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目的了解广州市5岁以下婴幼儿诺如病毒感染状况及对诺如病毒阳性株进行基因型分析。方法收集广州市2008年5家病毒性腹泻监测点医院的门诊临床诊断为病毒性腹泻的5岁以下患儿临床资料及粪便标本692份,采用ELISA方法检测轮状病毒、腺病毒、星状病毒和诺如病毒抗原,将诺如病毒抗原阳性的标本用RT-PCR方法进行诺如病毒核酸扩增,阳性产物回收、纯化并测序,结合GenBank中的相关序列进行型别流行特点分析。结果 692份标本中,ELISA方法检测4种病毒的阳性率分别为轮状病毒31.9%(221/692)、诺如病毒21.2%(147/692)、腺病毒6.1%(42/692)、星状病毒1.2%(8/692),混合感染占6.8%(47/692)。诺如病毒腹泻病例发病高峰在9—11月份,占51.7%(76/147),2岁以下病例数占91.8%(135/147)。临床症状以腹泻、呕吐、发热、腹痛为主。147份诺如病毒ELISA阳性标本中RT-PCR方法检测诺如病毒核酸阳性率为84.4%(124/147),经测序及与GenBank中的相关序列比对,证实124份均属诺如病毒GⅡ遗传组,其中1份是GⅡ2型,其余均为GⅡ4型,GⅡ4型中又有不同分支。结论诺如病毒是广州市5岁以下儿童病毒性腹泻的常见病原之一,仅次于轮状病毒,常见于2岁以下婴幼儿,流行优势株基因型为GⅡ4型。
Objective To understand the status of Norovirus infection in infants under 5 years of age in Guangzhou and genotype analysis of Norovirus positive strains. Methods The clinical data and stool samples of 5 children aged less than 5 years who were clinically diagnosed as viral diarrhea in 5 outpatients of viral diarrhea monitoring hospitals in Guangzhou in 2008 were collected. The detection of rotavirus, adenovirus, astrovirus And Norovirus antigen. Norovirus positive samples were amplified by Norovirus RT-PCR, the positive products were recovered, purified and sequenced. The genotypes of GenBank were analyzed by GenBank. Results Among the 692 samples, the positive rates of rotavirus, rotavirus and rotavirus were 21.9% (21/692), 21.2% (147/692), 6.1% (42/692) 1.2% (8/692) of the viruses and mixed infections accounted for 6.8% (47/692). The incidence of Norovirus diarrhea cases peaked in September-November, accounting for 51.7% (76/147), the number of cases under the age of 2 accounted for 91.8% (135/147). Clinical symptoms of diarrhea, vomiting, fever, abdominal pain based. The positive rate of norovirus in 147 norovirus positive samples was 84.4% (124/147) by RT-PCR. Sequencing and comparison with the related sequences in GenBank confirmed that 124 were all Norovirus GⅡ Genetic group, of which 1 is G Ⅱ type 2, the rest are G Ⅱ 4 type, G Ⅱ 4 type have different branches. Conclusions Norovirus is one of the most common viral pathogens in children under 5 years old in Guangzhou. It is second only to rotavirus and common in babies under 2 years old. The predominant genotype is GⅡ4.