摘要
目的了解2011年郴州市手足口病病原学特征及EV71型分离株基因特性,为郴州地区手足口病防治工作提供依据。方法收集郴州市手足口病临床诊断病例的咽拭子或肛拭子、粪便标本,采用实时荧光PCR法检测EV71、CA16和其他肠道病毒核酸。随机挑选55份EV71阳性的标本进行RD细胞分离,10株分离株用逆转录-聚合酶链反应(RT-PCR)扩增EV71的VP1片段,并作基因测序和序列分子系统发生树分析。结果 2011年郴州市共报告手足口病例5 128例,发病有两个高峰,分别是5-7月和11-12月。病原学检测提示,2011年检测手足口病标本574例,发病年龄以1～3岁儿童为主,男性是女性的2.04倍,检出阳性标本461份,其中EV71占30.15%,CA16占31.89%,EV71和CA16同时阳性占0.65%,其他肠道病毒占37.31%;三种型别病毒分布在病例发病时间、发病年龄和地域上有所不同(P<0.001);重症病例25例,18例检出EV71病毒核酸,死亡病例6例均为EV71病毒感染;采用实时荧光PCR法随机检测68份其他肠道病毒,其中23份CA6、8份CA10,CA6和CA10占其他EV的45.59%。10株EV71分离株基因测序均为C4a亚型,重症和普通病例EV71的VP1基因序列差异较小。结论手足口病的发病存在明显季节、地区、性别、年龄差异,EV71是2011年郴州市引起手足口病重症和死亡病例的主要毒株类型,要开展对EV71型病毒的深入研究,同时也要关注非EV71和非CA16病毒的流行趋势,以防范其快速传播。
Objective To understand the pathogenic features of hand-foot-mouth disease（HFMD） and the genetic characteristics of isolates of enterovirus 71（EV71） in Chenzhou in 2011,so as to provide basis for the prevention and control of HFMD.Methods The throat swab,anal swab or fecal were collected from HFMD cases in HFMD surveillance hospitals.Nucleic acid of EV71,coxsackievirus A 16（CA16） and other enterovirus were detected by real time fluorescent PCR.55 samples were randomly selected from EV71 positive ones for RD cell separation.VP1 fragment of EV71 was amplified from 10 isolations by reversed transcription-polymerase chain reaction（RT-PCR） for gene sequencing and sequence molecular phylogeny tree analysis.Results Totally,5,128 HFMD cases were reported in Chenzhou in 2011.Two peak time of incidence was found in May to July and November to December.Pathogenic analysis of 574 HFMD samples indicated that children aged 1 to 3 years were more likely to get infected,and the ratio of boys to girls was 2.04.Pathogens were identified in 461 out of 574 samples,with EV71,CA16,EV71＋CA16 and other enterovirus accounting for 30.15%,31.89%,0.65% and 37.31%,respectively.HFMD caused by EV71,CA16 and other enterovirus differed in the distributions of the onset time,patient age and occurrence area（P0.001）.Among 25 severe cases,EV71 was detected in 18 patients.And all of the 6 death cases were infected with EV71.Random detection of 68 samples with other enterovirus by real time PCR revealed that CA6（23 cases） and CA10（8 cases） accounted for 45.59%.Gene sequencing of 10 EV71 isolations illustrated that the genotype were all subgenotype C4a.The VP1 gene sequences of EV71 isolations from severe cases and common cases had small differences.Conclusions The occurrence of HFMD has obvious season,area,gender and age features.EV71 is the predominant pathogen of HFMD severe cases and death cases in Chenzhou in 2011.To prevent and control the rapid spread of HFMD,further study is desired on EV71 and the epidemic trend o
出处
《实用预防医学》
CAS
2013年第3期287-291,共5页
Practical Preventive Medicine
