2017年深圳市龙华区手足口病病原学特征分析

Etiological characteristics of hand, foot, and mouth disease in Longhua district of Shenzhen in 2017

目的 分析2017年深圳市龙华区手足口病（hand,foot,and mouth disease,HFMD）病原学特点.方法 采用实时荧光PCR方法对哨点医院送检的242份HFMD临床诊断病例的肛拭子样品进行肠道病毒（enteroviurs,EV）、肠道病毒A组71型（EV71）和柯萨奇病毒A组16型（coxsackievirus A16,CV A16）核酸检测,并对非EV71非CV A16的其他肠道病毒和EV71的VP1区序列进行测定,亚型鉴定和系统进化分析.结果 实验室确诊病例有190例,阳性率为78.51％（190/242）,其中,EV71感染32例（16.84％,32/190）、CV A16感染11例（5.79％,11/190）、CV A6感染126例（66.32％,126/190）.实验室确诊病例中,男性占57.9％ （110/190）,女性占42.1％（80/190）;3岁以下儿童占78.95％（50/190）.系统进化树分析结果显示,2017年深圳市龙华区流行的EV71属于C4a进化分支,CV A6属于D3进化分支,CV A10属于C进化分支.结论 深圳市龙华区应进一步加强辖区HFMD监测,重点关注3岁以下儿童及病原谱构成和重要病原体进化情况.

Objective To analysis the etiological characsteristics of hand,foot,and mouth disease （HFMD） in Longhua district of Shenzhen in 2017.Methods Fluorescent quantitation RT-PCR method was used to detect nucleic acid of enteroviurs （EV）,enteroviurs A71 （EV71）,coxsackievirus A16 （CV A16） in anal swab samples of 242 clinically diagnosed HFMD cases from sentinel hospitals.Both VP1 region of the enterovirus other than EV71 or CV A16 and VP1 of EV71 were sequenced for subtyping and the systematic evolution analysis.Result There were 190 laboratory-confirmed cases and the positive rate was 78.51％ （190/242）,including 32 cases of EV71 infection （16.84％,32/190）,11 cases of CV A 16 infection （5.79％,11/190）,and 126 cases of CV A6 infection （66.32％,126/190）.The males and females accounted for 57.9％ （110/190） and 42.1％ （80/190）,respectively.The patients under the age of three years old accounted for 78.95％,（150/190）.Phylogenetic analysis indicated that the epidemic EV-A71 in Longhua district of Shenzhen in 2017 belonged to subgenerotype C4a and CV A6 belonged to subgenerotype D3,while CV A10 belonged to subgenerotype C.Conclusions The HFMD surveillance in the district shall be strengthened.Children under three years old,spectrum of pathogens and evolutionary status of important pathogens in Longhua district of Shenzhen should be concerned.