2018-2020年云南省手足口病病原监测及柯萨奇病毒A组4型VP1基因特征分析  

Surveillance of pathogens causing hand,foot and mouth disease and analysis of coxsackievirus A4 VP1 gene in Yunnan Province from 2018 to 2020

作　　者：曹亿会[1] 杨景晖[2] 周晓芳[1] 张勇[3] 寸建萍[1] 李楠 杨溪[1] 姜黎黎[1] 乔恩发[1] Cao Yihui;Yang Jinghui;Zhou Xiaofang;Zhang Yong;Cun Jianping;Li Nan;Yang Xi;Jiang Lili;Qiao Enfa(Division of Acute Infection Disease Prevention and Control,Yunnan Center for Disease Control and Prevention,Kunming 650022,China;Department of Pediatrics,the First People′s Hospital of Yunnan Province,Kunming 650034,China;National Institute for Viral Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]云南省疾病预防控制中心急性传染病防制所,昆明650022 [2]云南省第一人民医院儿科,昆明650034 [3]中国疾病预防控制中心病毒病预防控制所,北京102206

出　　处：《中华微生物学和免疫学杂志》2022年第12期917-923,共7页Chinese Journal of Microbiology and Immunology

基　　金：云南省临床病毒学重点实验室开放课题(202005AG070062-015);云南省中青年学术和技术带头人后备人才(202105AC160030)。

摘　　要：目的阐明2018-2020年云南省手足口病优势肠道病毒感染类型及柯萨奇病毒A组4型(CVA4)VP1基因特征分析。方法手足口病监测肠道病毒实时荧光定量PCR核酸阳性标本进一步病毒分离,送中国疾病预防控制中心并对VP1基因测序分析。结果2018-2020年共采集手足口病标本21757份,其中阳性标本16457份,阳性检出率75.64%。共分离阳性标本4114份,分离到毒株533份,其中肠道病毒71型(EVA71)共89例,占总病原的16.70%;柯萨奇病毒A组16型(CVA16)共180例,占33.77%;CVA10为76例,占14.26%;CVA6、CVA4分别占22.14%、4.88%;其他型别共44例,占8.26%。5岁以下儿童是手足口患者主要人群,男女性别比1.35∶1,气温较高的第二、三季度是手足口病高发季。云南省CVA4主要分布在曲靖和昆明等地,文山、红河零星分布,VP1基因全长915 bp,26株CVA4毒株均属于C基因型的C2亚型,与原始株AY421762-HighPoint之间遗传距离较远。VP1基因的18、23、34、102、148、164、200、262、174、275、285、303等位点均有不同程度的突变。核苷酸同源性为80.4%~99.0%,氨基酸同源性为95.6%~99.0%,核苷酸突变多为有义突变。结论CVA16、EVA6、EVA71和CVA10为云南省2018—2020年手足口病的优势肠道病毒。CVA4渐成为引起手足口病不可忽视的病原体,云南省CVA4属于C基因型的C2亚型,主要流行于云南省的东部及东南部,渐成为持续共循环优势株,长期动态监测对于提高手足口病预警敏感性具有重要的公共卫生意义。Objective To investigate the predominant types of enteroviruses and the characteristics of the VP1 gene of coxsackievirus A4(CVA4)causing hand,foot and mouth disease(HFMD)in Yunnan Province from 2018 to 2020.Methods Throat swab and stool samples were collected from HFMD cases and tested by real-time quantitative PCR for nucleic acid detection.The samples positive for enterovirus nucleic acids were used for viral isolation and sent to the National Center for Disease Control and Prevention.The VP1 gene of the isolated strains was sequenced and analyzed.Results From 2018 to 2020,a total of 21757 HFMD samples were collected,16457(75.64%)of which were positive for enteroviruses.Altogether 533 strains were isolated from 4114 positive samples that were selected for viral isolation,including 89 strains of enterovirus 71(EVA71,16.70%),180 strains of coxsackievirus A16(CVA16,33.77%),76 strains of CVA10(14.26%),118 strains of CVA6(22.14%),26 strains of CVA4(4.88%)and 44 strains of other types(8.26%).HFMD occurred mainly in children under five years old with higher incidence in males than in females(1.35∶1).The incidence of HFMD reached the peak in the second and third quarters.In Yunnan Province,CVA4 mainly circulated in Qujing and Kunming,and was sporadically detected in Wenshan and Honghe.The VP1 gene was 915 bp in length.Twenty-six CVA4 strains belonged to C2 subtype,which were genetically far from the prototype strain AY421762-HighPoint.Mutations in the VP1 gene were found at multiple sites including 18,23,34,102,148,164,200,262,174,275,285 and 303.These strains showed 80.4%-99.0%homology in nucleotide sequence and 95.6%-99.0%in amino acid sequence.Nucleotide mutations were mostly synonymous mutations.Conclusions CVA16,CVA6,EVA71 and CVA10 were the predominant enteroviruses causing HFMD in Yunnan Province from 2018 to 2020.The prevalence of CVA4 was also worthy of attention.CVA4 isolates in Yunnan Province belonged to C2 subtype,mainly circulating in the east and southeast of Yunnan Province and gradually becoming a c

关 键 词：手足口病 CVA4 VP1基因 系统进化分析 

分 类 号：R725.1[医药卫生—儿科] R446.5[医药卫生—临床医学]