2007年北京市急性出血性结膜炎的病原与分子进化分析  

Outbreak of Acute Hemorrhagic Conjunctivitis in Beijing City in 2007 Caused by Coxsackievirus A24 Variant: Molecular Identification and Phylogenetic Analysis

作　　者：丁丽新[1] 张勇[2] 李洁[1] 窦相峰[1] 严冬梅[2] 祝双利[2] 安洪秋[2] 许文波[2] 

机构地区：[1]北京市疾病预防控制中心传染病地方病控制所,北京100013 [2]中国疾病预防控制中心病毒病预防控制所,北京100052

出　　处：《病毒学报》2009年第4期251-256,共6页Chinese Journal of Virology

摘　　要：2007年北京市发生了急性出血性结膜炎（Acute Hemorrhagic Conjunctivitis,AHC）疫情。为鉴定引起这次疫情的致病病原体,采集北京市门诊就诊的AHC患者眼结膜拭子标本共57份,使用PCR或RT-PCR法分别检测临床标本中腺病毒、人肠道病毒70型（Human Enterovirus 70,HEV70）和柯萨奇病毒A组24型变种（CoxsackievirusA24 variant,CVA24v）的基因,其中有38份检测结果为CVA24v阳性,阳性率为66.7%,而腺病毒和HEV70检测结果均为阴性,说明引起本次AHC流行的病原体是CVA24v。使用HEp-2细胞共分离到9株病毒,通过分子定型均鉴定为CVA24v,对9株CVA24v进行全长VP1区扩增和核苷酸序列测定和分析后,发现除0744/BJ/CHN/2007株之外,其它8株在全长VP1区核苷酸水平和氨基酸水平上差异都很小,同源性分别大于99.6%和100.0%,而0744/BJ/CHN/2007株与其它8株CVA24v的核苷酸和氨基酸同源性分别为96.8%~97.2%和99.7%。进化树图显示,2007年北京CVA24v分离株与基因群I中的代表株聚为一簇,代表了基因群I中的第四和第五进化分支,说明本次流行至少存在两个传播链。相对于CVA24v的3C区而言,VP1区是进行分子流行病学研究的更为严谨的靶序列,加强对CVA24v的血清流行病学和分子流行病学监测和研究,了解CVA24v的基因特征和分子进化,对预防和控制CVA24v在中国的流行具有重要意义。In 2007, an outbreak of acute hemorrhagic conjunctivitis （AHC） occurred in Beijing. In order to identify the etiology of this outbreak, 57 eye conjunctival swabs were collected from 57 outpatient patients, and detected for adenovirus, human enterovirus 70 （HEV70） and Coxsackievirus A24 variant （CVA24v） genes by using RT-PCR or PCR methods. The results showed that 38 were positive for CVA24v, the positive rate was 66.7%, but none was positive for HEV70 and adenovirus, showing that this outbreak was caused by CVA24v. 9 viral isolates were obtained from 57 clinical specimens by using viral isolation method, and all were identified as CVA24v by molecular typing method. All 9 CVA24v isolates were performed by VP1 sequencing, the results showed that except for strain 0744/BJ/CHN/2007, the variability at nucleotide acid level and amino acid level among other 8 CVA24v were relatively low, and the homologies were more than 99.60%and 100.0%, respectively; the homologies of nucleotide acid and amino acid between strain 0744/BJ/CHN/2007 and other 8 CVA24v were 96.8%-97.2% and 99.7%, respectively. Phylogenetic analysis of 9 CVA24v revealed that they represented the Clade 4 and Clade 5 in Group I, showed that this outbreak was caused by at least 2 viral transmission chains. Comparing to 3C rgion of CVA24v frequently used before, VP1 region was considered as the most rigorous target for molecular epidemiology study of CVA24v. To enhance the research of sero-epidemiology and molecular epidemiology of CVA24v and to know the genetic characterizations and molecular evolution of CVA24v are most important to prevent and control the outbreaks of AHC in China.

关 键 词：急性出血性结膜炎 柯萨奇病毒A组24型变种 分子进化分析 

分 类 号：R373.2[医药卫生—病原生物学]