一起CV-A5引起的疱疹性咽峡炎疫情分子流行病学分析  

Molecular epidemiological analysis of an outbreak of herpangina caused by CV⁃A5

作　　者：曾庆 张晓[1] 杨结仪 刘静雯[1] 耿进妹[1] 李魁彪[1] 狄飚[1] 谢华萍[1] ZENG Qing;ZHANG Xiao;YANG Jieyi;LIU Jingwen;GENG Jinmei;LI Kuibiao;DI Biao;XIE Huaping(Guangzhou Center for Disease Control and Prevention(Guangzhou Institute of Health Supervision),Guangzhou,Guangdong 510440,China)

机构地区：[1]广州市疾病预防控制中心(广州市卫生监督所),广东广州510440

出　　处：《热带医学杂志》2025年第1期110-112,123,共4页Journal of Tropical Medicine

基　　金：广州市医学重点学科(2025-2027-11);广州市卫生健康科技项目(20221A010041,20221A011071)。

摘　　要：目的对2022年5月广州市某幼儿园一起疱疹性咽峡炎(HA)疫情进行病原学鉴定及病原基因特征分析。方法采用统一调查表对某幼儿园于2022年5月23-31日诊断为疱疹性咽峡炎及同一幼儿园有发热,伴咽痛、口腔疱疹等症状之一患儿进行个案调查。采集本次疫情7名患者大便样本,使用荧光RT-PCR和半巢式PCR法鉴定病原。对病毒VP1区全长进行测序,氨基酸位点变异及系统进化分析。结果7份样本经检测为肠道病毒阳性,均为柯萨奇病毒A5(CV-A5)。共获得4条CV-A5 VP1全长序列,核苷酸和氨基酸相似性均为100.0%;与CV-A5原型株核苷酸和氨基酸相似性分别为79.3%和94.6%;与C1亚型毒株核苷酸和氨基酸相似性分别为89.7%~96.9%和95.6%~99.3%。系统进化分析显示,此次疫情CV-A5均属于我国广泛流行的C1亚型。与CV-A5原型株相比,在VP1区存在16个氨基酸位点变异;与CV-A5 C1亚型毒株相比,存在2个氨基酸位点变异。结论CV-A5是引起此次HA疫情的病原,属于中国内地主要流行的C1亚型株。与C1亚型流行株相比,本次疫情在VP1区出现新的氨基酸变异,对于是否会引起病毒免疫逃逸及毒力改变还需进一步研究。Objective The etiological identification and pathogenic gene characteristics of an outbreak of herpangina(HA)in a kindergarten in Guangzhou in May 2022 were analyzed.Methods A unified questionnaire was used to investigate the children with herpangina or one of the symptoms of fever,sore throat and oral herpes in the same kindergarten from May 23 to 31,2022.The stool samples of 7 patients in this epidemic were collected,and the pathogens were identified by fluorescence RT-PCR and semi-nested PCR.The whole genome nucleotide sequences of VP1 were sequenced;the amino acid site variation and phylogenetic analysis were performed.Results A total of 7 samples were positive for enterovirus;all of which were coxsackievirus A5(CV-A5).A total of 4 CV-A5 VP1 whole genome nucleotide sequences were obtained;the similarity of nucleotide and amino acid was 100.0%;the similarity of nucleotide and amino acid with CV-A5 prototype strain was 79.3%and 94.6%,respectively;the nucleotide and amino acid similarities with C1 subtype strains were 89.7%-96.9%and 95.6%-99.3%,respectively.Phylogenetic analysis showed that CV-A5 belonged to C1 subtype,which was mainly prevalent in China.Compared with the CV-A5 prototype strain,there were 16 amino acid site mutations in the VP1 gene,and 2 amino acid site mutations compared with the CV-A5 C1 subtype strain.Conclusions CV-A5 was the pathogen causing the HA epidemic,which belongs to the C1 subtype strain that mainly prevalent in China's mainland .Compared with the C1 subtype epidemic strain,new amino acid substitutions occurred in the VP1 gene,and further research should be needed to determine whether it might cause virus immune escape and virulence changes.

关 键 词：疱疹性咽峡炎 柯萨奇病毒A5 VP1基因 系统进化分析 

分 类 号：R766.12[医药卫生—耳鼻咽喉科]