2009～2013年宁德市哨点医院手足口病病原学监测

Etiological monitoring of hand-foot-mouth disease in sentinel hospitals,Ningde city,2009-2013

目的了解2009~2013年宁德市手足口病的病原学特征及变化趋势,为手足口病防治工作提供科学依据。方法对宁德市11个手足口病哨点医院送检的手足口病病例咽拭子,应用实时荧光定量反转录-聚合酶链反应（Real-time PCR,RT-PCR）技术进行检测并判定病毒型别。结果 2009~2013年宁德市11个哨点医院共送检手足口病病例标本1 772份,检出阳性1 056例,阳性率59.59%,其中,单一肠道病毒71型（EV71）433例（41.00%）,单一柯萨奇病毒A组16型（CVA16）238例（22.54%）,EV71/CVA16混合感染4例（0.38%）,其他肠道病毒阳性381例（36.08%）;2009~2013年EV71型肠道病毒构成比分别为83.91%、75.14%、50.44%、36.19%、10.60%,呈逐年递减;而其他肠道病毒构成比分别为2.30%、1.10%、3.54%、41.55%、72.19%,呈逐年递增,在2012、2013年呈显著增加;EV71为重症和死亡病例的主要型别（85.71%）;死亡7例均为EV71型感染。结论 2009~2011年宁德市手足口病病原体以EV71为主,2012和2013年其他肠道病毒已成为引起宁德市手足口病最主要的病原体;EV71仍然是引起手足口病重症和死亡病例的优势流行型别。

Objective To understand the etiological characteristics of hand,foot and mouth disease（HFMD）in Ningde citty,2009-2013,so as to provide a scientific basis for prevention and control of HFMD. Methods Nasopharyngeal swabs of the cases from 11 sentinel hospitals were collected and assayed by real-time fluorescence quantitative RT-PCR,than judge the type. Results A total of 1 772 samples of HFMD were tested during 2009-2013,1 056 were intestinal viruses positive,the average positive rate was 59.59%.Among them 433EV71 cases,238CVA16cases,4cases were EV71 and CVA16mixed infection,381 cases were the other intestinal viruses The positive rate of EV71 decreased year by year（83.91%,75.14%,50.44%,36.19%,10.60%）,and other intestinal viruses increased（2.30,1.10%,3.54%,41.55%,72.19%）,especially in 2012 and 2013.EV71 were the main types for severe cases and deaths（85.71%）;7deaths were all EV71 infection. Conclusion EV 71 is the predominant pathogen of HFMD in Ningde city,2009-2013.However,other intestinal viruses become the predominant pathogens in 2012 and 2013.EV71 is still the predominant type for severe and fatal HFMD cases.