2009～2011年上海地区部分急性呼吸道感染人群中肠道病毒流行规律分析

Epidemic and molecular characteristics of enterovirus in acute respiratory tract infection patients in Shanghai,China,2009-2011

本文旨在探讨上海地区急性呼吸道感染（ARTI）病例中肠道病毒的病原谱构成和分子流行病学特征。收集2009年5月-2011年4月上海3家哨点医院住院或门诊的2 282例ARTI病例的鼻咽拭子标本,用RV15试剂盒检测常见的呼吸道病原,对肠道病毒（EV）阳性标本用半套式聚合酶链反应（PCR）扩增病毒结构蛋白VP1基因片段,测序并进行基因分型。结果显示,共检测出34份（1.49%）肠道病毒阳性标本。其中检出率最高的为柯萨奇病毒A2型（CVA2）和柯萨奇病毒B5型（CVB5）,各有6例（17.6%）;CVA5有5例（14.7%）。不常见的CVA21和EV68分别有2例和1例。由肠道病毒VP1区5’端310个核苷酸序列构建的CVA2、CVA5、CVB5、CVA21和EV68系统进化树显示,2009-2010年CVA2上海株与2株北京地区2009年代表株高度同源（98.1%）,CVA5上海株与2007-2009年中国大陆地区流行株高度同源（99.7%）,CVB5上海株与2009年大陆地区流行株高度同源（99.7%）,CVA21上海株与2002-2008年中国大陆地区流行株高度同源（99.4%）,EV68上海株与2006-2008年北京地区流行株高度同源（96.6%）。本研究显示,上海地区2009-2011年ARTI患者中肠道病毒以CVA2、CVB5、CVA5为主,也有不常见的CVA21和EV68。进化关系分析显示,CVA2、CVA5、CVA21和EV68上海株序列均与2009年以前国内流行株高度同源。

The present paper in acute respiratory tract aims to analyze the infection （ ARTI ） etiological and molecular characteristics of enterovirus （EV） patients in Shanghai, China between 2009 and 2011 Nasopharyngeal swabs were obtained from 2 282 patients with ARTI complications in three sentinel hospitals in Shanghai. Enteroviruses were screened by multiplex polymerase chain reaction （PCR） using RV15 kit. Then the serotypes of enteroviruses were determined by semi-nested reverse transcriptase-PCR. The results demonstrated that 34 （1.49%） samples were positive for enterovirus. Among them, coxsackievirus A2 （CVA2） （17.6%）, CVB5 （17.6%） and CVA5 （14.7%） were most frequently detected. Rare enterovirus serotypes EV68 and CVA21 were detected. According to the N-J phylogenetic tree, the Shanghai CVA2 isolates shared high similarity （98.1%） with Beijing isolates in 2009; the Shanghai CVA5 isolates shared high similarity （99.7%） with the China's Mainland strains from 2007 to 2009~ the Shanghai CVB5 isolates shared high similarity （99.7%） with the China's Mainland strains in 2009; the Shanghai CVA21 isolates shared high similarity （99.4%） with the China's Mainland strains from 2002 to 2008; the Shanghai EV68 isolates shared high similarity （96.6%） with Beijing strains from 2006 to 2008. It is concluded that CVA2, CVB5 and CVA5 are most frequently detected in ARTI patients in Shanghai, China between 2009 and 2011. Phylogenetic analyses showed that the Shanghai isolates are closely related to the China's Mainland isolates before 2009.