2010-2021年杭州市儿童埃可病毒感染及流行特征分析  

Detection and Epidemiological Characteristics of Pediatric Echovirus Infection in Hangzhou City,China,from 2010 to 2021

作　　者：邱晓枫[1] 李钧[1] 张国忠[1] 于新芬[1] 潘劲草[1] 赵刚[1] QIU Xiaofeng;LI Jun;ZHANG Guozhong;YU Xinfen;PAN Jincao;ZHAO Gang(Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China)

机构地区：[1]杭州市疾病预防控制中心,杭州310021

出　　处：《病毒学报》2023年第2期401-409,共9页Chinese Journal of Virology

基　　金：杭州市农业与社会发展科研计划项目(项目号:20170533B76),题目:杭州市区手足口病患儿中埃可病毒的检测及其分子特征研究。

摘　　要：研究杭州市儿童感染埃可病毒(Echovirus,E)状况和流行病学特征。收集2010-2021年杭州市发热患儿咽拭子、肛拭子等临床样本。首先通过实时荧光RT-PCR试剂盒进行肠道病毒(Enterovirus,EV)通用筛查。选取Ct值≤30且EV-A71、CVA16、CVA6、CVA10均为阴性的EV阳性核酸样本,用普通PCR方法扩增EV VP1序列。获得VP1序列通过GenBank进行BLAST比对,确定埃可病毒血清型,并对埃可病毒优势血清型构建遗传进化树。通过回顾性调查埃可病毒阳性患儿的临床资料进行流行病学特征分析。采用卡方检验对埃可病毒阳性患儿的采样时间、年龄、性别等进行分组比较。本研究共收集临床样本7 835份,获得EV通用阳性样本数共计2 023份。选取827份Ct值≤30且EV-A71、CVA16、CVA6、CVA10均为阴性的EV通用核酸阳性样本;共检出埃可病毒68份,8个血清型,阳性率为8.22%;分别为21份E30、12份E9、13份E6、7份E11、11份E18、2份E25、1份E7、1份E3。春、夏、秋、冬四季的埃可病毒阳性率分别为4.37%、21.03%、1.75%、1.22%。0~4岁、4~7岁、7~14岁患儿的埃可病毒阳性数分别为29、23、16,在EV阳性病例中的阳性率分别为5.24%、10.09%、34.78%。男、女童埃可病毒阳性率分别为9.48%、6.13%。埃可病毒阳性患儿临床诊断主要以急性上呼吸道感染为主,有29例占42.65%;其次是病毒性脑炎25例占36.76%;再是手足口病11例占16.18%。构建E30遗传进化树,发现杭州21株E30病毒株有多个不同进化分支,可能存在不同的流行传播链。E30杭州株之间核苷酸和氨基酸序列相似性分别为88.0%~100.0%、97.3%~100.0%。2010-2021年期间,夏季是杭州市儿童埃可病毒感染的高发季;建议医疗机构在夏季加强埃可病毒监测,有效预防和控制夏季埃可病毒引起的疫情暴发流行。We wished to study the serotypes and epidemiological characteristics of echovirus infection in children in Hangzhou City(HC) in China. Throat swabs, anal swabs and other samples were collected from children suffering from fever in HC from 2010 to 2021. First, universal screening of enteroviruses(EVs) was carried out by real-time reverse transcription-polymerase chain reaction(RT-PCR). The VP1 sequence of EVs was amplified by PCR from EV-positive samples with cycle threshold(Ct) ≤30. Also, all samples were negative for EV-A71, coxsackievirus(CV) A16, CVA6 and CVA10. Echovirus serotypes were confirmed by BLAST analysis of VP1 sequences in GenBank. A phylogenetic tree of dominant serotypes was constructed.Epidemiological characteristics were analyzed by retrospective investigation of the data of echovirus-positive children. The chi-square test was used to compare the sampling season, age and sex of echovirus-positive children. A total of 7835 clinical specimens were collected and 2023 EV universal-positive samples were obtained. Echoviruses were detected in 68(8.22%) out of 827 EV universal nucleic acid-positive samples with Ct≤30, and all samples were negative for EV-A71, CVA16, CVA6 and CVA10. The 68 echoviruses samples belonged to eight serotypes. Twenty-one cases had the E30 serotype, whereas 12 had E9, 13 had E6, seven had E11, 11 had E18, two had E25, one had E7, and one had the E3 serotype. The percentage of positive cases of echovirus was 4.37% in spring, 21.03% in summer, 1.75% in autumn and 1.22% in winter. The number of echovirus-positive samples in those aged 0–4 years,4–7 years and 7–14 years was 29,23 and 16, and the percent echovirus-positivity in EV-positive cases was 5.24%, 10.09% and 34.78%, respectively. The percentage of positive cases of echovirus in boys and girls was 9.48% and 9.05%, respectively. Main clinical diagnosis of echovirus-positive children include acute infection of the upper respiratory tract(29 cases, 42.65%), viral encephalitis(25, 36.76%), hand, foot and mouth disease

关 键 词：埃可病毒 发热儿童 病毒性脑炎 手足口病 VP1基因 流行病学 

分 类 号：R373.2[医药卫生—病原生物学]