2018—2019年广东省和江苏省手足口病病原分子流行特征分析

Molecular epidemic characteristics of pathogen of hand,foot and mouth disease in Guangdong and Jiangsu Provinces,China from 2018 to 2019

目的分析广东省和江苏省2018—2019年手足口病(hand,foot and mouth disease,HFMD)病原分子流行特征,为HFMD的防控及疫苗研发提供依据。方法对2018—2019年广东省和江苏省5个临床中心监测的HFMD病例采集咽肛拭子,荧光PCR检测为肠道病毒(enterovirus,EV)阳性的样本,应用EV通用引物和特异性引物扩增5′UTR区和VP1区序列,通过BLAST确定病原种类,并应用VP1序列构建种系进化树,分析毒株分子流行特征。结果广东省和江苏省2018—2019年HFMD病例中96%以上为CV-A16(63.69%~72.43%)和CV-A6(24.81%~32.38%)阳性,其次为CV-A10和EV-A71。本研究检测到的EV流行株分别为EV-A71 C4、CV-A16 B1/B2、CV-A6D3和CV-A10 F3亚型,同样也是近年来我国大陆流行的主要亚型。结论 CV-A16和CV-A6感染在HFMD发病中占较高比例,对婴幼儿人群有较大危害,应研发包含CV-A16和CV-A6在内的HFMD多价疫苗。

Objective To analyze the molecular epidemic characteristics of hand,foot and mouth disease(HFMD) in Guangdong and Jiangsu Provinces,China from 2018 to 2019 and provide a basis for prevention and control of HFMD and vaccine development. Methods The throat and anal swabs were collected from the patients with HFMD monitored in five clinical centers in Guangdong and Jiangsu Provinces from 2018 to 2019. Samples with positive results tested by real-time fluorescent quantitative PCR were amplified with EV pan primers and specific primers to obtain 5′ UTR region and VP1 region sequences. The pathogen genotypes were determined by BLAST,and phylogenetic trees were constructed based on the VP1 sequences to analyze the molecular epidemic characteristics of main pathogens. Results Of the cases of HFMD in Guangdong and Jiangsu from 2018 to 2019,more than 96% were positive for CV-A16(63. 69% ~ 72. 43%)and CVA6(24. 81% ~ 32. 38%),followed by those for CV-A10 and EV-A71. The EV strains detected in this study were of subgenotypes EV-A71 C4,CV-A16 B1/B2,CV-A6 D3 and CV-A10 F3,which were also the main subgenotypes of HFMD pathogens in China's Mainland during the past decade. Conclusion CV-A16 and CV-A6 infections caused a relatively large proportion of HFMD cases,which threatened the health of infants and young children. Multivalent HFMD vaccines containing CV-A16 and CV-A6 should be developed.