| BackgroundInfectious diarrhea, a very common infectious that will cause serious harm to the public, with a high incidence and has affected a wide range of people. There are more than one million diarrhea people infected each year, the infectious diarrhea has become an important public problem. with a complex and long-term prevention and control situation, strengthening the surveillance of the diarrhea is needed. With more and more research on the infectious diarrhea in China, but many of them were focus on the children, especially children under 5 years of age, research specifically for adult was rarely. Study on the adult infected with diarrhea would help understanding the prevalence and spectrum of this disease, while carrying out the surveillance of the adult patients with diarrhea-relateddisease pathogens can provide the scientific basis and improve the ability to prevent and respond to the possible outbreaks of diarrheal disease at any time.ObjectiveTo identify the spectrum of viral pathogens and the epidemiological characteristics in the adult diarrhea patients in Bei Jing, 2010-2011. Select the Norovirus, Human Adenovirus and Bufavirus as the typical of the viral pathogens and new emerging pathogens, to explore and understand their distribution characteristics, epidemiological trend, genetic variation and evolutionary characteristics.Materials and MethodsDuring 2010-2011, a total of 716 feces samples were collected in adult outpatients with acute diarrheal who was treated in the outpatient department in The General Hospital ofPLA(301 Hospital) in Bei Jing. After extracting the sample DNA / RNA nucleic acid, more than 9 viral pathogens and 13 pathogens, including including rotavirus group A, B, C, Norovirus type I and type II, Astrovirus, Sapovirus, Human adenovirus, Bocavirus, Circovirus, Picobirnavirus Type I and II and Bufavirus were detected by PCR and sequenced.Results1. A total of 716 specimens were collected, of which 335 were ditected at least one virus, the detection rate of positive samples was 46.79%. 381 samples were detected negative, the negative rate was 53.21%. Of all the positive samples, 277 were detected one virus, the rate of single infection was 38.69%, constitute more than 82.69% of the positive samples; 58 samples were detected more than one virus, and the rate of composite infection was 8.1%, constitute more than 17.31% of the positive samples. Of all the 58 composite infection samples, 53 were detected 2 virus(91.38%), and the other 5 were detected 3 virus(8.62%), no one was detected more than 3 virus. People aged 18-30 and older than 60 have the highest and lowest prevelance, and there were a high prevelance from January to April, April and February has the higher and lower prevelance.2. A total of 8 virus(9 pathogens) were found among all the 9 virus(13 pathogens), of which rotavirus group B, rotavirus group C, astrovirus and norovirus type 1 were not detected. Among all the detected pathogens, rotavirus group A has the highest detection rate(192 / 716,26.82%), and the other pathogens’ detection rate were norovirus type II(100 / 716,13.97%), Bocavirus(32 / 716,4.47%), Human adenovirus(31 / 716,4.33%), bufavirus(18 / 716,2.51%), PBV type I(12 / 716,1.68%), Sapovirus(8 / 716,1.12 %), Circovirus(4 / 716,0.56%) and PBV type II(1 / 716,0.14%).3. 100 samples were detected positive for norovirus, and 96 were success typed, of which GII.4 2006 b and GII.4 New Orleans 2009 type were detected in 65 and 22, respectively, as the most common norovirus genetype, the other positive samples were typed as GII.12 / GII.3(4,4%), GII.16 / GII.2(3,3%), GII.21 / GII.13(1,1%) and GII.6( 1,1%), fourpositive samples were not typed.4. 31 HAdv positive samples were sequenced and successfully genotyped. Including 3 subgroup(group B, C and F) were detected, subgroup F(HAdv-40 and HAdv-41 type) was the most common positive samples, of which 25 cases were detected, followed by subgroup B(HAdv-3 and HAdv-7 type) and subgroup C(HAdv-1 and HAdv-6 type) were all detected in 3 cases. The number of each type were HAdv-41 in 23, HAdv-3, HAdv-6 and HAdv-40 in 2 and HAdv-1, HAdv-7 in 1.Conclusions1.Rotavirus group A and norovirus type II has the highest detection rate in adult patients with diarrhea, followed by Bocaviruses, Adenovirus, bufavirus, Picobirnavirus, Sapovirus and circovirus. Rotavirus group A and norovirus type II was the most common pathogen causing diarrhea adult in this study.2. GII.4 2006 b and GII.4 New Orleans 2009 was the predominant strain of Norovirus in adult patients with diarrhea in Bei Jing,2010-2011. There are some recombinant strains were all detected, including GII.12 / GII.3, GII.16 / GII.2 and GII.21 / GII.13 recombinant strains, of which GII.21 / GII.13 was first detected in China.3. Adenovirus subgroup F(HAdv-40 and HAdv-41) was the most common type in the adenovirus positive samples, which mainly was HAdv-41, the other detected type were HAdv-3, HAdv-6, HAdv-1, HAdv-7.4. This was the first time detected of bufavirus in China, and the bufavirus temporarily detected only in the presence of diarrhea in Northern China, but showing a lower detection rate, of all ages of the patients with diarrhea can be infected with bufavirus. |
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