【摘要】 目的了解2014年湖南省郴州市手足口病病原谱和优势毒株的基因特征,为郴州市手足口病的防治提供科学依据。方法采集2014年郴州市手足口病监测病例标本,应用荧光PCR方法检测HEV71、CVA16、CVA6、CVA10和其他肠道病毒。未能分型的其他HEV阳性标本进行RT-PCR扩增,通过基因测序鉴定病原体型别。结果共检测854份标本,阳性检出率为55.62%。病原谱中已知型别的前5位分别为CVA16(28.00%)、HEV71(25.05%)、CVA6(13.89%)、CVA10(12.42%)、CVB5(0.84%),仍有20.63%的其他HEV未分型。不同月份、不同年龄组、不同病例类型的病原体型别的构成比差异均有统计学意义(均P<0.05);男女性别的病原体型别的构成比差异无统计学意义(P>0.05)。郴州市的6株CVA16分离株均为B1基因亚型。结论 2014年郴州市的手足口病流行毒株显示了一定的季节性分布特征,主要的几种优势毒株相互交替流行,并与人群的免疫基础相互作用体现在月份和年龄组的分布上。郴州市的CVA16分离株与国内流行株的基因型别一致。更多还原

【Abstract】 Objective To study the etiology spectrum of hand,foot and mouth disease( HFMD) and genetic characteristics of coxasckievirus A16 in Chenzhou City,Hunan Province,2014,and provide scientific data for HFMD control and prevention.Methods Clinical specimens of HFMD cases were collected from the sentinel hospitals of Chenzhou City in 2014. Viral RNA of human enterovirus type A71( HEV71),coxasckievirus A16( CVA16),A6( CVA6),A10( CVA10) and other enterovirus( HEV) were detected by fluorescent PCR. The genotyping of HEV were performed by sequencing of the VP1 regions. Phylogenetic analysis was performed by MEGA6. Results A total of 854 samples were detected,and 55. 62% were enterovirus-postive,with the most frequent serotypes of CVA16( 28. 00%),HEV71( 25. 05%),CVA6( 13. 89%),CVA10( 12. 42%) and CVB5( 0. 84%)20. 63% enterovirus had unknown genotypes. Significant differences were found in the constituent ratios of various pathogens among different months,age and patients,but not between genders( P>0. 05). Gene sequencing of 6 CVA16 isolates illustrated that the genotyp were all subtype B1. Conclusions The occurrence of HFMD in Chenzhou City in 2014 has obvious seasonal features.The main dominant pathogens are prevalent alternately. Their interaction with human immune is reflected in their distribution in months and age. The CVA16 isolates in Chenzhou City are homologous to strains circulating in other areas of mainland China.更多还原