2016年至2017年广州市手足口病流行病学及非肠道病毒A组71型非柯萨奇病毒A组16型肠道病毒型别分析

Hand, foot, and mouth disease in Guangzhou, 2016-2017:an epidemiological study and genotype analysis of non-enterovirus group A 71 non-coxsackievirus group A 16 enterovirus

目的了解2016年至2017年广州市手足口病流行病学及非肠道病毒A组71型(enterovirus 71, EV-A71)病毒非柯萨奇病毒A组16型(coxsaekievirus group A 16,CV-A16)病毒的分子流行病学特征,为其治疗和防控提供依据。方法运用荧光反转录-PCR对2016年至2017年疑似手足口病患者标本同时进行EV通用型、EV-A71、CV-A16检测,并选取EV-A71和CV-A16是阴性而EV通用型是阳性的标本进行型别鉴定,设计5′非编码区(UTR)引物,RT-PCR扩增后进行序列测定,用BLAST程序进行序列的EV型别确定。结果2016年至2017年同时进行EV通用型、EV-A71型、CV-A16型3类病毒的疑似手足口病例标本共25 779份,总阳性16 300份,阳性率为63.23%;其中EV-A71阳性1 178份,占4.57%;CV-A16阳性3 274份,占12.70%;非EV-A71非CV-A16EV阳性标本11 848份,占45.96%。2017年非EV-A71非CV-A16EV全年平均检出率(55.68%)比2016年检出率(35.14%)更高。95份非EV-A71非CV-Al6阳性标本的序列分析结果有16种型别,分别为CV-A6、CV-A10、CV-A4、CV-A2、CV-A8、CV-A12、CV-A9、CV-B5、CV-B2、CV-B4、CV-B3、E1、E16、E30、E2和E18,其中CV-A6占主,(26.32%),其次是CV-A10(15.79%),这两种病毒占到非EV-A71非CV-A16EV的42.11%。结论2016年至2017年EV-A71感染较低,2016年4月至7月CV-A16存在一个感染小高峰。2016年至2017年手足口病主要以非EV-A71非CV-A16为主,序列分析表明非EV-A71非CV-A16中以CV-A6和CV-A10为主,应加强对以CV-A6、CV-A10为主的非EV-A71非CV-A16的研究及监测。

Objective To study the epidemiology of hand, foot, and mouth disease (HFMD) and the spectrum of serotypes in the other enterovirus (EV) (non-EV-A71 and non-Coxsaekievirus group A 16, CV-A 16) from 2016 to 2017 in Guangzhou, to provide the basis for its treatment, prevention and control. Methods Enteroviruses universal type, EV-A71 and CV-A16 were detected by real time reverse transeription-polymerase chain reaction in the specimens from HFMD suspected patients from 2016 to 2017.The positive specimens of non-EV-A71 and non-CV-A16 were amplified and sequenced based on 5′-untranslated region (UTR) region.The spectrum of serotypes was analyzed with BLAST in NCBI on the basis of 5′-UTR region. Results A total of 25 779 specimens from HFMD patients were collected during 2016-2017, 16 300 (63.23%) of which were positive.The positive rates of EV-A71, CV-A16, non-EV-A71 and non-CV-A16 were 4.57% (1 178/25 779), 12.70% (3 274/25 779) and 45.96% (11 848/25 779), respectively.The average positive rate of non-EV-A71 and non-CV-A16 in 2017 was 55.68%, which was higher than that in 2016.Sequence analysis showed that there were 16 genotypes in 95 non-EV-A71 and non-CV-A16 positive specimen, including CV-A6, CV-A10, CV-A4, CV-A2, CV-A8, CV-A12, CV-A9, Coxsakievirus B5 (CV-B5), CV-B2, CV-B4, CV-B3, Echovirus 1 (E1), E16, E30, E2 and E18.CV-A6 (26.32%), and CV-A10 (15.79%) were the most common genotypes, followed by CV-A4 (6.32%)、CV-A8(4.21%), and CV-A2 (4.21%). Conclusions The infection rate of EV-A71 is very low during 2016-2017.From April to July 2016, there is a small peak of CV-A16 infection.The non-EV-A71 and non-CV-A16 enterovirus becomes the main causative agent of HFMD during 2016 to 2017.CV-A6 and CV-A10 are the most prevalent pathogens of non-EV-A71 and non-CV-A16 enterovirus.Research and monitoring of CV-A6, CV-A10 as the main non-EV-A71and non-CV-A16 virus should be strengthened.