BACKGROUND & AIMS:
BACKGROUND:The study aimed to investigate the molecular epidemiology of severe viral gastroenteritis (AGE) in children in Taiwan after the implementation of the rotavirus vaccine in the private sector.
METHODS:Fecal samples from hospitalized children with severe AGE from April 2004 to March 2011 were examined by reverse transcription-polymerase chain reaction or polymerase chain reaction to identify enteric viral pathogens. The study period was divided to prevaccine (before September 2006) and postvaccine (after October 2006) periods. The prevalence of enteric viruses between the 2 periods was analyzed. The disease burdens of rotavirus- and norovirus-associated diseases were assessed according to vaccine implementation status and were adjusted for age.
RESULTS:A total of 755 stool samples were collected from hospitalized patients with AGE; enteric viruses were identified in 586 patients (77.6%), including 44 with concomitant bacterial infection. Viral enteric infection by rotavirus, norovirus, astrovirus, sapovirus, enteric adenovirus, multiple viruses and bacterial coinfections were found in 216 (28.6%), 128 (17.0%), 24 (3.2%), 6 (0.8%), 69 (9.1 %), 99 (13.1%) and 44 (5.8%) patients, respectively. A significant increase of norovirus infection was found in the postvaccine period (P < 0.001); on the other hand, rotavirus infection in infants has been reduced substainally (P = 0.056) and the annual peak of rotavirus infection has gradually become less prominent, with a significant decline of coinfection of rotavirus with other pathogens.
CONCLUSIONS:Suboptimal use of rotavirus vaccines in the private sector caused a slow but modest impact on severe rotavirus AGE, whereas norovirus infection became more common.
背景与目标:
背景:这项研究旨在调查在私营部门实施轮状病毒疫苗后台湾儿童中的严重病毒性肠胃炎(AGE)的分子流行病学。
方法:采用逆转录-聚合酶链反应或聚合酶链反应方法检测2004年4月至2011年3月住院的重度AGE患儿的粪便样本,以鉴定肠道病毒病原体。研究期分为疫苗接种前(2006年9月之前)和疫苗接种后(2006年10月之后)两个时期。分析了这两个时期之间的肠道病毒患病率。根据疫苗实施状况评估轮状病毒和诺如病毒相关疾病的疾病负担,并根据年龄进行调整。
结果:从住院的AGE患者中共采集了755份粪便样本。 586例患者中检出了肠道病毒(77.6%),其中包括44例伴随细菌感染。轮状病毒,诺如病毒,星状病毒,沙波病毒,肠腺病毒,多种病毒和细菌合并感染引起的病毒性肠感染被发现为216(28.6%),128(17.0%),24(3.2%),6(0.8%),69(9.1) %),99(13.1%)和44(5.8%)的患者。疫苗接种后发现诺如病毒感染显着增加(P <0.001);另一方面,婴幼儿轮状病毒感染已得到实质性减少(P = 0.056),轮状病毒感染的年度高峰逐渐变得不那么突出,轮状病毒与其他病原体的共感染显着下降。
结论:在私营部门中轮状病毒疫苗的不理想使用对严重的轮状病毒AGE产生了缓慢但适度的影响,而诺如病毒感染变得更加普遍。