甲胎蛋白和高敏甲胎蛋白异质体比率在肝细胞癌早期诊断中的应用价值

观察基于μTASwako i30微流控系统监测的甲胎蛋白(AFP)和高敏甲胎蛋白异质体比率(hs-AFP-L3%)在慢性病毒性肝炎、肝硬化及肝细胞癌(HCC)患者中的水平变化, 探讨其对HCC早期诊断的临床价值。

选择2019年1月至2019年12月初次就诊的慢性病毒性肝炎(64例, 慢性病毒性肝炎组)、肝硬化(68例, 肝硬化组)和HCC患者(67例, HCC组), 同时按年龄和性别匹配选择同期就诊的65例肝血管瘤患者作为对照组。采用μTASwako i30微流控免疫荧光技术对血清AFP及hs-AFP-L3%进行测定。分别以≥20μg/L和≥10%作为AFP和hs-AFP-L3%诊断HCC的临界值。

(1) 各组患者血清hs-AFP-L3%和AFP水平比较: HCC组均较肝硬化组、慢性病毒性肝炎组显著升高, 肝硬化组、慢性病毒性肝炎组均较对照组显著升高, 差异有统计学意义(均P < 0.05);肝硬化组AFP水平较慢性病毒性肝炎组显著升高(P < 0.05), 而hs-AFP-L3%水平差异无统计学意义(P > 0.05)。(2)各组患者血清hs-AFP-L3%和AFP阳性率的比较: HCC组均较肝硬化组、慢性病毒性肝炎组显著升高(均P < 0.05), 肝硬化组、慢性病毒性肝炎组均较对照组显著升高(均P < 0.05), 肝硬化组AFP阳性率较慢性病毒性肝炎组显著升高(P < 0.05)。(3)HCC肿瘤直径≥5 cm患者、低分化患者、Ⅲ-Ⅳ期患者血清hs-AFP-L3%、AFP水平及阳性率均较肿瘤直径 < 5 cm患者、高分化患者、Ⅰ-Ⅱ期患者显著增加(均P < 0.05)。(4)AFP检测HCC的灵敏度高于hs-AFP-L3%(P < 0.05), 而联合检测的灵敏度高于hs-AFP-L3%和AFP(P < 0.05);hs-AFP-L3%检测HCC的特异度高于AFP和联合检测(均P < 0.05)。

基于μTASwako i30微流控系统的hs-AFP-L3%和AFP的联合检测可显著提高hs-AFP-L3%或AFP检测HCC的灵敏性, 对早期HCC有一定的预警意义。

     

川崎病及川崎病冠状动脉病变患儿肠道菌群变化

研究川崎病及川崎病冠状动脉病变患儿肠道菌群变化情况, 为调节其肠道菌群提供参考。

选择我院2018年7月至2020年5月纳入的97例川崎病患儿作为观察对象, 依据超声心动图检查将其中出现冠状动脉病变的45例患儿作为研究组, 另外52例单纯川崎病患儿作为对照组, 检测两组患儿肠道菌群情况。

两组患儿肠道菌群多样性相比差异无统计学意义(P > 0.05), 但研究组患儿肠道菌群丰度高于对照组(P < 0.05)。研究组患儿肠道厚壁菌门占35.85%, 低于对照组的54.06%(P < 0.05)。研究组患儿肠道拟杆菌门占33.57%, 高于对照组的21.30%(P < 0.05)。研究组患儿肠道变形菌门占24.39%, 与对照组的25.21%相比差异无统计学意义(P > 0.05)。研究组患儿肠道乳杆菌属、拟杆菌属、韦荣球菌属分别占3.87%、25.03%、2.75%, 与对照组的21.23%、16.23%、17.95%相比差异均有统计学意义(均P < 0.05)。

川崎病冠状动脉病变患儿肠道菌群状况与单纯川崎病患儿存在显著差异, 合并冠状动脉病变的患儿肠道菌群紊乱更为显著, 应受到临床重视。

     

急性脑卒中患者肠道菌群研究

通过粪便标本检测急性脑卒中患者肠道菌群变化情况, 探讨急性脑卒中患者肠道菌群结构。

通过高通量二代测序技术对10例健康者(对照组)及10例急性脑卒中患者(疾病组)粪便样本进行菌群结构测序分析。

与对照组比较, 急性脑卒中患者粪便样本中物种OTU信息量显著增加(P < 0.01), 菌群多样性指数(Shannon)和物种均一度指数(Evenness)也有所增加但差异无统计学意义(均P > 0.05)。门水平上, 疾病组患者肠道Bacteroidetes数量较对照组显著增加, Firmicutes数量显著减少(均P < 0.05)。属水平上, 疾病组患者肠道Bacteroides、Bilophila、Butyricimonas比例较对照组显著升高, 而Collinsella、Coprococcus、Clostridium等比例较对照组显著降低(均P < 0.05)。

急性脑卒中患者肠道菌群结构与健康人存在显著差异。

     

益生菌联用泻药对中国成人功能性便秘的疗效——基于随机对照试验的Meta分析

探讨国内益生菌联合泻药对于成人功能性便秘的疗效。

以“益生菌”和“功能性便秘”为关键词, 分别在中国知网、维普、万方数据库、中国生物医学文献数据系统、PubMed、Embase和Cochrane Library检索益生菌联合泻药对功能性便秘的疗效, 检索时限从建库至2020年12月6日。采用Stata 13.1和RevMan 5.4软件进行Meta分析。

共检索出16 929篇文献, 最终纳入23篇文献。联合组在有效率[OR=4.39, 95%CI=(3.25, 5.92), P < 0.000 01]、排便频率改善[WMD=0.77, 95%CI=(0.16, 1.38), P < 0.000 01]、粪便性状改善[WMD=1.12, 95%CI=(0.87, 1.37), P < 0.000 01]等方面均优于对照组。

益生菌联合泻药比单用泻药更能有效缓解便秘。

     

高危型人乳头瘤病毒感染与阴道微生态及宫颈局部细胞免疫的相关性

探讨高危型人乳头瘤病毒(HR-HPV)感染与阴道微生态及宫颈局部细胞免疫的相关性, 为该类患者的治疗提供参考。

选择2018年1月至2020年1月我院收治的126例HPV感染者, 依据感染病毒类型分为非HR-HPV感染组(n=69)和HR-HPV感染组(n=57), 并纳入同期来我院体检的50名健康体检者作为对照组。分析HPV感染类型、患者阴道微生态状况及宫颈局部组织T淋巴细胞亚群水平。

患者中复合型与单一型HR-HPV感染率分别为15.8%、84.2%, 差异有统计学意义(χ²=5.324, P=0.047)。对照组、非HR-HPV感染组和HR-HPV感染组对象阴道微生态失调率分别为22.0%、34.8%、45.6%, 其中对照组对象阴道微生态失调率最低(χ²=5.638, P=0.048)。非HR-HPV感染组和HR-HPV感染组患者阴道病原菌检出率高于对照组(均P < 0.05)。非HR-HPV感染组和HR-HPV感染组患者宫颈局部T淋巴细胞亚群水平低于对照组(均P < 0.05)。

HPV33、16、18型为HPV感染主要类型, 会加重阴道微生态紊乱程度, 影响局部细胞免疫功能。检测患者HPV感染情况和宫颈局部细胞免疫功能可为患者临床治疗提供有效数据, 有利于治疗措施的制定。

     

不同分期的慢性阻塞性肺疾病患者肠道微生态的变化

探讨慢性阻塞性肺疾病(COPD)不同分期肠道微生态的菌群多样性及丰度变化。

本研究为前瞻性病例对照研究。纳入COPD急性加重期患者(A组)、COPD稳定期患者(S组)以及正常对照者(N组)各30例。收集3组研究对象临床资料, 留取粪便标本, 通过16S V3-V4区引物进行细菌多样性鉴定, 对序列进行可操作分类单元(OTU)聚类和物种注释, 分析3组研究对象肠道菌群结构、丰度以及多样性变化。

完成研究且标本合格者80例, 其中A组29例、S组29例、N组22例。比较3组研究对象肠道菌群组内多样性指标(Alpha多样性)和组间多样性指标(Beta多样性), 均提示差异有统计学意义(均P < 0.01)。3组研究对象肠道菌群结构发生改变, 在门水平, 厚壁菌门、拟杆菌门、放线菌门、软壁菌门、变形菌门和梭杆菌门差异有统计学意义(均P < 0.01);在属水平, 29种菌属差异有统计学意义(均P < 0.05)。进一步采用线性判别分析效应量(LEfSe分析)找出3组的差异菌。

与正常对照相比, COPD急性加重期及稳定期肠道菌群多样性均有下降, 而急性加重期下降更显著; 3组研究对象肠道菌群结构差异显著, 菌群结构改变可能与急性加重有关。

     

发酵乳对脓毒症患者肠黏膜屏障功能的影响

观察发酵乳对脓毒症患者肠黏膜屏障功能及炎症指标的影响。

选取60例确诊为脓毒症的患者, 随机分成对照组和发酵乳组, 每组各30例。对照组给予抗生素及营养支持治疗, 治疗组在常规综合治疗的基础上给予口服发酵乳治疗。在治疗前及治疗1周后分别检测并比较两组患者肠黏膜屏障功能、C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平变化, 记录患者APACHEⅡ评分。采用SPSS 22.0软件进行数据统计。

治疗前两组患者的肠屏障功能、PCT和IL-6水平差异无统计学意义(P > 0.05)。治疗1周后, 发酵乳组血清内毒素(LPS)、血清二胺氧化酶(DAO)、D-乳酸、CRP、PCT、TNF-α、IL-6水平和APACHEⅡ评分较治疗前均显著降低(P < 0.05), 较对照组治疗后也降低(P < 0.05)。

脓毒症患者在常规综合治疗基础上加用发酵乳可改善肠粘膜屏障功能, 减轻患者全身炎症反应。

     

2015-2020年大连市流感病毒分离鉴定情况分析

对2015-2020年大连市流感病毒分离鉴定情况进行对比分析, 为大连市流感防控工作提供参考。

采集大连市2家国家级流感监测哨点医院的流感样病例咽拭子样本, 用MDCK细胞和鸡胚分别进行病毒分离培养, 并采用HA试验和HI试验对分离的病毒滴度和型别进行鉴定。

2015-2020年共分离培养流感病毒核酸检测阳性的咽拭子1 055份, 其中MDCK细胞分离出流感病毒501株, 鸡胚分离出流感病毒72株, 总体病毒分离率54.31%。MDCK细胞分离出A(H1N1)、A(H3N2)、B(Victoria)和B(Yamagata)型病毒, 鸡胚对A(H3N2)型病毒不敏感, 但可以分离出A(H1N1)、B(Victoria)和B(Yamagata)型病毒。每年的优势毒株虽不同, 但分离流感病毒的月份均在流行季内, 与北方流行形势一致。

MDCK细胞与鸡胚的流感病毒分离率不同。大连市每年流感流行的优势株和流行程度虽不同, 但流行程度处于相对平稳状态。

     

沼泽红假单胞菌对健康小鼠肠道微生物的影响

探讨不同剂量沼泽红假单胞菌对健康小鼠生理功能及肠道微生物结构的影响。

将48只C57/BL6小鼠随机分为对照组(无菌生理盐水)以及沼泽红假单胞菌低剂量组(5×10⁸ CFU/mL)、中剂量组(5×10⁹ CFU/mL)、高剂量组(5×10¹⁰ CFU/mL), 每组12只; 不同剂量灌胃4周后, 测定小鼠胃泌素(Gas)、生长抑素(SS)含量, 观察肠道形态, 并应用Illumina-MiSeq测序平台进行16S rRNA基因V3-V4区测序, 分析其肠道微生物群落结构、多样性及组间差异。

与对照组相比, 低剂量组对促进小鼠Gas分泌差异具有统计学意义(t=6.426, P < 0.01), 高剂量组对抑制小鼠SS分泌差异具有统计学意义(t=3.711, P < 0.05);对照组小鼠回肠肠绒毛高度差异无统计学意义(P > 0.05), 且无肠道炎症刺激反应。沼泽红假单胞菌干预后细菌丰富度和多样性增加, 在门水平上, 与对照组相比, 实验组小鼠肠道菌群拟杆菌门丰度显著降低, 厚壁菌门丰度显著增加(均P < 0.05);在属水平上, 与对照组相比, 实验组小鼠肠道菌群Lachnospiraceae NK4A136 group、乳杆菌属、拟杆菌属、理研菌属和Prevotellaceae UCG-001相对丰度显著增加(均P < 0.05)。

沼泽红假单胞菌能够维持胃肠激素稳态和肠道形态结构, 且对健康小鼠肠道菌群的丰富度和组成产生一定的影响, 维持肠道平衡与稳定。

     

胚胎移植前的阴道微生态对辅助生殖患者妊娠结局的影响

探讨辅助生殖治疗患者在胚胎移植前的阴道微生态对妊娠结局的影响。

选取1 420例在北部战区总医院生殖医学科经体外受精/卵胞浆内单精子注射(IVF/ICSI)治疗并接受冻融胚胎移植的不孕患者。在胚胎移植前取阴道分泌物涂片、革兰染色、显微镜镜检检查阴道微生态情况, 回顾性分析阴道微生态对辅助生殖患者妊娠结局的影响。

微生态失衡患者的HCG阳性率、临床妊娠率、胚胎种植率、流产率和早产率与微生态正常患者相比差异无统计学意义(P > 0.05)。708例微生态失衡患者中, 菌群正常功能下降335例、菌群抑制141例、白细胞异常127例、BV中间型52例、BV 30例、VVC 23例。BV患者的流产率与其他几种微生态失衡情况相比, 差异有统计学意义(P < 0.01)。

微生态失衡对辅助生殖患者的妊娠率影响有限; BV患者在胚胎移植后可能有流产的风险, 建议调整阴道微生态的平衡防止流产发生。

     

Predominance of Norovirus and Sapovirus in Nicaragua after Implementation of Universal Rotavirus Vaccination

Background

Despite significant reduction of rotavirus (RV) infections following implementation of RotaTeq vaccination in Nicaragua, a large burden of patients with diarrhea persists.

Methods

We conducted a community- and hospital-based study of the burden of RV, norovirus (NV) and sapovirus (SV) infections as cause of sporadic acute gastroenteritis (GE) among 330 children ≤ 5 years of age between September 2009 and October 2010 in two major cities of Nicaragua with a RotaTeq coverage rate of 95%.

Results

We found that NV, SV and RV infections altogether accounted for 45% of cases of GE. Notably, NV was found in 24% (79/330) of the children, followed by SV (17%, 57/330) and RV (8%, 25/330). The detection rate in the hospital setting was 27%, 15% and 14% for NV, SV and RV respectively, whereas in the community setting the detection rate of RV was < 1%. Among each of the investigated viruses one particular genogroup or genotype was dominant; GII.4 (82%) for NV, GI (46%) for SV and G1P[8] (64%) in RV. These variants were also found in higher proportions in the hospital setting compared to the community setting. The GII.4.2006 Minerva strain circulating globally since 2006 was the most common among genotyped NV in this study, with the GII.4-2010 New Orleans emerging in 2010.

Conclusions

This study shows that NV has become the leading viral cause of gastroenteritis at hospital and community settings in Nicaragua after implementation of RV vaccination.     

Proportion of sporadic gastroenteritis cases caused by rotavirus, norovirus, adenovirus and bacteria in Japan from January 2000 to December 2003

Many kinds of virus and bacterium have been identified as pathogens that cause sporadic gastroenteritis (SG). Among the pathogens, rotavirus (RV), norovirus (NV; previously known as Norwalk-like virus), and adenovirus (AdV) types 40/41 have been considered as the prevalent viruses implicated in the aetiology of childhood gastroenteritis. In the present study, we attempted to estimate monthly proportions of SG cases caused by the viral agents (RV, NV, AdV and other viruses (OV)) and bacterial agents in the whole of Japan. The estimation was carried out by using time series data of the incidence of SG and the viral and bacterial agents of SG, which were collected by a nationwide surveillance system in Japan from January 2000 to December 2003. It was confirmed that, in the dominant period of RV and NV, the proportion of RV-associated SG and that of NV-associated SG indicate almost same level with each other: 46-69% during February-May for RV, and 41-75% during October-December for NV.     

High-Pressure Inactivation of Rotaviruses: Role of Treatment Temperature and Strain Diversity in Virus Inactivation

Rotavirus (RV) is the major etiological agent of acute gastroenteritis in infants worldwide. Although high-pressure processing (HPP) is a popular method to inactivate enteric pathogens in food, the sensitivity of different virus strains within same species and serotype to HPP is variable. This study aimed to compare the barosensitivities of seven RV strains derived from four serotypes (serotype G1, strains Wa, Ku, and K8; serotype G2, strain S2; serotype G3, strains SA-11 and YO; and serotype G4, strain ST3) following high-pressure treatment. RV strains showed various responses to HPP based on the initial temperature and had different inactivation profiles. Ku, K8, S2, SA-11, YO, and ST3 showed enhanced inactivation at 4°C compared to 20°C. In contrast, strain Wa was not significantly impacted by the initial treatment temperature. Within serotype G1, strain Wa was significantly (P < 0.05) more resistant to HPP than strains Ku and K8. Overall, the resistance of the human RV strains to HPP at 4°C can be ranked as Wa > Ku = K8 > S2 > YO > ST3, and in terms of serotype the ranking is G1 > G2 > G3 > G4. In addition, pressure treatment of 400 MPa for 2 min was sufficient to eliminate the Wa strain, the most pressure-resistant RV, from oyster tissues. HPP disrupted virion structure but did not degrade viral protein or RNA, providing insight into the mechanism of viral inactivation by HPP. In conclusion, HPP is capable of inactivating RV at commercially acceptable pressures, and the efficacy of inactivation is strain dependent.     

长春地区轮状病毒流行株VP7基因的遗传变异

A组轮状病毒是引起婴幼儿秋冬季病毒性腹泻的主要病原.目前没有有效的治疗药物,应用安全而有效的疫苗是控制重症腹泻的首要措施.对当地A组轮状病毒流行株的主要中和抗原VP7的编码基因进行遗传变异分析,可以为疫苗的应用和开发提供有益的指导.利用ELISA方法对长春地区1999～2005年的腹泻患儿标本检测A组轮状病毒,RT-PCR方法对阳性标本进行G血清分型,发现长春地区2001年以后流行的轮状病毒以G3型血清为主.选取1999～2005年的G3型轮状病毒标本31份,对其VP7基因进行扩增、克隆、测序,经过计算机分析比对,31株G3型轮状病毒VP7基因核苷酸序列没有显著差异.同一流行季节的毒株具有较相似的遗传变异特征.在2003年轮状病毒流行季节内,有6株G3型分离株的VP7基因在碱基1 038位置上出现一个碱基缺失.毒株发生在A、B、C三个高变区的碱基突变,位点相同或者位置临近.2002年以后毒株的基因突变增加,非高变区的碱基变异增加,这可能有助于维持G3型轮状病毒成为流行株.有规律的变异多发生在高变区,但是非高变区的非连续性变异的增加值得引起注意.     

Genetic diversity and epidemiology of infectious hematopoietic necrosis virus in Alaska

Forty-two infectious hematopoietic necrosis virus (IHNV) isolates from Alaska were analyzed using the ribonuclease protection assay (RPA) and nucleotide sequencing. RPA analyses, utilizing 4 probes, N5, N3 (N gene), GF (G gene), and NV (NV gene), determined that the haplotypes of all 3 genes demonstrated a consistent spatial pattern. Virus isolates belonging to the most common haplotype groups were distributed throughout Alaska, whereas isolates in small haplotype groups were obtained from only 1 site (hatchery, lake, etc.). The temporal pattern of the GF haplotypes suggested a 'genetic acclimation' of the G gene, possibly due to positive selection on the glycoprotein. A pairwise comparison of the sequence data determined that the maximum nucleotide diversity of the isolates was 2.75% (10 mismatches) for the NV gene, and 1.99% (6 mismatches) for a 301 base pair region of the G gene, indicating that the genetic diversity of IHNV within Alaska is notably lower than in the more southern portions of the IHNV North American range. Phylogenetic analysis of representative Alaskan sequences and sequences of 12 previously characterized IHNV strains from Washington, Oregon, Idaho, California (USA) and British Columbia (Canada) distinguished the isolates into clusters that correlated with geographic origin and indicated that the Alaskan and British Columbia isolates may have a common viral ancestral lineage. Comparisons of multiple isolates from the same site provided epidemiological insights into viral transmission patterns and indicated that viral evolution, viral introduction, and genetic stasis were the mechanisms involved with IHN virus population dynamics in Alaska. The examples of genetic stasis and the overall low sequence heterogeneity of the Alaskan isolates suggested that they are evolutionarily constrained. This study establishes a baseline of genetic fingerprint patterns and sequence groups representing the genetic diversity of Alaskan IHNV isolates. This information could be used to determine the source of an IHN outbreak and to facilitate decisions in fisheries management of Alaskan salmonid stocks.     

2018–2020年人轮状病毒锦州地方株VP4及VP7基因特征

【背景】人A组轮状病毒(Rotavirus Group A,RVA)是婴幼儿胃肠炎的主要病原体及发展中国家婴幼儿死亡的重要原因,目前无特效药物治疗,疫苗预防是唯一可行的预防感染方法。外衣壳蛋白VP7和VP4是疫苗设计的主要靶点,针对该基因加强RVA地方株分子流行病学监测十分必要。【目的】对锦州地方流行RVA株VP7和VP4基因进行型别鉴定和序列特征分析。【方法】收集锦州地区2018-2020年RVA感染腹泻患儿的粪便标本,提取病毒RNA,通过RT-PCR扩增VP7、VP4基因片段并测序,得到7株RVA VP7和VP4序列。使用在线基因分型工具Rota C V2.0对测序结果进行分型分析。应用BLAST、DNAStar、MEGA X、Bio Edit等生物软件与临床流行株及疫苗株进行系统发育分析及氨基酸序列比对分析。【结果】分型结果表明7株锦州地方株均为G9P[8]型,系统发育分析证实其VP7和VP4基因分别属于G9-Ⅵ和P[8]-3谱系,核苷酸序列相似性分别为99.32%-100%与99.41%-100%。JZ株VP7与疫苗株Rotavac和Rotasiil相比,在抗原表位区7-1a、7-1b、7-2中分别存在4个和3个氨基酸替换。JZ株VP4与疫苗株Rotarix和Rota Teq VP4氨基酸序列相比,发现7个和4个氨基酸替换,位于抗原表位区8-1和8-3。【结论】2018-2020年在辽宁锦州地区检测到7株G9P[8]型RVA株,VP7和VP4序列相似性高于99%,G9P[8]型可能是辽宁省锦州地区2018-2020年婴幼儿轮状病毒腹泻的主要流行基因型之一。与同基因型疫苗株比较,位于JZ株VP7和VP4抗原表位区的氨基酸位点差异对于野毒株免疫逃逸机制的研究具有意义。     

Isolation and oral immunogenicity assessment of porcine epidemic diarrhea virus NH-TA2020 strain: One of the predominant strains circulating in China from 2017 to 2021

Porcine epidemic diarrhea (PED) caused by porcine epidemic diarrhea virus (PEDV) is one of the most devastating diseases in the global pig industry due to its high mortality rate in piglets. Maternal vaccines can effectively enhance the gut-mammary gland-secretory IgA axis to boost lactogenic immunity and passive protection of nursing piglets against PEDV challenge. From 2017 to 2021, we collected 882 diarrhea samples from 303 farms in China to investigate the epidemiology of PEDV. The result showed that about 52.15% (158/303) of the farms were positive for PEDV with an overall detection rate of 63.95% (564/882) of the samples. The S1 fragments of S gene from 104 strains were sequenced for the phylogenetic analysis. A total of 71 PEDV strains (68.27%) sequenced in this study were clustered into the predominant G2c subgroup, while the newly-defined G2d strains (9.62%) were identified in three provinces of China. The NH-TA2020 strain of G2c subgroup was isolated and cultured, and its infection to piglets caused watery diarrhea within 24 h, indicating its strong pathogenicity. Oral administration of NH-TA2020 strain to pregnant gilts stimulated high levels of IgA antibody in colostrum. The piglets fed by the gilts above were challenged with NH-TA2020 strain or CH–HeB-RY-2020 strain from G2d subgroup, and the clinical symptoms and virus shedding were significantly reduced compared to the mock group. Our findings suggest that G2c subgroup is the predominant branch circulating in China from 2017 to 2021. Oral administration of NH-TA2020 enhances maternal IgA and lactogenic immune responses, which confer protection against the homologous and emerging G2d PEDV strains challenges in neonates.     

Low prevalence of rotavirus and high prevalence of norovirus in hospital and community wastewater after introduction of rotavirus vaccine in Nicaragua

Rotavirus (RV) and norovirus (NoV) are major causes of pediatric diarrhea and are altogether associated with approximately 800,000 deaths in young children every year. In Nicaragua, national RV vaccination program using the pentavalent RV5 vaccine from Merck was implemented in October 2006. To determine whether RV vaccination decreased the overall number of RV infections, we investigated the occurrence of RV and NoV in wastewater in the city of León from July 2007 to July 2008 and compared these data with pre-vaccination data. The major finding was the low prevalence of RV compared to NoV in all sampling points (11% vs 44%, p<0.05), and that RV concentration was lower as compared to NoV. RV was observed mainly during the rainy season (July-September), and the majority of all RV detected (6/9) belonged to subgroup (SG) I. The partial VP7-gene obtained from one RV positive sample was similar (99% nt identity) to a G6 VP7-gene of bovine origin and similar to the corresponding gene of the vaccine strain (98%). Furthermore RV G-types 2 and 4 were found in the incoming wastewater. NoV strains were detected throughout the year, of which a majority (20/21) were of genotype GII.4. We conclude that the introduction of RV vaccination reduced the transmission of RV in the community in Nicaragua. However, the burden of diarrhea in the country remains high, and the high prevalence of NoVs in hospital and municipal wastewater is noteworthy. This study highlights the need for further assessment of NoV following RV vaccine introduction.