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目的了解2011年广东省深圳市手足口病的病原构成情况,为科学防治手足口病提供实验室依据。方法对2011年哨点医院上送的临床诊断为手足口病病例的粪便标本,先用荧光RT-PCR进行肠道病毒71型(Enterovirus 71,EV71)、柯萨奇病毒A组16型(Cox A16)以及肠道病毒核酸检测,再对肠道病毒核酸检测为阳性的标本进一步用巢式RT-PCR(RT-Nested PCR)的方法扩增片段,PCR产物测序后,通过Blast软件进行分型。结果 409例病例中,5岁以下占93.64%,主要集中在1～2岁年龄组;5-9月为发病高峰期,11月出现一个小高峰。EV71阳性142例,构成比为43.83%;Cox A16阳性53例,构成比为16.36%;非EV71、非Cox A16的其他肠道病毒阳性129例,构成比为39.81%;129例其他肠道病毒阳性标本中,95例的序列测定结果 Cox A6有69例,构成比为72.63%;Cox A10有12例,构成比12.63%;Cox A12、Cox A9、Cox A2、Cox A4、Cox B2、Cox B4、ECHO2、ECHO14和ECHO18各有少部分病例。结论 2011年深圳市手足口病最主要病原为EV71,Cox A6次之,Cox A16位居第3位,应加强对手足口病的病原学监测。
Objective To understand the etiopathogenisis of hand, foot and mouth disease in Shenzhen City, Guangdong Province in 2011 and to provide a laboratory basis for the scientific prevention and treatment of hand, foot and mouth disease. Methods The stool specimens sent from the sentinel hospital for clinical diagnosis of hand-foot-mouth disease in 2011 were firstly tested by RT-PCR for Enterovirus 71 (EV71), Coxsackie A (type 16) (Cox A16) and enterovirus nucleic acid detection, and then positive for enterovirus nucleic acid specimens were further amplified by nested RT-PCR (RT-Nested PCR) method, PCR products were sequenced by Blast software . Results Among the 409 cases, 93.64% were under 5 years of age, mainly in the age group of 1 to 2 years. The incidence peak appeared in May to September and a small peak in November. The positive rate of EV71 was 142 (43.83%). The positive rate of Cox A16 was 53.3% (16.36%). The positive rates of other enteroviruses of non-EV71 and non-Cox A16 were 129 and 39.81% Among the positive samples, the sequence of Cox A6 was found in 69 cases with a ratio of 72.63%; Cox A10 was found in 12 cases with a ratio of 12.63%; Cox A12, Cox A9, Cox A2, Cox A4, Cox B2, Cox B4 , ECHO2, ECHO14 and ECHO18 each have a small number of cases. Conclusion The most common pathogen of HFMD in Shenzhen in 2011 was EV71, Cox A6 was the second, Cox A16 was the third, and etiopathogenisis should be strengthened.