咸阳市2018年手足口病重症病例病原谱及肠道病毒A71型基因特征分析  

Analysis of the pathogen spectrum of severe hand,foot and mouth disease and genetic characteristics of enterovirus A71 in Xianyang,2018

作　　者：张俊君 陈斌 王莹莹 杨囡 王丽娟 李玄 Zhang Junjun;Chen Bin;Wang Yingying;Yang Nan;Wang Lijuan;Li Xuan(Xianyang City Center for Disease Control and Prevention,Xianyang 712000,China)

机构地区：[1]咸阳市疾病预防控制中心,712000

出　　处：《中华实验和临床病毒学杂志》2019年第6期593-597,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：陕西省手足口病防治项目专项资金(陕财社办-2012-233号)。

摘　　要：目的 确定咸阳市2018年重症手足口病(hand, foot and mouth disease, HFMD)的病原谱构成,对引起重症HFMD的肠道病毒A组71型(enterovirus A group 71 type, EV-A71)的基因进行分析。方法 收集67例咸阳市2018年重症HFMD患者标本,采用实时定量RT-PCR进行HFMD病原体检测,根据VP4区对肠道病毒(enterovirus, EV)进行型别确定;扩增EV-A71的VP1区并进行核苷酸和氨基酸序列分析。结果 67例重症病例中EV核酸检测阳性为30例,其中EV-A71型9例,柯萨奇病毒A组6型(coxsackievirus A group 6 type, CV-A6)11例,柯萨奇病毒A组16型(coxsackievirus A group 16 type, CV-A16)5例,柯萨奇病毒A组10型(coxsackievirus A group 10 type, CV-A10)2例,柯萨奇病毒A组4型(coxsackievirus A group 4 type, CV-A4)2例,柯萨奇病毒B组(coxsackievirus B group, CV-B)1例。4株EV-A71型的核苷酸和氨基酸序列同源性分别为96.7%~99.9%和99.3%~100%。系统进化分析显示4株EV-A71与C4a亚型处于同一分支;4株EV-A71共变异区的6个氨基酸组合模式均为KADSTV;4株EV-A71的抗原决定簇的EF区、GH区与部分代表株一致,但毒株SZK222、SZK497株EV-A71在BC loop区的93位(I93V)发生突变。结论 咸阳市2018年重症HFMD病原主要为EV-A71和CV-A6,其中EV-A71均属于C4a亚型且VP1未发生较大的突变。Objective To understand the pathogen spectrum of severe hand,foot and mouth disease(HFMD),and analyze the genetic characteristics of enterovirus A71(EV-A71)in Xianyang in 2018.Methods Totally 67 specimens of severe cases of HFMD were collected.Enteroviruses associated with HFMD were detected by real-time PCR and the genotypes of enteroviruses were identified by VP4 region of enteroviruses.The nucleotide and amino acid sequences of VP1 region of EV-A71 were analyzed.Results A total of 30 samples were positive for enterovirus among samples from 67 severe cases with HFMD,including 9 cases of EV-A71,11 cases of coxsackievirus A6(CV-A6),5 cases of coxsackievirus A16(CV-A16),2 cases of coxsackievirus A10(CV-A10)and 2 cases of coxsackievirus A4(CV-A4).The nucleotide and amino acid homologies of EV-A71 among 4 strains reached 96.7%-99.9%and 99.3%-100%respectively.The 4 strains of EV-A71 belonged to C4a subtypes by phylogenetic analysis.The six amino acid composite model was KADSTV in 4 strains of EV-A71.The EF region and GH region in antigenic determinants of 4 strains of EV-A71 kept consistent with representative reference strains,however,the EV-A71 SZK222 and SZK497 strains developed mutation at site 93(I93V)of BC loop region.Conclusions EV-A71 and CV-A6 are major agents of severe HFMD in Xianyang in 2018.The genotype of EV-A71 belonged to C4a subtype and the VP1 gene did not show more mutations.

关 键 词：手足口病 重症 EV-A71 基因特征分析 

分 类 号：R725.1[医药卫生—儿科] R440[医药卫生—临床医学]