2011年度288例儿童手足口病住院患者的病原学分析

Etiology of 288 cases with hand, foot and mouth disease

目的了解2011年北京大学北京地坛医院教学医院儿童手足口病住院患者的病原体分布情况及变化趋势,为手足口病的预防、诊断及治疗等提供依据。方法本研究共收集288例手足口病患者的咽拭子标本,使用肠道病毒通用型、肠道病毒71型和柯萨奇16型核酸检测试剂盒应用实时荧光逆转录-聚合酶链反应法(real-time PCR)进行检测。结果 2011年度本院肠道病毒阳性标本占51.74%(149/288)。病毒分型结果显示,EV71阳性标本占总标本例数的23.26%(67/288);CoxA16阳性标本占7.29%(21/288);非EV71非CoxA16型阳性标本占21.18%(61/288)。2009至2011年北京地区的手足口病病原学分析结果显示,3年间EV71阳性率变化并不明显;CoxA16阳性率显著下降;非EV71非CoxA16型阳性率显著升高。结论 2011年度本院手足口病患儿在主要流行期以EV71和非EV71非CoxA16型肠道病毒感染为主;北京地区2011年手足口病病原学和前两年相比非EV71非CoxA16型感染比例继续升高。

Objective To investigate the pathogen distribution of patients with hand, foot and mouth diseases （HFMD） hospitalized in Division of Pediatrics, Beijing Ditan Hospital in 2011. Methods Real-time fluorescence quantitative RT-PCR kits with three reagents： universal enterovirus primer, coxsackievirus A16 （CoxA16） primers and enterovirus 71 （EV71） primers were used to detect the samples, respectively. Results The enterovirus-positive rate was 51.74% （149/288）. Among this, the positive rate of EV71, CoxA16 and other types of entervirus were 23.26% （67/288）, 7.29% （21/288）, 21.18% （61/288）, respectively. And the study reveals that the positive rate of CoxA16 had significantly decreased, EV71 changed little, other types of entervirus significantly increased, during 2009-2011. Conclusions In extensively epidemic-period of 2011, the etiology of children with hand, foot and mouth disease hospitalized in our hospital was dominated alternately by EV71 and non-EV71, non-CoxA16 virus. The positive rate of non-EV71, non-CA16 virus in Beijing area has been persistently increased during 2009-2011.