手足口病患者咽拭子、肛拭子标本病毒检出率的比较

Comparison of enterovirus detection rates of throat swabs and anal swabs in patients with hand-foot-mouth disease

目的对手足口病患者不同类型标本进行病原学检测和分析,了解手足口病患者肠道病毒的检测结果,为临床工作中早期、快速做出病原学诊断选择更好的方法。方法对2018年5月~7月临床诊断手足口病患者同时采集肛拭子及咽拭子标本,用实时荧光定量逆转录多聚酶链反应检测肠道病毒71型(EV71)、柯萨奇病毒A组16型(CA16)和其它肠道病毒(EV),比较两种标本的肠道病毒检测阳性率。结果新入院123例患者中,咽拭子标本阳性者109例(88.62%),肛拭子标本阳性者115例(93.5%),两种标本阳性率差异无统计学意义(P>0.05),出院120例患者中,咽拭子标本阳性者36例(30.0%),肛拭子标本阳性者81例(67.5%),肛拭子标本阳性率明显高于咽拭子标本阳性率,差异有统计学意义(P<0.01)。结论咽拭子标本与肛拭子标本均可有效检测病毒,为提高手足口病病原学诊断率,建议同时采集咽拭子和肛拭子;治愈后患者仍有传染性,建议出院后继续隔离1~2周。

Objective To investigate and analyze the pathogens of different types of specimens of patients with handfoot-mouth disease(HFMD), to understand the detection results of enterovirus in patients with HFMD, and to select a better method for early and rapid pathogen diagnosis in clinical work. Methods The anal swab and throat swab specimens were collected from patients with HFMD clinically diagnosed from May 2018 to July 2018. Real-time fluorescent quantitative reverse transcription polymerase chain reaction(RT-PCR) to detect Enterovirus 71(EV71),Coxsackievirus group A type 16(CAl6) and other Enterovirus(EV)was performed.The enterovirus detection rates were compared in the two specimens. Results Of the 123 patients admitted to the hospital, 109(88.62 %) were positive for throat swab specimens and 115(93.5 %) were positive for anal swab specimens. There was no significant difference between the two specimens(P>0.05).Among the 120 patients discharged, 36 cases(30.0 %) were positive for throat swab specimens and 81 cases(67.5 %) were positive for anal swab specimens. The positive rate of anal swab specimens was significantly higher than that of throat swab specimens. The difference was statistically significant.(P <0.01). Conclutions Throat swab specimens and anal swab specimens can effectively detect viruses. To improve the pathogenic diagnosis rate of patients with HFMD, it is recommended to collect throat swabs and anal swabs at the same time.Patients are still contagious after curing, and it is recommended to continue isolation for 1-2 weeks after discharge.