2022年昆明市407例手足口病病例病原学监测分析

Etiological surveillance and analysis of 407 cases of hand,foot and mouth disease in a hospital of Kunming in 2022

目的了解2022年云南省昆明市手足口病病例的病原构成,为手足口病的预防和控制提供科学依据。方法收集2022年6―9月昆明市儿童医院诊断为手足口病患儿的407份粪便样品,采用巢式反转录-聚合酶链反应(reverse transcription-polymerase chain reaction,RT-PCR)方法对粪便样品进行肠道病毒核酸检测,利用通用肠道病毒引物扩增其VP1区基因并测序,采用SPSS 11.5,肠道病毒定型和Mega 6.0等软件分析数据。结果407份粪便样品中,肠道病毒阳性检出率为74.69%(304/407),有13种肠道病毒被检测到,其中,柯萨奇病毒A组6型(coxsackievirus A6,CVA6)所占比例最高,达42.43%(129/304),其次是CVA16(35.53%,108/304)、CVA5(11.84%,36/304)、CVA12(2.30%,7/304)、CVA2(1.97%,6/304)、CVA10(1.31%,4/304),CVA4、柯萨奇病毒B组5型(coxsackievirus B5,CVB5)和埃可病毒11型(echovirus 11,E11)均各占0.99%(3/304),CVB2占0.66%(2/304),CVA8、E3和肠道病毒A组71型(enterovirus A71,EV-A71)均各占0.33%(1/304)。其中CVA6和CVA16分别属于B1a和D3a基因型。结论2022年昆明市儿童医院手足口病由13种肠道病毒引起,其中CVA6和CVA16为优势病原体并属于中国流行株。

Objective To understand the pathogen composition of hand,foot and mouth disease(HFMD)in a hospital in Kunming,Yunnan province in 2022,and to provide some scientific basis for the prevention and control of HFMD.Methods A total of 407 stool samples were collected from children diagnosed with HFMD in a hospital in Kunming from June to September 2022.The VP1 coding region of enterovirus(EV)was amplified by RT-PCR and EV positive strains were sequenced.Three hundred and four The clinical and pathogenic characteristics were analyzed using software such as SPSS 11.5,enterovirus genotyping and Mega 6.06.Results A total of 407 specimens(74.69%),were positive for EV.A total of 13 genotypes were detected.Coxsackievirus A6(CVA6)was the most frequently detected in the EV(42.43%,129/304),followed by CVA16(35.53%,108/304),CVA5(11.84%,36/304),CVA12(2.30%,7/304),CVA2(1.97%,6/304),CVA10(1.31%,4/304).CVA4,coxsackievirus B5(CVB5)and echovirus 11(E11)accounted for 0.99%(3/304),CVB2 for 0.66%(2/304),and CVA8,E3 and enterovirus A71(EV-A71)were 0.33%(1/304).Among them,CVA6 and CVA16 belonged to B1a and D3a genotypes,respectively.Conclusion HFMD is caused by 13 enteroviruses in a hospital in Kunming city in 2022,of which CVA6 and CVA16 are the predominant pathogens and belonged to the epidemic strains in China.