深圳市龙华区2018年手足口病病原学特征

目的 分析2018年深圳市龙华区手足口病病原学特点,为辖区手足口病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方法对哨点医院送检的223份手足口病临床诊断病例的肛拭子样本进行肠道病毒（Enteroviurs, EV）、肠道病毒A组71型（Enteroviurs 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）核酸检测,并对EV核酸阳性样本进行VP1区序列测定、同源性分析、亚型鉴定和系统进化分析。结果 实验室确诊病例有166例,阳性率为74.44%,构成比前3位的病毒亚型依次为CV-A6（43.37%）,CV-A16（31.33%）,CV-A10（13.86%）;2018年深圳市龙华区流行的主要肠道病毒中,EV-A71属于C4a进化分支;CV-A16（n=18）核苷酸同源性为89.0%~99.9%,氨基酸同源性为98.3%~99.7%,属于B1a（38.89%,7/18）和B1b（61.11%,11/18）进化分支;CV-A6（n=45）核苷酸同源性为95.1%~99.9%,氨基酸同源性为98.1%~99.0%,均属于D3进化分支;CV-A10（n=12）核苷酸同源性为93.5%~99.8%,氨基酸同源性为97.6%~99.7%,均属于C进化分支。结论 深圳市龙华区应进一步加强辖区手足口病监测,持续关注病原谱构成和重要病原体进化情况。

Characteristics of the pathogen for hand-foot-and-mouth disease in Longhua District,Shenzhen in 2018

Objective The analysis of the characteristics of the pathogen for hand-foot-and-mouth disease (HFMD) in Longhua District, Shenzhen in 2018 provides scientific basis for developing and modifying the prevention and control strategies for the disease in the jurisdiction. Methods Use fluorescent quantitation RT-PCR method to conduct nucleic acid test for enteroviurs(EV), enteroviurs A71(EV-A71), coxsackievirus A16(CV-A16), Coxsackievirus A6（CV-A6）, Coxsackievirus A10（CV-A10） of anal swab samples in 223 HFMD clinically diagnosed cases submitted by sentinel hospitals, while determine VP1 region sequence of Enteroviruses to analyze the subtype identification and the system evolution. Results There were 166 lab-confirmed cases with the positive rate of 74.44%, the first three pathogens in turn were CV-A6（43.37%）,CV-A16（31.33%）,CV-A10（13.86%）;The epidemic EV-A71 in Longhua District in 2018 was of the evolutionary branch of C4a. CV-A16 (n=18) was of the evolutionary branch of B1a（38.89%, 7/18） and B1b（61.11%,11/18）, and the homology of nucleotide and amino acid were 89.0%-99.9% and 98.3%-99.7% respectively. CV-A6（n=54） was of the evolutionary branch of D3, and the homology of nucleotide and amino acid were 95.1%-99.9% and 98.1%-99.0% respectively. While CV-A10（n=12） was of the evolutionary branch of C evolution, the homology of nucleotide and amino acid were 93.5%-99.8% and 97.6%-99.7% respectively. Conclusion The HFMD monitoring in the district shall be further strengthened, and continuous attention to pathogen spectrum composition and evolution of important pathogens in Longhua District, Shenzhen.