2022年西安市手足口病的病原构成与EV-A71抗体调查

Investigation on pathogenic characteristics of hand,foot and mouth disease cases and enterovirus 71 antibody levels in healthy people in Xi′an in 2022

目的分析2022年西安市手足口病(hand,foot and mouth disease,HFMD)的病原构成和肠道病毒71型(enterovirus 71,EV-A71)的抗体水平,为手足口病的防控提供科学依据。方法收集手足口病的肛拭子或粪便标本,RT-PCR方法检测肠道病毒(enterovirus,EV)并鉴定血清型,酶联免疫吸附实验(ELISA)检测健康人群的EV-A71 IgG抗体。结果共收集到274例手足口病临床诊断病例,肠道病毒的阳性率为62.77%(172/274),EV-A71、CV-A16、CV-A6和CV-A10的构成比分别为0.58%(1/172)、55.23%(95/172)、37.21%(64/172)和0.58%(1/172)。春夏季的优势病原是CV-A16,秋冬季的优势病原是CV-A6,差异有统计学意义(χ^(2)=64.376,P<0.001),CV-A16感染手足口病(4.08±2.37岁)的平均年龄大于CV-A6感染手足口病(3.19±1.38岁),差异有统计学意义(t=2.709,P=0.007)。健康人群EV-A71 IgG的抗体阳性率为36.92%(168/455),男性EV-A71 IgG抗体阳性率(32.35%)低于女性(43.72%),差异有统计学意义(χ^(2)=6.605,P=0.014)。各年龄段人群EV-A71 IgG抗体阳性率为21.95%~54.78%,差异有统计学意义(χ^(2)=27.623,P<0.001)。结论西安市2022年手足口病的主要病原是CV-A16和CV-A6,5岁以下儿童EV-A71 IgG抗体阳性率较低,应加强EV-A71疫苗接种。

Objective To analyze the pathogenic composition of hand,foot and mouth disease(HFMD)cases and the antibody level of enterovirus 71(EV-A71)in healthy people in Xi′an in 2022,so as to provide evidence for the prevention and control of HFMD.Methods Anal swabs or stool specimens of HFMD cases were collected.RT-PCR was used to detect enterovirus(EV)and serotype was identified.Enzyme-linked immunosorbent assay(ELISA)was used to detect EV-A71 IgG antibody levels in healthy people.Results A total of 172 positive cases were detected from 274 HFMD clinical specimens with a total detection rate of 62.77%,including 1 case of EV-A71(0.58%),95 cases of CV-A16(55.23%),64 cases of CV-A6(37.21%),and 1 case of CV-A10(0.58%).CV-A16 was the dominant pathogen in spring and summer,and CV-A6 was the dominant pathogen in autumn and winter(χ^(2)=64.376,P<0.001).The age of HFMD cases caused by CV-A16 was older than the cases caused by CV-A6(t=2.709,P=0.007).The positive rate of EV-A71 IgG antibodies in healthy people was 36.92%(168/455).The positive rate of EV-A71 IgG antibodies in men(32.35%)was lower than that in women(43.72%),and the difference was statistically significant(χ^(2)=6.605,P=0.014).The positive rate of EV-A71 IgG antibodies in people of all ages ranged from 21.95%to 54.78%,and the difference was statistically significant(χ^(2)=27.623,P<0.001).Conclusion The main pathogens of hand,foot and mouth disease in Xi′an in 2022 are CV-A16 and CV-A6.The positive rate of EV-A71 IgG antibodies in children under 5 years old is low,and EV-A71 vaccination should be strengthened.