【摘要】 目的通过对上海地区腹泻住院患儿进行诺若病毒检测,对其流行株进行基因序列的测定,以了解诺若病毒在上海地区的流行特征,为该病原体所致腹泻的防治提供基础数据和理论依据。方法收集2001至2005年复旦大学附属儿科医院5岁以下腹泻住院患儿的粪便标本。首先进行轮状病毒的检测,在轮状病毒抗原阴性标本中,每隔8个标本按编号顺序行机械随机抽样,建立RT-PCR方法进行诺若病毒的检测。对PCR产物进行双向测序,测序结果通过Clustal W和Mega 4.1软件进行分析。结果研究期间共收集腹泻患儿粪便标本5534份,轮状病毒抗原阴性4084份,机械随机抽得484份用于诺若病毒检测,45/484份(9.3%)检测到诺若病毒。对诺若病毒感染季节分布和患儿年龄特点的分析表明,除4月和7月份未检测到诺若病毒外,其余各月份均检测到诺若病毒,其高发的月份是8至11月。5~6月也呈一个小高峰。77.8%(35/45)的患儿<2岁,其中6~11个月的患儿所占比例最高,达35.6%(16/45),<6个月的婴儿占20%(9/45)。GⅡ-4型是这5年间尤其是2003年之后的主要流行型别,2001至2002年尚存在其他的流行型别GⅡ-3和GⅡ-7型。结论上海地区近5年来诺若病毒感染的分子流行病学特征呈现一定的规律,今后需要进行更详细和深入的监测,为儿童急性腹泻病的防控提供依据。更多还原

【Abstract】 Objective As a genus of human calicivirus,norovirus has been recognized as the most common cause of food-borne and nosocomial outbreaks of acute non-bacterial gastroenteritis in humans worldwide and the secondly important pathogen for viral diarrhea in hospitalized children.The aim of the present study was to evaluate the prevalence of norovirus in hospitalized children under 5 years old with acute gastroenteritis in the biggest pediatric hospital in Shanghai,China over a long period.The information will provide important data and theoretical basis for development of norovirus vaccine and control of norovirus infection.Methods A total of 5 534 stool samples were collected from hospitalized children with acute diarrhea in children’s hospital,Fudan University during 2001 to 2005.96% of the samples were collected within 5 days after illness onset.After all the samples were tested for rotavirus antigen,systematic sampling was applied to collect 484 samples from all the rotavirus negative stools.RNA was purified from 10%(W/V) of fecal suspensions using TRIzol.RT-PCR was applied for determination of norovirus.A multiple sequence alignment of 170nt nucleotide sequence from region B of the polymerase region sequence was constructed using Clustal W.Phylogenetic trees were constructed using Mega 4.1 software by the neighbor-joining methods.Results Of the 45 norovirus infected children,more than one-third(35.6%) were at 6-11 months of age,followed by 12-23 months(22.2%) and 0-5 months(20%).The monthly distribution of norovirus infection illustrated a seasonal peak from August(17%) to November(9.8%).Another small peak was found in May and June.Among the 6 norovirus positive samples in 2001,2 were identified to be GⅡ-7,one was GⅡ-3 and the other 3 strains were GⅡ-4 genotype.1 sample belonged to GⅡ-3 and the other 3 were GⅡ-4 in the years of 2002.All the 27 samples during the years of 2003 to 2005 were identified to be GⅡ-4 genotype.Conclusions A seasonal and age distribution of norovirus infections was found in hospitalized children in Shanghai.GⅡ-4 was the most predominant genocluster circulating in the 5 years.Our findings will provide useful data for prevention of norovirus diseases in children in Shanghai.更多还原