目的 了解2011年广东省深圳市手足口病的病原构成情况,为科学防治手足口病提供实验室依据。 方法 对2011年哨点医院上送的临床诊断为手足口病病例的粪便标本,先用荧光RT-PCR进行肠道病毒71型(Enterovirus 71, EV71)、柯萨奇病毒A组16型(Cox A16)以及肠道病毒核酸检测,再对肠道病毒核酸检测为阳性的标本进一步用巢式RT-PCR(RT-Nested PCR)的方法扩增片段,PCR产物测序后,通过Blast软件进行分型。 结果 409例病例中,5岁以下占93.64%,主要集中在1~2岁年龄组;5-9月为发病高峰期,11月出现一个小高峰。EV71阳性142例,构成比为43.83%;Cox A16阳性53例,构成比为16.36%;非EV71、非Cox A16的其他肠道病毒阳性129例,构成比为39.81%;129例其他肠道病毒阳性标本中,95例的序列测定结果Cox A6有69例,构成比为72.63%;Cox A10有12例,构成比12.63%; Cox A12、Cox A9、Cox A2、Cox A4、Cox B2、Cox B4、ECHO2、ECHO14和ECHO18各有少部分病例。 结论 2011年深圳市手足口病最主要病原为EV71,Cox A6次之,Cox A16位居第3位,应加强对手足口病的病原学监测。
Objective To study the etiology of hand, foot and mouth disease in Shenzhen, Guangdong province, in 2011, and provide laboratory evidence for the prevention and treatment of HFMD. Methods Stool samples were collected from HFMD cases clinically diagnosed in sentinel surveillance hospitals in Shenzhen to detect viral nucleic acid of Enterovirus 71(EV71), Coxakivirus A16(Cox A16) and other enteroviruses by using fluorescent RT-PCR. The amplification of the viral nucleic acid fragments of positive samples were conducted by using RT-nested PCR, then the amplification products sequencing was done. The typing of the viruses was conducted by using Blast software. Results Among 409 HFMD cases,93.64% were under 5 years old, and most of them were aged 1-2 years. The incidence peak occurred during May-September and sub-peak in November. There were 142 EV71 infections(43.83%),53 Cox A16 infections(16.36%) and 129 other enteroviruses infections(39.81%). Among 95 of the 129 other enteroviruses infections,69 were Cox A6 infections(72.63%),12 were Cox A10 infections(12.63%). The remaining cases were Cox A12, Cox A9, Cox A2, Cox A4, Cox B2, Cox B4, ECHO2, ECHO14 and ECHO18 infections. Conclusion The major pathogen of HFMD was EV71 in Shenzhen in 2011, followed by Cox A6 and Cox A16. It is necessary to strengthen the etiological surveillance of HFMD.