【摘要】 目的 了解2019-2021年深圳市疑似病毒性腹泻门诊病例诺如病毒（NoV）的感染特征，为深圳市NoV的预防控制提供科学依据。方法 收集2019年1月-2021年12月深圳市病毒性腹泻监测平台上送的门诊疑似病毒性腹泻患者的粪便样品2 494份，采用诺如病毒（GI、GII型）双重核酸检测试剂盒检测NoV核酸，实时荧光PCR阳性样品进一步用特异性引物扩增后测序，并通过NoV在线分型网站进行基因分型，同时并对其流行病学资料进行统计分析。结果 2019-2021年深圳市NoV总体检出率为19.93%(497/2 494)，各年检出率分别为22.50%、17.55%、18.90%。男性NoV检出率为21.12%(297/1 406)，女性检出率为18.38%(200/1 088)，男女NoV检出率差异无统计学意义（χ~2=2.889,P>0.05）。15～<20岁组检出率最高，为31.25%(25/80)，其余依次为1～<5岁组23.47%(134/571)、≥20岁组23.15%(254/1 097)、5～<15岁组19.05%(28/147)、6月龄～<1岁组14.55%(40/275)和0～<6月龄组4.94%(16/324)。2019年NoV无明显的感染高峰，2020、2021年NoV均在秋冬季形成感染高峰。2019、2021年分别有11、10份样品为NoV混合其他腹泻病毒感染。双重核酸检测结果显示，2019-2021年NoV均以GII型检出最多，分别占77.78%、79.31%、81.82%；少量为GI型和GII型的混合感染。进一步的基因分型结果显示，497份样品中共有420份样品获得测序分型结果，总计分型项数为435份，GII.4型为本地区门诊病例NoV的最主要流行株（48.97%,213/435），其次为GII.2型（12.41%,54/435）和GII.17型（9.43%,41/435），此外有GI.5型、GII.3型等15种基因型各有1～25份不等数量的检出。结论 深圳市疑似病毒性腹泻门诊病例NoV仍然维持较高的感染水平，且其在人群中感染的型别繁多，存在持续造成聚集性暴发的风险，应继续持续加强对NoV的监测工作。更多还原

【Abstract】 Objective To evaluate norovirus(NoV) infection and genetic characteristics of norovirus among outpatients with suspected viral diarrhea in Shenzhen city from 2019 to 2021, and provide primary data for the prevention and treatment of NoV. Methods A total of 2 494 stool samples from outpatients with suspected viral diarrhea were collected from the Shenzhen viral diarrhea surveillance network from January 2019 to December 2021. All samples were analyzed by RT-PCR to detect NoV, and sequence analysis was conducted for the positive samples. “Noroviurs Typing Tool version 2.0” was used for genotyping, and the epidemiological data were statistically analyzed. Results The overall NoV detection rate in Shenzhen from 2019 to 2021 was 19.93%(497/2 494); with 22.50%, 17.55% and 18.90% in each year respectively. The detection rate of NoV was 21.12%(297/1 406) in male and 18.38%(200/1 088) in female; there was no significant difference between male and female（χ~2=2.889, P>0.05）. Across all age groups, the highest detection rate was 31.25%(25/80) for the 15-<20 age group, followed by 23.47%(134/571) for the 1-<5 age group, 23.15%(254/1 097) for the ≥20age group, 19.05%(28/147) for the 5-<15 age group, 14.55%(40/275) for the 6 months-<1 age group, and 4.94%(16/324) for the 0-<6 months group. In 2019 there was no obvious peak of NoV infection, but in 2020 and 2021 the peak occurred in autumn and winter. In 2019 and 2021, there were 11 and 10 samples which were infected with mixtures of NoV and other diarrhea viruses respectively. The results of RT-PCR showed that from 2019 to 2021,NoV type GII was the most common type,which accounted for 77.78%,79.31%,81.82%, and there was also a small amount of mixed infection of NoV type GI and GII. Further genotyping results showed that among the 497 samples infected with NoV, we took 420 samples for genotyping, which produced a total of 435 typing items,and GII. 4 was the most prevalent NoV strain(48.97%,213/435), followed by GII.2(12. 41%,54/435) and GII.17(9.43%,41/435). In addition, 15 genotypes, such as GI.5 and GII.3, were detected in 1 out of 25 samples. Conclusions NoV infection in suspected viral diarrhea cases in Shenzhen still maintained a high level, and there were many types of infection in the population. Thus, the risk of cluster outbreaks still remained, and it should be necessary to maintain close surveillance of NoV.更多还原