内蒙古自治区某医院5岁以下腹泻儿童隐孢子虫感染分子流行病学研究

doi:10.20199/j.issn.1672-2302.2026.01.006

摘要/Abstract

摘要：

目的了解内蒙古自治区某医院5岁及以下腹泻儿童隐孢子虫感染分子流行病学特点，为本地区隐孢子虫感染的防控提供参考。方法收集2021年9月至2022年8月在内蒙古自治区妇幼保健院就诊的5岁及以下腹泻患儿的粪便样本，采用巢式PCR扩增隐孢子虫的18S rRNA基因片段以了解隐孢子虫感染情况。基于18S rRNA基因序列进行同源性分析并构建系统发育树，进行虫种鉴定；基于gp60基因位点进一步鉴定基因亚型。结果共采集1 292例腹泻儿童粪便样本，其中156例样本隐孢子虫18S rRNA基因测序阳性，阳性率为12.07%。男童和女童阳性率分别为13.37%（92/688）和10.60%（64/604），差异无统计学意义（χ²=2.335，P>0.05）。1~3岁年龄组阳性率最高（15.70%，81/516），各年龄组间差异有统计学意义（χ²=12.620，P<0.05）。居住于郊县的腹泻儿童阳性率（15.66%，62/396）高于市区（10.49%，94/896），差异有统计学意义（χ²=6.902，P<0.05）。各月均检出阳性样本，其中12月阳性率最高（17.81%，13/73）。所有阳性样本经同源性分析均鉴定为微小隐孢子虫，系统发育树显示与微小隐孢子虫参考株聚为同一分支。基于gp60基因共检出5种亚型，分别为ⅡdA23G3、ⅡdA24G3、ⅡdA24G4、ⅡdA25G3和ⅡdA25G4，其中ⅡdA25G3为优势亚型（占42.95%，67/156）。系统发育树显示上述5种亚型形成独立进化分支，且与已知微小隐孢子虫Ⅱd亚型参考株聚为同一分支。结论当地腹泻儿童隐孢子虫感染水平较高，3岁及以下婴幼儿是重点关注对象，郊县为重点关注地区。流行虫种为微小隐孢子虫，ⅡdA25G3为优势亚型。

关键词: 隐孢子虫, 儿童, 腹泻, 分子流行病学, 内蒙古自治区

Abstract:

Objective To understand the molecular epidemiological characteristics of Cryptosporidium infection in children 5 years old and under with diarrhea in a hospital in Inner Mongolia Autonomous Region for a reference in prevention and control of this infection in the local area. Methods The fecal samples were obtained from children 5 years old and under with diarrhea who were treated at the Inner Mongolia Autonomous Region Maternal and Child Health Hospital during September 2021 and August 2022. The 18S rRNA gene fragment of Cryptosporidium was amplified using nested PCR to investigate the infection status of this protozoan parasite. Homology analysis was performed based on the 18S rRNA gene sequence and a phylogenetic tree for the species identified was constructed. The gene subtypes were further identified based on the gp60 gene locus. Results A total of 1 292 fecal samples were collected from the diarrheic children, in which 156 samples were positive for Cryptosporidium 18S rRNA gene sequencing, with a positive rate of 12.07%. The positive rate was 13.37% (92/688) for boys and 10.60% (64/604) for girls. The difference was insignificant (χ²=2.335, P>0.05). Children aged 1-3 years had the highest positive rate (15.70%，81/516), the difference was statistically significant between groups (χ²=12.620, P<0.05). The positive rate was higher in the children with diarrhea living in the suburban and rural counties than that of those from urban areas (15.66%, 62/396 vs. 10.49%, 94/896), and the difference was statistically significant (χ²=6.902, P<0.05). Positive cases were detected in all months, with December having the highest positivity rate (17.81%, 13/73). All positive samples were identified as Cryptosporidium parvum through homology analysis, and the phylogenetic tree showed clustering with reference strains of Cryptosporidium parvum in the same branch. Based on the gp60 gene, five subtypes were detected, including ⅡdA23G3, ⅡdA24G3, ⅡdA24G4, ⅡdA25G3, and ⅡdA25G4, with ⅡdA25G3 being the dominant subtype (42.95%, 67/156). The phylogenetic tree revealed that these five subtypes formed independent evolutionary branches and clustered with known Ⅱd subtypes of Cryptosporidium parvum in the same branch. Conclusion The prevalence of Cryptosporidium infection among local children with diarrhea is relatively high. Children aged 3 years and under are the key target population, and suburban counties are the important regions of concern. The prevalent species is Cryptosporidium parvum, with ⅡdA25G3 being the dominant subtype.

Key words: Cryptosporidium, Children, Diarrhea, Molecular epidemiology, Inner Mongolia Autonomous Region

中图分类号:

R725.7

梁茹, 张亮, 郭文慧, 薛新宇, 李瑞凤. 内蒙古自治区某医院5岁以下腹泻儿童隐孢子虫感染分子流行病学研究[J]. 热带病与寄生虫学, 2026, 24(1): 30-35.

LIANG Ru, ZHANG Liang, GUO Wenhui, XUE Xinyu, LI Ruifeng. Molecular epidemiological related research on Cryptosporidium infection in children under 5 years old with diarrhea in a hospital of Inner Mongolia Autonomous Region[J]. Journal of Tropical Diseases and Parasitology, 2026, 24(1): 30-35.

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分布特征	检测数（例）	阳性数（例）	阳性率（%）	分布特征	检测数（例）	阳性数（例）	阳性率（%）
性别				土默特左旗	71	12	16.90
男	688	92	13.37	清水河县	63	8	12.70
女	604	64	10.60	检出月份
年龄（岁）				1	72	12	16.67
<1	668	69	10.33	2	60	9	15.00
1~3	516	81	15.70	3	97	11	11.34
4~5	108	6	5.56	4	110	11	10.00
居住地				5	115	11	9.57
赛罕区	277	29	10.47	6	148	14	9.46
回民区	209	25	11.97	7	132	16	12.12
新城区	234	23	9.83	8	141	16	11.35
玉泉区	176	17	9.66	9	118	13	11.02
武川县	104	15	14.42	10	116	16	13.79
和林格尔县	76	14	18.42	11	110	14	12.73
托克托县	82	13	15.85	12	73	13	17.81