盐城市2013年手足口病病原学特征分析

摘要

目的：对盐城地区2013年手足口病患儿及其临床重症病例进行病原学特征分析。方法：采集手足口病患儿咽、肛拭子，用肠道病毒实时荧光RT-PCR，对其病毒核酸进行肠道病毒检测定型。结果：491例（重症26例）患儿采集咽、肛拭子标本中，共检出肠道病毒核酸阳性193例（39.31%）中，EV71型35例（18.13%）；CVA16型35例（18.13%）， CVA6型96例（49.74%），其他未分型27例（13.99%）。临床重症病例14例中，EV71型3例，CVA16型0例，CVA6型9例，未分型2例，CVA6与EV71、CVA16三者发病比较，差异有统计学意义（χ2=8.0，P<0.01）。结论：检测的以往常见的EV71和CVA16型转变为CVA6型，它是引起重症病例的主要病原体，也是区域性手足口病的重要病原。%Objective: To investigate the etiology of patients with hand-foot-and-mouth disease and clinical severe symptoms in Yancheng Area in 2013. Methods: Enterovirus RNA of 491 patients with HFMD were isolated by collecting throat and rectal swabs from them and “Universal, EV71, CVA16 and CVA6 types”were detected by using real-time fluo-rescent quantitative RT-PCR. Results:(1) A total of 193 enterovirus RNA–positive samples were detected, with a positive detection rate of 39.31%. Among them, the positive samples of CVA16, EV71 and CVA6 were 35(18.13%), 35(18.13%) and 96(49.74%) respectively, while in the untyped cases was 27(13.99%). (2) 14 enterovirus RNA-positive samples out of the 26 clinically severe disease patients were tested. Among these cases, 3(21.43%) EV71-positive, 0 CA16-positive samples and 9 ( 64 . 29%) CVA6 were identified while the untyped samples were 2 ( 13 . 99%) . Conclusions:The main pathogens of the hand-foot-and-mouth disease in children were basically detected by EV71 and CVA6 into which CVA16 had transformed in Yancheng Area in 2013. CVA6 was the major pathogen that could cause severe disease. Further tests and observations were needed to identify whether CVA6 had been the major pathogen of the HFMD in Yancheng Area.