2014年-2015年南通市手足口病病原学监测结果分析

Analysis of etilogical surveillance results of hand-foot-mouth disease in Nantong from 2014 to 2015

目的了解南通市手足口病的病原学特征及流行特点,为科学防控手足口病提供依据。方法对采集的咽拭子样品使用磁珠法提取核酸,再用实时荧光定量PCR对核酸进行检测、分型。结果 1 145份咽拭子标本中,肠道病毒核酸总阳性率为48.73%(558/1 145);2015年未分型肠道病毒阳性标本检出率为32.59%,高于2014年(21.89%),差异有统计学意义(χ2=9.55,P<0.01);2014年Cox A16型肠道病毒阳性率(16.37%)高于2015年(8.23%),差异有统计学意义(χ2=11.09,P<0.01);2014年EV71型肠道病毒阳性率(9.43%)高于2015年(8.92%),差异无统计学意义(χ2=0.01,P>0.05)。2014年、2015年未分型肠道病毒构成比分别为45.89%、65.52%,所占比例明显提高。结论引起南通市手足口病流行的主要肠道病原体为未分型肠道病毒;2014年与2015年相比,Cox A16型肠道病毒的阳性检出率有所下降;EV71型肠道病毒的阳性检出率有所提高。根据动态监测结果调整监测及防控策略对手足口病的防控具有重要意义。

Objective To understand the etilogical and epidemic characteristics of hand-foot-mouth disease（ HFMD）,so as to provide scientific basis for the prevention of HFMD. Methods Nucleic acid was attracted from the collected swab samples by magnetic beads technology,and then nucleic acid was detected and classified by real-time fluorescence quantitative PCR. Results In the 1 145 swab samples,the total positive rate of enteroviruses was 48. 73%（ 558/1 145）; while the positive rate of non-classified enteroviruses in 2015（ 32. 59%） was higher than that in 2014（ 21. 89%）,and the difference was statistically significance（ χ2= 9. 55,P 0. 01）; the positive rate of Cox A16 in 2014（ 16. 37%） was higher than that in 2015（ 8. 23%）,with the difference statistically significant（ χ2= 11. 09,P 0. 01）; the positive rate of EV71 in 2014（ 9. 43%） was higher than that in 2015（ 8. 92%）,and the difference was not statistically significant（ χ2= 0. 01,P 0. 05）. The non-classified enteroviruses ratios in 2014 and 2015 were separately 45. 89% and 65. 52%,and the rate increased obviously. Conclusion The major enterovirus agents which cause HFMDs in Nantong were the non-classified enteroviruses; the positive rate of Cox A16 enteroviruses in 2015 declined comparing with that in 2014; the positive rate of EV71 enteroviruses in 2015 increased comparing with that in 2014. According to results of these dynamic surveillance,the monitoring and prevention regime of HFMD is vital to HFMD control.