北京市2010-2013年急性出血性结膜炎的病原学分析

Etiology characteristics of acute hemorrhagic conjunctivitis during 2010-2013 in Beijing, China

目的 确定北京市急性出血性结膜炎的病原学及流行病学特征.方法 2010-2013年7月至10月在北京地区所有区县监测点收集急性结膜炎患者眼拭子标本,通过RT-PCR分别鉴定柯萨奇病毒A24变种（CVA24v）和肠道病毒70（EV70）.分析急性出血性结膜炎的时间分布、患者性别、年龄及临床症状特征,利用系统发育树分析CA24v的VP1区、3Cpro区基因特征.结果 随机抽取的1144件急性结膜炎样本中,4.5％（52/1144）为CVA24v阳性,未检测到EV70.CVA24v相关急性出血性结膜炎在9月达到高峰.各年龄组发病差异有统计学意义,10-19岁年龄组发病率最高.CA24v和非CA24v急性结膜炎的症状构成比无统计学差异.北京市2007-2012年分离的CA24v株VP1、3Cpro的核苷酸序列同源性分别为95.2％-100％和92.8％-100％.结论 2010-2013年CVA24v是引起北京市急性出血性结膜炎的最主要病原体.

Objective To determine the etiology characteristics of acute hemorrhagic conjunctivitis in Beijing.Methods Surveillance of acute conjunctivitis was implemented during July-October in 2010-2013 by collecting eye swabs from patients consulting to surveillance hospitals affiliated to 18 districts Center for Disease Prevention and Control （CDC） in Beijing.Coxsackievirus A24 variant （CA24v）,Enterovirus 70 （EV70） were identified by RT-PCR.Time distribution and characteristics about the cases were described.Phylogenetic analysis of VP1 and 3Cpro of CA24v were conducted.Comparison of proportions and statistical significance were calculated using the Chi-square test.Results About 4.5% （52/1144） cases were CVA24v infected cases.EV70 didn＆#39;t be identified.There was no significant difference between CVA24v and non-CVA24v in term of six symptoms.Prevalence peak of CVA24v mediated conjunctivitis was observed at September.Nucleotide sequence of VP1,3Cpro among isolated CVA24v strains had a range of 95.2%-100% and 92.8%-100% identity value,respectively.Conclusions CVA24v was the most major agent to cause acute conjunctivitis in Beijing.