婴幼儿腹泻轮状病毒和腺病毒检测结果分析

目的了解本地区婴幼儿腹泻患者中轮状病毒和腺病毒的感染情况,为临床治疗提供依据。方法收集2013年1月-12月门诊和住院腹泻患儿的粪便,进行轮状病毒和腺病毒抗原检测,并对结果进行统计学分析。结果在检测的2 579例婴幼儿腹泻中轮状病毒阳性为616例,阳性率为23.89%,高发季节为1月、11月和12月,高发年龄组为13-24月婴幼儿,腺病毒阳性共102例,阳性率为3.96%,程散发状况,高发年龄组为7-12月的婴幼儿。结论轮状病毒和腺病毒都能引起婴幼儿腹泻,但是轮状病毒为最主要的病原体,及时检测轮状病毒抗原,为临床治疗和疾病监测提供参考。     

杭州地区腹泻儿童轮状病毒与腺病毒感染调查

目的 分析不同季节及不同年龄段腹泻患儿感染轮状病毒（RV）与腺病毒（Eads）情况,为临床提供早期、快速、准确、可靠的依据,以便及时采取相应的治疗使患儿早日康复。方法 采用杭州艾博医药有限公司提供的轮状病毒（A组）/腺病毒检测试剂盒（乳胶法）,对2012年1月至2015年12月浙江省人民医院门诊和住院就诊的3 368例腹泻儿童粪便标本进行轮状病毒和腺病毒抗原检测。结果 3 368例腹泻儿童粪便中,RV阳性578例占17.16%,Eads阳性106例占3.15%。11月至次年1月为轮状病毒感染的高发月份,1～3岁为儿童感染的高发年龄;腺病毒感染阳性率低,呈散发性。结论 杭州地区近年1～3岁婴幼儿的腹泻主要是由轮状病毒和腺病毒引起,其中轮状病毒感染率明显高于腺病毒,且有明显的季节性;而腺病毒感染呈散发流行,未表现出明显的季节性及年龄分布。     

Antigenemia, RNAemia, and innate immunity in children with acute rotavirus diarrhea

Antigenemia is commonly detected in children with acute rotavirus diarrhea, but the prevalence of viremia has not been clearly defined. We examined antigenemia in plasma and RNAemia in peripheral blood mononuclear cells (PBMC) of children with acute diarrhea by EIA, RT-PCR, and Southern hybridization, using primers and a probe specific to rotavirus NSP4 gene. We detected the presence of rotavirus antigen in 33.3% and almost full-length NSP4 gene in 70.8% of the acute-phase plasma and PBMC, respectively. In contrast, antigenemia and RNAemia were detected in 0% and 4.2% of the convalescent-phase plasma and PBMC, respectively, which were similar to antigenemia (0%) and RNAemia (7.7%) in healthy controls. We demonstrated an increase in the proportions of activated myeloid dendritic cells (mDC) and activated plasmacytoid DC (pDC) in acute-phase PBMC of patients when compared to those in convalescent phase of patients and in PBMC of healthy controls. The activation of mDC peaked on days 2-4 after illness onset, and the activation of acute-phase pDC appeared to correlate with levels of antigenemia. High prevalence of NSP4 gene in acute-phase PBMC indicates possible rotavirus replication in white blood cells, and extraintestinal spread and the activation of DC may have implications for the prevention of rotavirus disease in children.     

Malnutrition and its association with intestinal parasitism among children from a village in the Colombian Amazonian region

Intestinal parasites and malnutrition cause high morbidity among children in developing countries. A study to establish the associations between intestinal parasitism and undernourishment was undertaken in a village in the Colombian Amazon region. Two hundred thirty seven children each provided four stool samples for parasitic analysis. Anthropometric indices were calculated based on height and weight (HAZ), weight and age (WAZ) and height and weight (WHZ) using the international growth standards recommended by the World Health Organization. Of the 237 children, 86.1% were carrying parasites, 54% had 2 or more parasites, 30% were stunted, 10% were underweight, and 2.5% were wasting. HAZ and WAZ indices were inversely related to age and number of parasites. Socioeconomic status was positively correlated with the number of parasites and inversely related to the HAZ index (p < 0.05). In conclusion, frequencies of undernourishment and intestinal parasites among the sample population were higher than the national average for Colombia. As previous studies have indicated, age, intestinal parasitism and socio-economic level are variables significantly related to nutritional state.     

炎琥宁注射液对小儿轮状病毒腹泻的治疗及对患儿心肌酶的影响

目的探讨炎琥宁注射液对小儿轮状病毒腹泻的疗效及对患儿心肌酶的影响。方法选择2016年1月至2016年12月大兴区妇幼保健院收治的94例小儿轮状病毒腹泻患儿为研究对象,所有患儿按照随机数字表法分为观察组(47例)与对照组(47例)。两组患儿均采用常规治疗,观察组在常规治疗基础上结合炎琥宁注射液治疗。两组患儿疗程均为7d。比较两组患儿的疗效,治疗前后肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶心型同工酶(CK-MB)的变化,止泻时间、腹胀消失时间、退热时间,及不良反应发生情况。结果观察组患儿治疗总有效率(93.62%)高于对照组(74.47%),差异有统计学意义(P0.05)。两组患儿治疗后CK、LDH、CK-MB水平较治疗前降低(P0.05),且观察组低于对照组(P0.05)。观察组患儿止泻时间、腹胀消失时间及退热时间均短于对照组(P0.05)。两组患儿不良反应发生率比较差异无统计学意义(P0.05)。结论炎琥宁注射液治疗小儿轮状病毒腹泻效果显著,且可明显改善患儿心肌酶水平,具有一定临床应用价值。     

Curli fimbria production among Escherichia coli strains isolated from children with diarrhea and healthy children

E. coli curli fimbria are produced during starvation and at room temperature. In the study curli synthesis among E. coli strains isolated from children with diarrhea and healthy children was investigated at human body temperature and in the variable atmosphere conditions: aerobic, supplemented with CO2 and anaerobic. The ability of curli synthesis was estimated using qualitative and quantitative methods basing on Congo red binding by curli. Curli production of all E. coli strains examined was observed at temperature 37 degrees C during anaerobic cultivation, confirming their role in colonization of intestinal mucosa.     

2009～2010年北京儿童腹泻中轮状病毒新VP4基因亚型的研究

P[8]b基因亚型是国内外新近发现的A组人轮状病毒(HRV)VP4基因的一种新亚型,本研究旨在建立有效鉴别HRV P[8]a和P[8]b基因亚型及P[4]和P[6]基因型的VP4基因打点杂交分型方法,并运用此方法对2009～2010年首都儿科研究所附属儿童医院门诊及住院腹泻患儿中P[8]b基因亚型HRV的流行情况及其G/P基因组合情况进行研究。通过对GenBank序列数据库可检索到的国内外HRV各种P基因型及亚型的VP4基因序列应用相关软件进行基因分析,在不同基因型别间核苷酸变异密集而相同P基因型内核苷酸高度保守的的位置设计各型别探针,并分别以本实验室上传GenBank的北京HRV地方株P[4]和P[6]基因型及P[8]a和P[8]b亚型的VP4基因作为相应型别探针的合成引物的设计模板及探针经PCR合成的合成模板,合成地高辛素标记的DNA探针。经测序验证所建立的VP4基因杂交分型方法结果可靠。对门诊88例(55%,88/160)及住院79例(70.5%,79/112)HRV腹泻患儿的P分型结果显示P[8]a亚型仍为主要型别,前者为96.6%(85/88),而后者为62.0%(49/79);P[8]b亚型在住院HRV感染腹泻患儿中占较高比例(27.9%,22/79),虽然其在门诊HRV感染患儿中也存在,但仅占2.3%(2/88);另外单纯P[4]基因型HRV感染仅在住院腹泻患儿中检测到1例(1.3%,1/79),而P[6]基因型在门诊及住院HRV感染腹泻患儿中均未检测到;本组标本中HRV P[8]b亚型主要与G9基因型组合。本研究表明G9P[8]b型HRV在北京腹泻儿童中有流行。     

Bacterial, viral and parasitic enteric pathogens associated with acute diarrhea in hospitalized children from northern Jordan

To determine the etiology of acute diarrhea in Jordanian children under 5 years of age, we examined stool samples from 265 children admitted to the pediatric ward at Princess Rahma Hospital for Children, Irbid, Jordan, for parasites, rotavirus and enteric bacteria. Using both traditional and molecular diagnostic techniques, we detected enteropathogens in 66.4% of patients with diarrhea. A single enteric pathogen was detected in 50.9% of the children, and multiple pathogens were detected in 15.5%. The prevalence of enteropathogens identified was as follows: rotavirus (32.5%), enteropathogenic Escherichia coli (12.8%), enteroaggregative E. coli (10.2), enterotoxigenic E. coli (5.7%), Shigella spp. (4.9%), Entamoeba histolytica (4.9%), Salmonella spp. (4.5%), Campylobacter jejuni/coli (1.5%), Cryptosporidium spp. (1.5%), enteroinvasive E. coli (1.5%), eae-, Ehly-positive E. coli (0.8%), Giardia lamblia (0. 8%) and Yersinia enterocolitica (0.4%). No Vibrio cholerae, Shiga toxin-producing E. coli, microsporidia, adenovirus or small round virus were detected. Findings from this study demonstrate that rotavirus and several types of diarrheagenic E. coli, which are not screened for during routine examinations of stool samples in public health laboratories, were the most frequently detected enteropathogens in these children. Our findings highlight the value of using a combination of traditional and molecular techniques in the diagnosis of diarrheal disease in this population.     

A food‐borne outbreak of gastroenteritis due to genotype G1P[8] rotavirus among adolescents in Japan

Six high school students in Tochigi prefecture, Japan, developed gastroenteritis after eating at a pork cutlet shop. Molecular epidemiologic analyses showed that the causative agent was genotype G1P[8] rotavirus (RV), this being detected in stool samples from both the patients and the asymptomatic food handlers. The detected RV strains were closely related genetically. The only uncooked food that all victims had eaten was raw sliced cabbage. These findings results suggest that uncooked foods contaminated with RV may be sources of infectious gastroenteritis in adolescents.     

Estimating diarrhea mortality among young children in low and middle income countries

Background

Diarrhea remains one of the leading causes of morbidity and mortality among children under 5 years of age, but in many low and middle-income countries where vital registration data are lacking, updated estimates with regard to the proportion of deaths attributable to diarrhea are needed.

Methods

We conducted a systematic literature review to identify studies reporting diarrhea proportionate mortality for children 1–59 mo of age published between 1980 and 2009. Using the published proportionate mortality estimates and country level covariates we constructed a logistic regression model to estimate country and regional level proportionate mortality and estimated uncertainty bounds using Monte-Carlo simulations.

Findings

We identified more than 90 verbal autopsy studies from around the world to contribute data to a single-cause model. We estimated diarrhea proportionate mortality for 84 countries in 6 regions and found diarrhea to account for between 10.0% of deaths in the Americas to 31.3% of deaths in the South-east Asian region.

Discussion

Diarrhea remains a leading cause of death for children 1–59 mo of age. Published literature can be used to create a single-cause mortality disease model to estimate mortality for countries lacking vital registration data.