Diagnosis of Acute Gastroenteritis with Immunochromatography and Effectiveness of Rotavirus Vaccine in a Japanese Clinic.
Diagnosis of Acute Gastroenteritis with Immunochromatography and Effectiveness of Rotavirus Vaccine in a Japanese Clinic.
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日本一家诊所的急性胃肠炎免疫层析诊断和轮状病毒疫苗的有效性。
DOI：
10.1099/acmi.0.000085
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Ushijima H.
中科院分区：
文献类型：
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作者：
Kawata K;Hikita T;Takanashi S;Hikita H;Ogita K;Okitsu S;Hoque SA;Phan T G;Ushijima H.
尽管两种获得许可的口服减毒活轮状病毒(RV)疫苗Rotarix和RotaTeq的有效性众所周知，但考虑到RV的不断进化的能力和重组能力，对疫苗有效性(VE)的持续监测是必不可少的。在这项研究中，我们使用基于免疫层析(IC)的试剂盒检测了2014年6月至2018年9月在日本群马麒麟市儿科诊所就诊的急性胃肠炎(AGE)儿童中轮状病毒、诺如病毒(NV)和腺病毒(AV)的感染。采用测试阴性的研究设计来确定VE。1658名儿童中检出轮状病毒96例(5.8 %)，新城疫146例(8.8 %)，新城疫46例(2.8 %)。有趣的是，感染的分布与年龄和性别有关。女性(P=0.0 2)和19~30 月龄组RV感染显著高于女性(P=0.0 2)，而新城疫(NV)和新城疫(AV)感染分别在13~2 4 月龄组和7~18 月龄组高发。轮状病毒和新城疫感染的病情严重程度相似，明显高于新城疫感染。RV疫苗对所有RV感染的VE为49.8 %(95 %CI：22.7~67.3 %)，对重度RV感染的VE为67.2 %(95 %CI：35.3~83.4 %)。接种轮状病毒疫苗的儿童在轮状病毒感染中的症状较轻，而接种轮状病毒疫苗和未接种轮状病毒疫苗的儿童的年龄仍然不那么严重。最后，自2015年以来，轮状病毒感染在该人群中的流行率保持在最低水平(≤5.4 %)。因此，这项研究提供了有关幼儿主要年龄分布的重要信息，并展示了轮状病毒疫苗在后疫苗时代的有效作用。
Despite the well known effectiveness of two licensed live attenuated oral rotavirus (RV)-vaccines, Rotarix and RotaTeq, constant monitoring of vaccine effectiveness (VE) is essential considering the evolving power and reassortment capability of RVs. In this study, we detected RV, norovirus (NV) and adenovirus (AV) infections using immunochromatography (IC)-based kits in children with acute gastroenteritis (AGE) who attended a pediatric clinic in Kiryu city, Gunma, Japan during June, 2014–September, 2018. VEs were determined using a test-negative study design. Among 1658 AGE-children, RV, NV and AV were detected in 96 (5.8 %), 146 (8.8 %) and 46 (2.8 %) children, respectively. Interestingly, the distributions of infections were found to be associated with age and sex. Namely, RV infections were significantly higher in female (P=0.02) and in the 19–30 month age group children, while NV and AV infections predominated in the 13–24 month and 7–18 month age groups, respectively. The disease severity for RV and NV infections remained similar and significantly higher than that of AV infections. The VE of RV-vaccines was 49.8 % (95 % CI: 22.7 to 67.3 %) against all RV infections, which was increased up to 67.2 % (95 % CI: 35.3 to 83.4 %) against severe RV infections. RV-vaccinated children experienced less severe symptoms in RV-infections while non-RV AGE remained less serious for both RV-vaccinated and unvaccinated children. Finally, the prevalence of RV infection remained minimized (≤5.4 %) in this population since 2015. Thus, this study provided important information on distribution of major AGEs in young children and exhibited the effective role of RV vaccines in post-vaccine era.