2008年-2017年湖州市手足口病病原学特征分析

Etiological features of hand foot and mouth disease in Huzhou during 2008-2017

目的了解湖州市手足口病病原学构成特征,为防控手足口病提供实验室数据。方法收集临床诊断为手足口病患者疱疹液、咽拭子等标本3194份,用实时荧光定量聚合酶链反应(real-timePCR)检测并分型。结果2008年-2017年从3194份标本检出肠道病毒核酸阳性2328份,阳性率为72.9%,其中肠道病毒71型(EV71)602份,阳性率为25.9%,柯萨奇病毒A组16型(CA16)570份,阳性率为24.5%。2009年-2011年手足口病病原体型别以EV71为优势毒株,2012年以EV71和CA16为优势毒株,2013年-2017年及2008年以其他肠道病毒为优势毒株。2016年-2017年从321份其他肠道病毒核酸阳性中检出柯萨奇病毒A组6型(CA6)96份,阳性率为29.9%,柯萨奇病毒A组10型(CA10)21份,阳性率为6.5%。结论十年间湖州市手足口病病原检出率较高,不同年份的各型别优势毒株呈动态出现。加强手足口病病原学监测,进一步明确本地区病原谱构成,掌握病毒流行规律,更好地预防和控制手足口病发生。

Objective To understand the etiological characteristics of hand, foot and mouth disease ( HFMD) in Huzhou, so as to provide laboratory data for the prevention and treatment of HFMD. Methods A total of 3 194 specimens of herpes zoster and throat swabs were collected from patients with hand - foot - mouth disease. Real - time PCR was used to detect and classify the specimens. Results From 2008 to 2017, 2 328 positive samples of enteroviruses were detected from 3 194 samples, the positive rate was 72. 9%, including 602 cases of enterovirus 71 ( EV71), the positive rate was 25. 9%, and 570 cases of Coxsackie virus A group 16 ( CA16), with a positive rate of 24. 5%. From 2009 to 2011, the pathogenic type of HFMD was dominated by EV71. EV71 and CA16 were the dominant strains in 2012 and other enteroviruses were the dominant strains in 2013 - 2017 and 2008. From 2016 to 2017, 96 copies of Coxsackie virus type A type 6 ( CA6) and 21 copies of Coxsackie virus A type 10 ( CA10) were detected from 527 positive samples with other enterovirus nucleic acids, with the positive rate of 29. 9% and 6. 5%. Conclusion The detection rate of pathogens of hand - foot - mouth disease in Huzhou City was relatively high during the ten years. The dominant virus strains with different types appeared dynamically in different years. It is necessary to strengthen the monitoring of etiology of hand - foot - mouth disease, further clarify the composition of pathogenic spectrum in the region, so as to better prevent and control the occurrence of hand - foot - mouth disease.