2013-2015年郴州市手足口病病原谱及柯萨奇病毒A6基因特征分析  

Pathogenic spectrum of hand,foot,and mouth disease and genetic characteristics of coxasckievirus A6 in Chenzhou City,2013-2015

作　　者：谢群[1] 刘爱平[1] 谭徽[1] 陈柏塘[1] 朱韩武[1] 陈白鹭[1] XIE Qun, LIU Ai-ping, TAN Hui, CHEN Bai-tang, ZHU Han-wu, CHEN Bai-lu(Chenzhou Municipal Center for Disease Control and Prevention, Chenzhou, Hunan 423000, China)

机构地区：[1]湖南省郴州市疾病预防控制中心,湖南郴州423000

出　　处：《实用预防医学》2018年第11期1286-1289,共4页Practical Preventive Medicine

基　　金：郴州市科技计划项目(CZ2013108)

摘　　要：目的了解2013-2015年湖南省郴州市手足口病(hand,foot,and mouth disease,HFMD)病原谱和优势毒株基因特征,为该病的防控提供科学依据。方法采集2013-2015年郴州市HFMD临床诊断病例肛拭子或粪便标本,用荧光定量PCR方法检测人肠道病毒71型(human enterovirus 71,HEV71)、柯萨奇病毒A组16型(coxasckievirus A16,CVA16)、CVA6、CVA10和其他肠道病毒(HEV)。除上述型别外无法分型的其他HEV阳性标本再进行RT-PCR扩增,通过基因测序比对,鉴定病原体型别。结果郴州市2013-2015年共检测HFMD标本2 343份,肠道病毒阳性1 325份,阳性检出率为56. 55%; HFMD病原谱包括16种肠道病毒,已知型别中前5位分别为CVA6(31.77%),CVA16(16.45%),HEV71(13.74%),CVA10(11.47%),柯萨奇B组5型(CVB5)(0.30%),仍有25.13%的其他HEV未分型;聚集性病例以CVA16和其他HEV为主,重症及死亡病例以HEV71和其他HEV为主,不同年份(χ2=64.90,P<0.001)、不同类型(χ2=56.41,P<0.001)。郴州市的CVA6分离株均分布于同一进化簇,与长沙市分离株亲缘关系最近。结论 2013-2015年,CVA6已成为郴州地区引发手足口病的主要病原型别,在手足口病监测中应加强非HEV71和非CVA16型肠道病毒检测。Objective To study the pathogenic spectrum of hand,foot,and mouth disease（ HFMD） and genetic characteristics of coxasckievirus A6 in Chenzhou City,Hunan Province from 2013 to 2015,and to provide a scientific basis for HFMD control and prevention. Methods Anal swabs and stool specimens were collected from HFMD cases diagnosed in the sentinel hospitals in Chenzhou City in 2013-2015. RNA of human enterovirus A71（ HEV71）,coxasckievirus A16（ CVA16）,coxasckievirus A6（ CVA6）,coxasckievirus A10（ CVA10） and other human enterovirus（ HEV） was detected by fluorescent quantitative PCR assay.The other unidentified HEV positive specimens were amplified with RT-PCR and the pathogens was genotyped by gene sequencing.Results A total of 2,343 HFMD specimens were detected in Chenzhou City from 2013 to 2015. 1,325 specimens were positive for human enterovirus,with the detection rate of 56.55%. The pathogenic spectrum of HFMD included 16 types of intestinal viruses,with the top five genotypes of CVA6（ 31. 77%）,CVA16（ 16. 45%）,HEV71（ 13. 74%）,CVA10（ 11. 47%） and CVB5（ 0.30%）. 25.13% of the specimens were identified as other HEV without typing. CVA6 and other HEV were the major pathogens for clustered HFMD cases,while HEV 71 and other HEV were the predominant pathogens for severe HFMD cases and deaths.There were statistically significant differences in the genotypes of pathogens among HFMD cases with different types（ χ2= 56.41,P〈0.001） and in different years（ χ2= 64.90,P〈0.001）. CVA6 circulating strains in Chenzhou City were all distributed in the same cluster,and they were homologous to the circulating strains in Changsha City. Conclusions CVA6 had become the main pathogen of HFMD in Chenzhou City in 2013-2015. It is necessary to strengthen the detection of non-EV71 and non-CVA16 enteroviruses in HFMD monitoring.

关 键 词：手足口病 病原谱 柯萨奇病毒A组6型 基因特征 

分 类 号：R512.5[医药卫生—内科学]