2010-2015年广州地区手足口病Cox A6,Cox A4和Cox A10的病原监测和流行分析  

Surveillance for hand foot and mouth disease pathogens Cox A6,Cox A4 and Cox AlO in Guangzhou

作　　者：张颖[1] 甄若楠 谢华萍[1] 陈纯[1] 耿进妹[1] 刘静雯[1] 狄飚[1] 王鸣[1] 

机构地区：[1]广州市疾病预防控制中心,广东广州510440

出　　处：《疾病监测》2016年第10期817-823,共7页Disease Surveillance

基　　金：国家科技重大专项(No.2012ZX10004213-005);广州市医学重点学科建设项目(No.2017-2019-04);广州市科技计划项目科技惠民专项(No.2014Y2-00031);广州市科技计划项目协同创新重大专项(No.201400000004-1);广东省医学科研基金立项课题(No.B2015100;A2014584);广州市卫生和计划生育科技项目(No.2016A010063)~~

摘　　要：目的 了解引起广州地区手足口病（HFMD）的柯萨奇病毒A组6型（Cox A6）、A组4型（Cox A4）和A组10型（Cox A10）的分子流行病学特征。方法 对2010-2015年收集的HFMD病例标本进行荧光定量PCR检测,以Cox A6、Cox A4和Cox A10的VP1部分基因序列进行同源分析和构建系统发育树。运用统计学方法对不同肠道病毒引起的HFMD流行特征进行描述性分析。结果 从广州地区HFMD患儿的12 054份临床标本中检出8945份肠道病毒阳性,其中2174份为Cox A6（24.30%）,144份为Cox A4（1.61%）,155份为Cox A10阳性（1.73%）。Cox A6和Cox A10的主要感染人群为1~2岁幼儿,Cox A4为3~4岁幼儿,男性病例多于女性。HFMD发病时间集中于的4-10月。广州市肠道病毒Cox A6、Cox A4和Cox A10流行株与国内其他地区的流行株亲缘关系接近。结论 广州地区引起HFMD流行的优势病毒株包括EV71、Cox A16和Cox A6 3种肠道病毒,并呈交替或共同流行状态。Cox A4和Cox A10也是重要的病原体。应加强肠道病毒流行趋势的长期监测及深入研究,以掌握HFMD流行的变化趋势。Objective To understand the molecular epidemiological characteristics of coxsackievirus A6 （ Cox A6）, A4 （ Cox A4） and A10（Cox A10） isolated from hand foot and mouth disease （HFMD） cases in Guangzhou. Methods Clinical samples were collected from suspected HFMD cases from 2010 to 2015. The RNA detections of Cox A6, A4 and A10 was conducted by using real-time PCR, and the partial VPI genes of the viruses were sequenced. The homology comparison and phylogenetic analysis of the isolates were performed. The epidemiological characteristics of HFMD caused by different enterovirnses were analyzed. Results Among 12 054 clinical samples collected, 8945 were enterovirus positive, including 2174 Cox A6 samples （24. 30% ）, 144 Cox A4 samples （ 1.61% ） and 155 Cox A10 samples （ 1.73% ）. HFMD mainly occurred during April - October. The infection rates of Cox A6 and Cox A10 were highest in age group 1 - 2 years （30. 82%, 23.23% ）, while the infection rate of Cox A4 was highest in age group 3 - 4 years （27.78%）. More cases occurred in males than in females. Phylogenetic analysis showed that Cox A6, A4 and A10 isolated in Guangzhou shared high homology with the enterovirus strains isolated in other areas in China. Conclusion The major pathogens causing HFMD were EV71, Cox A16 and Cox A6 in Guangzhou, which co-circulated or alternatively circulated. Cox A4 and Cox A10 were also the important pathogen causing HFMD. Long-term surveillance and research of HFMD incidence trend should be strengthened for the prevention and control of HFMD.

关 键 词：手足口病 柯萨奇病毒A6型 柯萨奇病毒A4型 柯萨奇病毒A10型 

分 类 号：R512.5[医药卫生—内科学] R181.3[医药卫生—临床医学]