2022年嘉兴市手足口病病原构成及柯萨奇病毒CV-A4基因特征分析  

Pathogen spectrum of hand,foot and mouth disease and genetic characteristics of coxsackievirus A4 in Jiaxing City,2022

作　　者：吕沈聪[1] 吉季梅 陈中文[1] 燕勇[1] 宋银 朱国英[1] LYU Shencong;JI Jimei;CHEN Zhongwen;YAN Yong;SONG Yin;ZHU Guoying(Jiaxing Municipal Center for Disease Control and Prevention,Jiaxing,Zhejiang 314050,China)

机构地区：[1]嘉兴市疾病预防控制中心,浙江嘉兴314050

出　　处：《实用预防医学》2025年第3期297-302,共6页Practical Preventive Medicine

基　　金：嘉兴市科技计划项目(2023AD11049,2022AY30024)。

摘　　要：目的分析嘉兴市2022年手足口病的病原学组成,并对柯萨奇病毒A4型(coxsackievirus A4,CV-A4)的基因特征进行研究,为手足口病防控提供依据。方法对2022年嘉兴市采集的585份临床诊断为手足口病的儿童肛拭子和咽拭子样本进行核酸检测肠道病毒(enterovirus,EV)、肠道病毒71型(enterovirus A71,EV-A71)、柯萨奇病毒A组16型(coxsackievirus A16,CV-A16)、柯萨奇病毒A组6型(coxsackievirus A6,CV-A6)、柯萨奇病毒A组10型(coxsackievirus A10,CV-A10)。未分出型别的样本开展基因测序,对CV-A4样本构建进化树以及进行核苷酸和氨基酸分析。结果2022年共收集到585份手足口病临床样本,其中检出CV-A6302份,CV-A1691份,CV-A1071份,分别占51.62%、15.56%和12.14%;非EV-A71/CV-A6/CV-A10/CV-A16的EV阳性样本78份,占13.33%。选择非EV-A71/CV-A6/CV-A10/CV-A16的EV阳性样本中的部分标本开展基因测序,检出CV-A412份。序列分析发现嘉兴市检出的CV-A4均属于C2基因亚型,VP1基因核苷酸同源性为90.7%~100.0%,氨基酸同源性为98.0%~100.0%。与原型株High_Point(AY421762.1)VP1基因相比较,12份CV-A4 VP1序列共存在12个变异位点。结论引起嘉兴市2022年手足口病流行的病原中CV-A6最多,其次为CV-A16和CV-A10。其他样本中发现CV-A4血清型也是引起手足口病的常见型别,需要密切关注其分子流行特征。Objective To analyze the pathogenic composition of hand,foot and mouth disease(HFMD)in Jiaxing City in 2022,to study the genetic features of coxsackievirus A4(CV-A4),and to provide a basis for HFMD prevention and control.Methods A total of 585 anal and throat swabs collected from children clinically diagnosed with HFMD in Jiaxing City in 2022 were detected for enterovirus(EV),enterovirus A71(EV-A71),coxsackievirus A16(CV-A16),coxsackievirus A6(CV-A6)and coxsackievirus A10(CV-A10)nucleic acids.Gene sequencing was conducted on untyped samples,phylogenetic trees were constructed for CV-A4 samples,and nucleotide and amino acid sequence analyses were performed.Results A total of 585 clinical samples of HFMD were collected in 2022,and 302 CV-A6-positive samples,91 CV-A16-positive samples and 71 CV-A10-positive samples were detected,accounting for 51.62%,15.56%and 12.14%respectively.78 EV-positive samples that were non-EV-A71/CV-A6/CV-A10/CV-A16 genotypes were detected,accounting for 13.33%.Partial EV-positive samples that were non-EV-A71/CV-A6/CV-A10/CV-A16 genotypes were further subjected to gene sequencing,and 12 CV-A4-positive samples were detected.Sequence analysis displayed that all the CV-A4 strains detected in Jiaxing City belonged to subgenotype C2.The homologies of nucleotide sequences in viral capsid protein 1(VP1)region were 90.7%-100.0%,and the homologies of amino acid sequences were 98.0%-100.0%.Compared with CV-A4 prototype strain High_Point(AY421762.1),12 mutation sites of amino acid in VP1 region were identified in 12 CV-A4-positive samples.Conclusion The results showed that the prevalence of HFMD in Jiaxing City in 2022 was dominated by CV-A6,supplemented with CV-A16 and CV-A10.CV-A4 was also found to be the abundant strain among the untyped EV-positive samples.It is necessary to pay close attention to the molecular epidemiological characteristics of CV-A4.

关 键 词：手足口病 柯萨奇病毒A组4型 VP1区 基因型 

分 类 号：R725.1[医药卫生—儿科]