2017-2023年浙江省台州市手足口病病原学监测及柯萨奇A6型VP1基因特征分析  

Etiological surveillance of hand,foot,and mouth disease and genetic characterization of coxsackievirus A6 VP1 gene in Taizhou city,Zhejiang province from2017 to 2023

作　　者：沈钱通 李聪聪 翁坚[1] 管雅雅 沈伟伟[1] SHEN Qian-tong;LI Cong-cong;WENG Jian;GUAN Ya-ya;SHEN Wei-wei(MicrobiologicalLaboratory,Taizhou City Center for Disease Control and Prevention(Taizhou Health Supervision Institute),Zhejiang 318001,China)

机构地区：[1]台州市疾病预防控制中心(台州市卫生监督所)微生物检验所,浙江318001

出　　处：《预防医学论坛》2025年第1期15-20,共6页Preventive Medicine Tribune

基　　金：新型疫苗浙江省工程研究中心开放课题项目(ERCNV-202302)。

摘　　要：目的了解2017-2023年浙江省台州市手足口病病原学现状和柯萨奇A6型VP1片段基因特征,为手足口病的防治工作提供依据。方法对2017-2023年浙江省台州市临床诊断为手足口病患者的4008例样本进行病原学检测,采用反转录聚合酶链反应对手足口病相关的四种肠道病毒进行鉴别,进行病原学特征回顾性分析,用SaTScan软件探索时空聚集区域,并对CA6分离株进行测序,用生物信息学软件进行基因特征分析。结果2017-2023年共采集临床标本4008例,检出阳性2827例,总检出率为70.54%。以CA6为主,占比为55.50%(1569/2827)。CA6在秋冬季出现感染高峰,CA16在夏季出现感染高峰;男性检出率高于女性,性别比为1.57∶1。1~3岁儿童为主要发病人群,占比66.04%(1867/2827)。不同地区中以三门县检出率最高为93.69%(401/428)。时空扫描探测到一级聚集区域1个,二级聚集区1个。2023年流行的CA6型基因特征为D3a亚型。结论2017-2023年浙江省台州市手足口病流行具有明显的时间、地区和人群分布特征,并具有明显的时空聚集性,且CA6成为优势流行毒株,亚型为D3a。Objective To understand the etiology of hand,foot,and mouth disease(HFMD)and analyze the genetic characteristics of Coxsackie A6VP1fragments in Taizhou city,Zhejiang province from 2017to 2023,so as to provide a basis for prevention and control.Methods From 2017to 2023,4008clinical samples were collected from patients clinically diagnosed with HFMD in Taizhou city and tested for pathogens.Four enteroviruses associated with HFMD were identified by reverse transcription polymerase chain reaction(RT-PCR),a retrospective analysis of pathogenetic characterization was performed.Spatio-temporal aggregation regions were explored with SaTScan software,and CA6isolates were sequenced using bioinformatics software for genetic characterization.Results A total of 4008clinical specimens were collected from 2017to 2023,and 2827cases were detected as positive,with an overall detection rate of 70.54%,CA6was predominant,accounting for 55.50%(1569/2827)of the positive cases.CA6infections peaked in autumn and winter,while CA16infections peaked in summer.The detection rate was higher in males than in females,with a sex ratio of 1.57∶1.The main affected group was children aged 1to 3years,accounting for 66.04%(1867/2827)of the cases.Among the different regions,Sanmen county had the highest detection rate at 93.69%(401/428).Spatio-temporal scanning identified 1primary and 1secondary aggregation area.The CA6strain prevalent in 2023was genetically characterized as the D3asubtype.Conclusion The epidemic of HFMD in Taizhou city is characterized by obvious distribution of time,area and population with obvious spatio-temporal aggregation,and CA6became the dominant prevalent strain with subtype D3a.

关 键 词：手足口病 病原学 柯萨奇A组6型 肠道病毒 

分 类 号：R512.5[医药卫生—内科学]