不同类型标本对肠道病毒病检测结果的影响

Influence of different sampling specimens on the detection results of hand,foot,and mouth diseases

目的通过对日照市2010年—2021年收集到的不同手足口标本的检测结果进行对比分析,了解各种肠道病毒类型在咽拭子和粪便标本中的分布。方法收集手足口病患儿的粪便和咽拭子标本,采用PCR的方法检测总肠道病毒、肠道病毒71型和柯萨奇病毒A组16型。结果2010年—2021年日照市疾病控制中心共收到手足口病标本2673份,其中粪便标本2148份,肠道病毒阳性率为90.1%,咽拭子标本528份,阳性率为55.9%。咽拭子阳性标本中EV71、CA 16和其他类型肠道病毒分别占阳性标本中的比例为34.00%、22.83%、43.17%;粪便标本阳性为2148份,粪便标本中EV71、CA 16和其他类型肠道病毒所占阳性标本的比例分别为36.18%、32.79%、30.03%。3种导致手足口病的肠道病毒在粪便和咽拭子标本中的分布差异有统计学意义(χ^(2)=16.09,P<0.05);在不同的年龄组中,除了2岁患儿组外,3种肠道病毒在咽拭子和粪便中的分布差异有统计学意义(P<0.05)。结论不同类型肠道病毒在手足口病患者咽拭子和粪便标本中的检出率和病毒类型分布均有一定的差别,在长期的日常监测中,为做好长期比对,应固定同一种类型的临床标本作为监测对象,且横向对比时应注意采样标本带来的差别。

Objective Through comparative analysis of the detection results of different hand,foot and mouth diseases(HFMD)specimens collected from 2010 to 2021 in Rizhao City,to understand the distribution of various intestinal types in throat swabs and feces specimens.Methods Total enterovirus,enterovirus 71 and Coxsackie virus A16 were detected by PCR in stool and throat swabs of children with HFMD.Results From 2010 to 2021,a total of 2673 samples of HFMD were received from Rizhao Municipal Center for Disease Control and Prevention,including 2148 stool samples with a positive rate of 90.1%for enterovirus and 528 throat swab samples with a positive rate of 55.9%.EV71,CA 16 and other types of enterovirus accounted for 34.00%,22.83%and 43.17%of the positive samples of pharyngeal swabs,respectively.The number of positive fecal samples was 2148,and the proportions of EV71,CA 16 and other types of enterovirus in positive samples were36.18%,32.79%and 30.03%,respectively.There was statistical significance on the differences in the distribution of enterovirus in stool and throat swab specimens(χ^(2)=16.09,P<0.05).In different age groups,except for the 2-year-old children group,there was statistical significance on the differences in the distribution of the three enteroviruses in throat swabs and feces(P<0.05).Conclusion There are certain differences in the detection rate and virus type distribution of different types of enteroviruses in pharyngeal swabs and fecal samples of patients with HFMD.In the long-term daily monitoring,in order to do a good long-term comparison,the same type of clinical samples should be fixed as the monitoring object,and attention should be paid to the differences caused by sampling samples in the horizontal comparison.