佛山市三水区2015年—2022年手足口病病原检测分析

Pathogen detection and analysis of hand-foot-mouth disease in Sanshui District,Foshan City from 2015 to 2022

目的为了解手足口病病原学特点,为手足口病防控提供科学依据。方法采用实时荧光RT-PCR法对2015年-2022年佛山市三水区临床诊断手足口病病例粪便和肛拭子标本进行肠道病毒通用型(EV-U)、肠道病毒71型(EV71)、柯萨奇病毒A16型(CoxA16)和柯萨奇病毒A6型(CoxA6)核酸检测。结果1739份标本中阳性1139份,总阳性检出率为65.50%。EV71、CoxA16、CoxA6、其他未分型肠道病毒和混合感染构成比分别为4.83%、20.98%、46.18%、27.66%和0.35%。8年间,有1年以CoxA16为优势流行毒株,2年以未分型肠道病毒流行为主,5年以CoxA6流行为主。全年均可检出手足口病病原,检出率在6月达小高峰,9月达最高峰。0岁~4岁年龄组阳性检出率最多,占92.01%。不同年份、不同性别、区内居民与区外流动人群检出率之间差异有统计学意义(P<0.05);7个镇(街道)之间、粪便和肛拭子之间检出率差异无统计学意义(P>0.05)。结论手足口病病原检出有明显的季节、年龄和性别差异,CoxA6已成为本区手足口病感染的主要病原,及时掌握病原学分型,有助于预防和控制手足口病。

Objective This paper aims to understand the etiological characteristics of hand-foot-mouth disease(HFMD)and provide scientific basis for the prevention and control of HFMD.Methods Real-time-polymerase chain reaction(RT-PCR)was used to detect enterovirus universal type(EV-U),enterovirus 71(EV71),Coxsackievirus A16(CoxA16)and Coxsackievirus A6(CoxA6)in stool and anal swab specimens from clinically diagnosed HFMD cases in Sanshui District of Fos-han City from 2015 to 2022.Results Among 1739 samples,1139 were positive,with the detection rate of 65.50%.The proportions of EV71,CoxA16,CoxA6,other enteroviruses and mixed infection were 4.83%,20.98%,46.18%,27.66%and 0.35%.During the 8 years,CoxA16 was the dominant strain in 1 year,the other enterovirus was the dominant strain in 2 years,and CoxA6 was the dominant epidemic strain in the remaining 5 years.The pathogen of HFMD could be detected all year round,and the detection rate reached a small peak in June and the highest peak in September.The positive detection rate of 0-4 age group was the highest,accounting for 92.01%.There was statistical significance on the differences in the detection rate between different years,different genders,residents in the area and floating population outside the area(P<0.05),and there was no statistical significance on the difference in the detection rate between 7 towns(streets)and between stool and anal swabs(P>0.05).Conclusion There are obvious differences in season,age and gender in the detection of pathogens of HFMD.CoxA6 has become the main pathogen of HFMD infection in our district.It is helpful for the prevention and control of HFMD to grasp the etiological classification in time.