2010-2016年广东省手足口病非EV71非CVA16肠道病毒病原谱分析

Analysis of non-EV71,non-CVA16 enterovirus among HFMD cases in Guangdong province in 2010-2016

目的了解广东省手足口病非肠道病毒71型(enterovirus 71,EV71)非柯萨奇病毒A16型(coxsackievirus A16,CVA16)其他肠道病毒(以下简称其他EV)的病原谱构成。方法通过广东省手足口病实验室监测网络,收集2010-2016年核酸检测结果为其他EV阳性的手足口病病例标本,共3701份,采用荧光定量PCR方法检测CVA6、CVA10,二者均为阴性的标本则通过巢式PCR扩增肠道病毒部分VP1序列,通过对测序获得的部分VP1序列进行比对,完成肠道病毒型别的鉴定。结果3701例其他EV阳性病例中,肠道病毒A、B、C和D组均有检出,主要为A组,占92.68%。另外,CVA6的构成比最高,为74.71%,其次为CVA10,占11.27%。2010-2016年每年比例最高的其他EV均为CVA6,构成比依次为44.02%、71.09%、71.27%、76.63%、59.00%、87.01%和63.17%。196例其他EV阳性重症病例中,CVA6占59.18%,CVA10占14.29%。另还检出19种包括其他CVA、CVB、埃可病毒和PV等肠道病毒。5例其他EV阳性死亡病例中,检出了CVA2、CVA4、CVA8、CVA14和E3各1例。结论2010-2016年广东省手足口病其他EV病原谱较广,但每年的优势血清型均为CVA6,其次为CVA10。

ObjectiveTo analyze the serotypes of non-enterovirus 71 and non-coxsackievirus A16 enteroviruses (other EV) among hand, foot, and mouth disease (HFMD) cases in Guangdong Province from 2010 to 2016.MethodsThrough the lab-based HFMD surveillance system, 3 701 samples that were positive for other EV were collected from HFMD cases during 2010-2016 in Guangdong. CVA6 and CVA10 were detected by real-time PCR. The negative samples of both viruses were used to amplify partial sequences of VP1 gene. The amplicons were then adopted for sequencing and genetic analysis.ResultsGroup A, B, C and D enteroviruses were detected among 3 701 samples, and group A was predominant, accounting for 92.68%. In addition, CVA6 was the main pathogen, accounting for 74.71%, followed by CVA10 (11.27%). From 2010 to 2016, CVA6 was the predominant type of other EV in each year, accounting for 44.02%, 71.09%, 71.27%, 76.63%, 59.00%, 87.01% and 63.17%, respectively. For 196 severe cases with other EV positive, CVA6 accounted for 59.18%, CVA10 accounted for 14.29%. Nineteen types of enterovirus, other than the two viruses, from CVA, CVB, echovirus (E) and poliovirus were detected. CVA2, CVA4, CVA8, CVA14 and E3 were detected in 5 death cases with other EV positive, respectively.ConclusionsFrom 2010 to 2016, the etiological spectrum of HFMD caused by other EV in Guangdong province was diverse, and the annual dominant serotype was CVA6 followed by CVA10.