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目的了解广州市医院门诊成人病毒性腹泻的感染情况和分子流行病学特征。方法 2011年6月至2012年5月在广州市两家哨点医院收集门诊18岁以上腹泻患者粪便标本127份。采用酶联免疫技术检测A群轮状病毒,逆转录-聚合酶链反应(RT-PCR)方法检测粪便标本中的诺如病毒、星状病毒和札幌病毒,聚合酶链反应(PCR)检测腺病毒。结果共127份腹泻患者粪便标本,其中男性占54.33%(69/127),女性占45.67%(58/127),年龄以60岁以上所占比例最高,为25%(7/28)。127份粪便标本中,单一腹泻病毒感染25份,阳性率19.69%,其中检出轮状病毒阳性7份,阳性率5.52%(7/127);诺如病毒阳性11份,阳性率8.66%(11/127);札幌病毒3份,腺病毒阳性3份,阳性率均为2.36%(3/127);星状病毒1份,阳性率0.79%(1/127)。未见混合感染,发病具有明显的秋冬季节升高现象,诺如病毒、札幌病毒、腺病毒、星状病毒流行株为别为GII-4型、GI-2型、AD41和HAstV-1。结论医院就诊成人腹泻病例中约1/4为病毒性腹泻,其中诺如病毒是最重要的病原体,感染对象主要是60岁以上人群。
Objective To understand the prevalence and molecular epidemiological characteristics of adult viral diarrhea in outpatient department of Guangzhou City. Methods From June 2011 to May 2012, 127 stool specimens from patients with diarrhea at the age of 18 were collected from two sentinel hospitals in Guangzhou. Enzyme-linked immunosorbent assay (ELISA) was used to detect group A rotavirus, and Norovirus, Astrovirus and Sapovirus were detected in stool samples by RT-PCR. PCR was used to detect glandular adenocarcinoma virus. Results A total of 127 stool specimens were collected from diarrhea patients, accounting for 54.33% (69/127) of males and 45.67% (58/127) of females, accounting for 25% (7/28) of the patients aged over 60 years. Of the 127 stool samples, 25 were positive for single diarrhea virus, with a positive rate of 19.69%, of which 7 were positive for rotavirus, the positive rate was 5.52% (7/127); norovirus was 11, the positive rate was 8.66% 11/127), 3 copies of Saponavirus and 3 copies of adenovirus. The positive rate was 2.36% (3/127), while that of astrovirus was 0.79% (1/127). No mixed infection, the incidence of significant autumn and winter seasons, norovirus, Sarko virus, adenovirus, astrovirus epidemic strains were not GII-4, GI-2, AD41 and HAstV-1. Conclusions Approximately one-quarter of the cases of adult diarrhea in hospital are viral diarrhea. Norovirus is the most important pathogen, and the main target of infection is over 60 years old.