重症手足口病患儿及其陪护家属肠道病毒感染情况调查

Investigation on the infection of enterovirus in children withsevere hand-foot-mouth disease and their accompanying family members

目的了解重症手足口病(HFMD)住院患儿肠道病毒的感染情况及其陪护家属的隐性感染情况,为肠道病毒感染的防控提供科学依据。方法采集西安市某儿童医院重症HFMD住院患儿及其陪护家属的肛拭子或咽拭子,采用RT-PCR法对肠道病毒71型(EV71)、柯萨奇病毒A组16型(CoxAl 6)和其他肠道病毒进行检测,SPSS 17.0进行统计学分析。结果 133例重症HFMD患儿肠道病毒的阳性率为90.98%,其中EV71、CA16和其他肠道病毒感染的构成比分别为47.92%、4.96%和47.12%。133例陪护家属肠道病毒的阳性率为18.05%,EV71和其他肠道病毒感染的构成比分别为33.33%和66.67%。HFMD患儿EV71阳性、其他肠道病毒阳性的陪护家属肠道病毒阳性率分别为12.07%和28.07%,差异有统计学意义(χ~2=4.60,P=0.03),陪护家属与患儿感染的肠道病毒血清型的一致性为79.17%。结论 HFMD住院患儿陪护家属肠道病毒的隐性感染比例较高,应重点对其采取有效的防控措施。

Objective To understand the infection status of enterovirus in hospitalized children with severe hand-foot-mouth disease(HFMD) and the pathogen-carrying status among the accompanying family members, and to provide scientific evidence for prevention and control of enterovirus infection. Methods The anal swabs or throat swabs of hospitalized children with severe HFMD and their accompanying family members were collected from a children′s hospital in Xi′an. The enterovirus type 71(EV71), coxsackievirus group A type 16(CoxAl6), and other enteroviruses were detected by RT-PCR.SPSS 17.0 was used for statistical analysis. HFMD cases admitted to a hospital in Xi′an were recruited for the present research. Rectal swabs from severe cases and throat swabs from accompanying family members were collected for extraction of RNA. Real-time RT-PCR was used to detect enterovirus(EV), enterovirus 71(EV71) and coxsackie virus A16(CAl6). SPSS 17.0 was used in performing statistical analysis. Results A total of 133 severe cases and their accompanying family members were tested. The enterovirus infection rates of the children with severe HFMD and their accompanying family members were 90.98% and 18.05%, respectively. Among the HFMD children, the overall positive detection rates on EV71, CoxAl6, and other enterovirus were 47.92%, 4.96%, and 47.12%, respectively, in HFMD children. Of all the accompanying family members, EV71 and other enterovirus group accounted for 33.33% and 66.67%,respectively. The positive rates of enterovirus in the accompany family members of EV71-positive and other enterovirus-positive HFMD children were 12.07% and 28.07%, respectively, and the difference was statistically significant(χ~2=4.60, P=0.03).79.17% of the accompanying family members were infected with the same type enterovirus detected in HFMD cases. Conclusion The enterovirus infection rates were high in the accompanying family members of hospitalized children with HFMD. It is suggested that the effective measures should be taken to prevent and control the enterovirus infection in these targeted people.