CAJ | 학술논문

目的探讨广东省＜5岁儿童腹泻病流行特征和重点病原监测.方法 2012年在广东省21个地市选择64家医院开展腹泻症状监测,其中14家医院采集＜5岁儿童腹泻病粪便标本,开展霍乱弧菌、志贺菌分离培养及轮状病毒、诺如病毒ELISA、PCR检测.分析52周腹泻病症状监测数据和1932例＜5岁儿童腹泻病重点病原监测结果.结果 2012年广东省＜5岁儿童腹泻就诊病例占监测门诊就诊总人次数的0.8％,占监测门诊全年龄组腹泻病例就诊总人次数的63.5％；以医院为基础报告＜5岁儿童感染性腹泻病年发病率为1454.5/10万.全年采集＜5岁儿童腹泻病标本1932份,检测霍乱弧菌均为阴性,宋内志贺菌1例阳性,轮状病毒阳性率为14.1％(273/1932),诺如病毒阳性率为16.9％ (326/1932),诺如病毒和轮状病毒合并感染24例(1.2％).112份轮状病毒和90份诺如病毒阳性标本测序表明,轮状病毒主要以G1[P8]为主(33.9％),其次为G9[P8] (25.9％)、G2[P4] (12.5％)、G3[P8](9.8％)；诺如病毒以GⅡ.4型为主(76.7％),并检出5份GⅠ型和16份GⅡ其他型/变异株,除6月(未开展测序工作)和12月外其余各月均检出GⅡ.4/2006b型(占50.0％),GⅡ.4/Sydney_2012变异株于8月首次检出并在12月成为流行优势株.结论＜5岁儿童是广东省腹泻病高危人群,感染的轮状病毒和诺如病毒具有基因多样性.
목적 탐토광동성＜5세인동복사병류행특정화중점병원감측.방법 2012년재광동성21개지시선택64가의원개전복사증상감측,기중14가의원채집＜5세인동복사병분편표본,개전곽란호균、지하균분리배양급륜상병독、낙여병독ELISA、PCR검측.분석52주복사병증상감측수거화1932례＜5세인동복사병중점병원감측결과.결과 2012년광동성＜5세인동복사취진병례점감측문진취진총인차수적0.8％,점감측문진전년령조복사병례취진총인차수적63.5％；이의원위기출보고＜5세인동감염성복사병년발병솔위1454.5/10만.전년채집＜5세인동복사병표본1932빈,검측곽란호균균위음성,송내지하균1례양성,륜상병독양성솔위14.1％(273/1932),낙여병독양성솔위16.9％ (326/1932),낙여병독화륜상병독합병감염24례(1.2％).112빈륜상병독화90빈낙여병독양성표본측서표명,륜상병독주요이G1[P8]위주(33.9％),기차위G9[P8] (25.9％)、G2[P4] (12.5％)、G3[P8](9.8％)；낙여병독이GⅡ.4형위주(76.7％),병검출5빈GⅠ형화16빈GⅡ기타형/변이주,제6월(미개전측서공작)화12월외기여각월균검출GⅡ.4/2006b형(점50.0％),GⅡ.4/Sydney_2012변이주우8월수차검출병재12월성위류행우세주.결론 ＜5세인동시광동성복사병고위인군,감염적륜상병독화낙여병독구유기인다양성.
Objective To analyze the epidemiological and etiological characteristics of diarrheal disease among children under 5 years of age in Guangdong province,in 2012.Methods 64 hospitals in 21 cities were chosen as the diarrheal syndromic surveillance sites,of which 14 hospitals were selected to carry out etiological surveillance among children under 5 years of age,including isolation and culture of both Vibrio cholera and Shigella as well as nucleic acid detection of rotavirus and norovirus by PCR.Descriptive method was used to analyze data from syndromic and etiological surveillance programs on diarrheal,from 1932 parents of the children.Results In 2012,the outpatient attendance rate on diarrheal among children under 5 years was 0.8％.The proportion of diarrheal in children under 5-year-olds was 63.5％,among the total number of diarrheal outpatients at the outpatient clinics under surveillance program.The morbidity of infectious diarrhea was 1454.5/10 million in children under 5 years of age.A total number of 1932 specimens were collected from children under 5 years of age,in the outpatient department.Among these specimens,Vibrio cholera appeared all negative but one was Shigella positive and proved to be Sh.sonnei.The positive rates of rotavirus and norovirus were 14.1％ (273/1932) and 16.9％ (326/1932).Both rotavirus and norovirus were found in 24 specimens,with a positive rate as 1.2％.112 specimens were successfully genesequenced for rotavirus,of which 33.9％ as G1 [P8] genotype,25.9％ as G9 [P8],12.5％ as G2 [P4] and 9.8％ as G3 [P8] respectively.90 specimens were successfully gene-sequenced for norovirus,of which 76.7％ as G Ⅱ.4 genotype.Genetic subtypes of G Ⅱ.4/2006b,accounted for 50.0％ and could be detected around the year except for June and December.New G Ⅱ.4/Sydney Strain_2012 was first detected in August and became the predominant in December.In addition,5 specimens belonged to G Ⅰ genotype with other 16 subtypes of G Ⅱ.Conclusion Results from our study proved that children under 5 years of age belonged to high-risk group for diarrheal disease in Guangdong province.Rotavirus and norovirus were both diverse in terms of genome.