지구인동복사상견적병원,낙여병독복사전년류행.상해지구낙여병독류행주구유다충기인형,존재불동기인형간중조주.GⅡ.4-2006b형변이주잉연위우세류행주,병미피신적변이주GⅡ.4-2009(New Orleans)소취대.
Objective To monitor the epidemiology of norovirus infection in diarrheal children in Shanghai between 2009 and 2011 and characterize the genotypes of norovirus strains.Method The stool samples were collected from children visiting outpatient clinic for acute non-dysenteric diarrhea between 2009 and 2011.One step real-time RT-PCR was used for screening norovirus genogroups G Ⅰ and G Ⅱ.The genotypes of norovirus genogroup G Ⅱ were classified based on the nucleotide sequences of both partial capsid and polymerase fragments.Result A total of 2 288 outpatient children with acute diarrhea were included in this study,out of whom,531 (23.1％) were positive for norovirus in the fecal specimens based on real-time RT-PCR test.Norovirus was prevalent throughout the year and an increased activity of norovirus infection was usually observed between July and October.Children ＜ 4 years of age accounted for 95.2％ of norovirusinfected cases,and the detection rate of norovirus was significantly higher in diarrheal children ＜ 4 years than in those ≥4 years (24.4％ vs.10.7％,x2 =10.66,P ＜0.05).Of 531 norovirus-positive specimens,4 (1.7％) were positive for genogroup G Ⅰ and 527 (98.3％) positive for genogroup G Ⅱ.Seven distinct capsid genotypes were identified in 234 norovirus strains,including 153 (64.4％) G Ⅱ.4 (9 belonging to 2010 variants and 145 belonging to 2006b variants),66 (27.6％) GⅡ.3,7 (2.9％) GⅡ.2,6 (2.5％) GⅡ.6,4 (1.7％) GⅡ.12,1 (0.4％) GⅡ.7 and GⅡ.14 in each.Seven polymerase genotypes were identified in 244 norovirus strains,including 189 (77.5％) G Ⅱ.4 (14 belonging to 2010 variants and 175 belonging to 2006b variants),47 (19.3％) G Ⅱ.12,2 (0.8％) G Ⅱ.16,G Ⅱ.b and G Ⅱ.g in each,1 (0.4％) G Ⅱ.2 and G Ⅱ.6 in each.A new G Ⅱ.4-2010 (New Orleans) variant was first detected in June 2010 and sporadically circulated afterwards.Of 198 norovirus strains in which both polymerase and capsid genotypes were determined,56 showed discordant results,indicating potential norovirus recombinants.The common discordant combinations of the polymerase and capsid genotypes were G Ⅱ.12/G Ⅱ.3 (69.6％) and G Ⅱ.4/G Ⅱ.3 (8.9％).Conclusion Norovirus is a common causative agent responsible for diarrhea in Shanghai children over the three years and norovirus-associated diarrhea was epidemic year round with high activity in late summer and autumn in Shanghai.Infants and young children are susceptible to norovirus infection.The circulating norovirus showed genetic diversity.The G Ⅱ.4-2006b variant continued to predominate in Shanghai during the period of 2009-2011 despite the emergence of the novel G Ⅱ.4-2010 (New Orleans) variant.