深圳市龙华区疱疹性咽峡炎病原学特点

目的 分析深圳市龙华区疱疹性咽峡炎病原学特点,为辖区疱疹性咽峡炎预防和控制策略的制定和调整提供科学依据。方法 采用荧光定量RT-PCR方法对手足口病哨点医院送检的疱疹性咽峡炎临床诊断病例的肛拭子样本进行肠道病毒（enteroviurs,EVs）、肠道病毒71型（enteroviurs -A71,EV-A71）和柯萨奇病毒A组16型（coxsackievirus A16, CV-A16）核酸检测,并对非EV-A71非CV-A16的其他肠道病毒的VP1区序列进行测定,亚型鉴定和系统进化分析。结果 临床诊断病例肛拭子样本38份中实验室确诊病例29例,确诊率为76.32%（29/38）,病原谱监测共发现有9种人肠道病毒（EV-A71、CV-A16、CV-A6、CV-A10、CV-A2、CV-A4、CV-A5、Echo9和CV-B4）,其中构成比占前3位的病原体分别CV-A2（24.14%,7/29）、CV-A10（20.69%,6/29）和CV-A6（17.24%,5/29）。实验室确诊病例中,男性有19例(65.52%,19/29）,女性有10例(34.48%,10/29）;3岁以下儿童25例（86.21%,25/29）。病例发病时间主要集中在4—6月份,有23例（占79.31%,23/29）。系统进化树分析结果显示,CV-A6属于D3进化分支,CV-A10（66.67%）属于C进化分支,CV-A2属于D进化分支。结论 深圳市龙华区应开展疱疹性咽峡炎常规监测,重点关注3岁以下儿童,并关注病原谱构成及重要病原体进化情况。

Characteristics of pathogen for herpangina in Longhua District,Shenzhen

Objective To analyse the characteristics of the pathogen for herpangina(HA) to provides scientific basis for developing and modifying the prevention and control strategies for the disease in Longhua District, Shenzhen.Methods Use fluorescent quantitation RT-PCR method to conduct nucleic acid test for enteroviurs(EV), enteroviurs A71, coxsackievirus A16 of anal swab samples in Herpangina clinically diagnosed cases submitted by sentinel hospitals, while determine other non-EVA71 and non-CV-A16 enteroviruses VP1 region sequence to analyze the subtype identification and the system evolution.Results There were 29 lab-confirmed cases with the positive rate of 76.32% (29/38). Pathogenic spectrum monitoring were found nine enterovirus including EV-A71, CV-A16, coxsackievirus A6, coxsackievirus A10, coxsackievirus A2, coxsackievirus A4, coxsackievirus A5, echovirus 9 and coxsackievirus B4. The proportion of the former three pathogens, coxsackievirus A2（24.14%,7/29）, coxsackievirus A10（20.69%,6/29） and coxsackievirus A6（17.24%,5/29）. For the lab-confirmed cases, the number of male (65.52%,19/29) was higher than that of female (34.48%,10/29), and 25 cases of children under 3 years old (86.21%, 25/29). Cases (79.31%, 23/29) were mainly concentrated from April to June. Phylogenetic tree analysis showed that coxsackievirus A6 was of the evolutionary branch of D3, coxsackievirus A10（66.67%）was of the evolutionary branch of C, coxsackievirus A2 was of the evolutionary branch of D.Conclusion The herpangina surveillance in the district should develop. The special attention shall be paid to the children under the age of three years old as well as the pathogen spectrum composition and important pathogen evolution situation in Longhua District, Shenzhen.