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目的分析湖州市散发急性胃肠炎病例诺如病毒感染的分子流行病学特征。方法选取2014年7月—2015年6月湖州市某哨点医院873例散发急性胃肠炎病例为研究对象,采用实时荧光定量RT-PCR方法对病例粪便标本进行诺如病毒核酸检测,选取部分阳性标本进行核苷酸序列测定,确定诺如病毒基因型并作流行病学分析。结果 873份腹泻粪便标本,检出诺如病毒核酸阳性256份,阳性率为29.32%;其中GⅠ型2份,GⅡ型254份。选取核酸浓度较高的169份PCR扩增阳性产物进行序列分析,结果显示:2株GⅠ型诺如病毒分属于GⅠ.7和GⅠ.Pb/GⅠ.6基因型;167株GⅡ型诺如病毒共存在10种基因亚型,以GⅡ.P17/GⅡ.17(65.27%)和GⅡ.Pe/GⅡ.4(28.74%)基因型为主,其他基因型有GⅡ.21、GⅡ.3、GⅡ.2、GⅡ.6、GⅡ.7、GⅡ.13、GⅡ.P7/GⅡ.6和GⅡ.P12/GⅡ.4,重组株出现频率高。诺如病毒感染的发病高峰为10月至次年3月。结论诺如病毒是湖州市散发急性胃肠炎病例的主要病原菌之一,其中GⅡ.P17/GⅡ.17型是流行的优势株。
Objective To analyze the molecular epidemiological characteristics of Norovirus infection in patients with acute gastroenteritis in Huzhou city. Methods From July 2014 to June 2015, 873 cases of acute gastroenteritis were collected from a sentinel hospital in Huzhou City. The real-time fluorescent quantitative RT-PCR method was used to detect Norovirus nucleic acid in case stool samples. Positive samples for nucleotide sequence determination, determination of norovirus genotype and make epidemiological analysis. Results 873 diarrhea stool specimens were detected positive for norovirus nucleic acid 256, the positive rate was 29.32%; of which 2 GⅠ, G Ⅱ 254. A total of 169 PCR products with high nucleic acid concentration were selected for sequence analysis. The results showed that two strains of GⅠNoviruses belong to GⅠ.7 and GⅠ.Pb / GⅠ.6 genotypes; 167 GⅡNoviruses There were 10 subtypes of genotypes, which were mainly GⅡ.P17 / GⅡ.17 (65.27%) and GⅡ.Pe / GⅡ.4 (28.74%). Other genotypes were GⅡ.21, GⅡ.3, GⅡ .2, GII.6, GII.7, GII.13, GII.P7 / GII.6 and GII.P12 / GII.4. The frequency of recombinant strains is high. Norovirus infection peak incidence from October to March next year. Conclusions Norovirus is one of the major pathogenic bacteria exuding acute gastroenteritis in Huzhou City, of which GⅡ.P17 / GⅡ.17 is the predominant strain.