【摘要】 目的了解2016-2017年盐城地区手足口病肠道病毒病原谱分布情况,并对鉴定为EV71型肠道病毒VP1基因进行分子进化特征分析。方法通过实时荧光RT-PCR方法对2016-2017年盐城市疑似手足口病咽肛拭子标本进行肠道病毒阳性标本的筛选,对非EV71非CVA16其他肠道病毒进行分子分型,RT-PCR扩增EV71型肠道病毒VP1基因片段并测序,采用相应的生物信息软件进行核苷酸及氨基酸序列比对及基因种系进化特征分析。结果 2016-2017年盐城市手足口病原主要以其他肠道病毒为主,EV71和CVA16仍占有一定比例。共有12个基因型肠道病毒的流行,分别为EV71、CVA16、CVA2、CVA4、CVA6、CVA8、CVA9、CVA10、ECHO3、ECH09、ECHO13、CVB4。其中,CVA6型为绝对优势流行株。遗传进化树显示,盐城地区EV71型代表株属于C4基因型C4a基因亚群的毒株,盐城代表株在C4a基因亚群进化谱中进化为两个主流分支。其中,盐城地区2016年8株代表株和2017年26株共34株处于较强传播链中。重症病例EV71型代表株在进化树呈散在性分布,没有单独聚集成簇。结论 2016-2017年盐城市手足病病原有多种基因型的肠道病毒同时流行,CVA6是优势病原体,EV71型属于C4基因型C4a基因亚群的毒株,EV71型肠道病毒仍是引起重症的主要型别。更多还原

【Abstract】 Objective To study the pathogenic spectrum of the enterovirus for hand,foot and mouth disease( HFMD) in Yancheng from 2016 to 2017,and analyze the VP1 genetic characteristics of molecular evolution in identified enterovirus 71.Methods Throat swabs and anal swabs of suspected HFMD cases in Yancheng from 2016-2017 were detected through real-time RT-PCR,and the strains of the non-EV71 and non-CVA16 enterovirus were identified by molecular subtyping. The VP1 gene sequences of EV71 were amplified through one-step RT-PCR method and were sequenced. Sequence alignment and genetic characteristics analysis of amino acid and nucleotide sequences were conducted by the corresponding bioinformatics software. Results The non-EV71 and non-CVA16 enterovirus were the main epidemic pathogens causing HFMD in Yancheng between 2016 and 2017,followed by EV71 and CVA16 enterovirus. The strains of the enteroviruses were classified into twelve genotypes( EV71,CVA16,CVA2,CVA4,CVA6,CVA8,CVA9,CVA10,ECHO3,ECH09,ECHO13,CVB4),among which coxsackievirus A6 was absolutely dominant. Phylogenetic trees analysis showed that the representative strains of EV71 in Yancheng belonged to subgenotype C4a,which had evolved into two mainstream branches,and eight representative strains in 2016 and twenty-six representative strains in 2017 were in the strong transmission chain. The representative strains of EV71 in severe cases were scattered in the evolutionary tree. Conclusion The spectrum of pathogens causing HFMD epidemics in Yancheng from 2016 to 2017 had a variety of genotypes and coxsackievirus A6 is predominant. The representative strains of EV71 belonged to subgenotype C4a and were also the main genotype of severe cases.更多还原