2014-2015年广州759例儿童肠道病毒感染病原谱调查  

Study on enterovirus etiology of 759 cases in Guangzhou during 2014-2015

作　　者：赵崇泉 郭勇晖[1,2] 沈永棋 陈满君 刘朵朵[1,2] 余楠[1,2] 

机构地区：[1]南方医科大学珠江医院检验医学部,广东广州510282 [2]广东省突发传染病病原微生物重点实验室,广东广州510282

出　　处：《中华疾病控制杂志》2017年第6期567-571,共5页Chinese Journal of Disease Control & Prevention

基　　金："十二五"国家科技重大专项(2014ZX 10004005)

摘　　要：目的调查2014-2015年我院759例儿童感染肠道病毒血清型的分布,了解广州地区肠道病毒(enterovirus,EV)病原谱。方法采集手足口病等疑似肠道病毒感染患儿肛拭子标本,采用荧光逆转录多聚酶链反应法(reverse transcriptase polymerase chain reaction,RT-PCR)检测通用型、肠道病毒71型(enterovirus 71,EV71)柯萨奇病毒A组16型(coxsackie virus A group 16,CA16)核酸,巢式PCR法扩增VP1基因测序分型。结果 1 060例疑似感染者检出759例EV阳性(检出率71.6%);两年均检出11种血清型,2014年CA16、EV71、CA4、CA10和CA6位列前五位,CA16和EV71占77.1%;2015年CA6、EV71、CA10、CA16和CA2列前五位,CA6占51.7%;性别比为1.8~5.3;感染以<3岁儿童为主(60.1%,456/759);全年均可检出,4~7月达高峰,5月CA16、EV71、CA10和CA2达高峰,7月CA6达高峰。由于病原谱不同,2015年病情普遍较2014年轻,两年均无死亡病例。EV71感染重症病例比率最高(12.7%),CA16、CA10、CA4和CA6偶见重症病例。结论广州主要流行十余种肠道病毒,两年病原谱不同,大部分感染引起疾病较轻。Objective To investigate the distribution of enterovirus （EV） serotypes of 759 cases in Guangzhou during 2014 -2015. Methods Rectal swabs were collected from children with suspected infection of enterovirus and detected for pan-EV-, EV71- and Coxsackie virus A group 16（ CA16）-specific nucleic acid using real-time reverse transcrip- tion-polymerase chain reaction （RT-PCR）. The serotype of EV-positive samples was identified using semi-nested RT-PCR and sequencing for VP1 gene product. Results A total of 759 （71.6 % ） were detected EV positive among the 1 060 specimens during 2014 - 2015. Eleven serotypes were identified circulating in both of years. The top five predominant sero- types were CA16, EV71, CA4, CA10, CB5 in 2014 and CA6, EV711 CA10, CA16 and CA2 in 2015 respectively. CA16 and EV71 accounted for 77. 1% in 2014, contrasting that CA6 accounted for 51.7% in 2015. The sex ratio ranged from 1.8 to 5.3. Children under 3 years old were more likely suffering from infection （60. 1% ,456/759）. EV could be detected throughout the year with CA16, EV71, CA10 and CA2 peaked in May while CA6 in July. Clinical manifestation was mild in most infection cases. However, severe cases were observed in 12. 7% of EV71 infection and occasionally in CA16, CA10, CA4 and CA6 infections. Conclusion Eleven serotypes of EV, with different spectrum, circulated in Guangzhou during 2014- 2015. Clinical manifestation in most EV infection were mild.

关 键 词：肠道病毒属 聚合酶链反应 手足口病 

分 类 号：R373.25[医药卫生—病原生物学] R512.57[医药卫生—基础医学]