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目的 研究2015-2018年上海市普陀区手足口病病原谱,并对鉴定为柯萨奇病毒A6型(coxsackievirus A6,CVA6)的VP1基因特征进行分析,以掌握本地区CVA6的分子流行病学特征.方法 采用实时荧光定量PCR法对收集的标本进行肠道病毒通用基因和分型基因检测,对鉴定为CVA6型病毒进行VP1基因测序并分析.结果 2015-2018年共检测943份手足口标本,肠道病毒通用基因阳性522份(55.36％),其中CVA6阳性332份(63.60％),柯萨奇病毒A16型(coxsackievirus A 16,CVA16)阳性1 10份(21.07％),肠道病毒71型(enterovirus 71,EV71)阳性56份(10.73％),柯萨奇病毒A10型(coxsackievirus A10,CVA10)阳性1 1份(2.1 1％),其他肠道病毒13份(2.49％).20株CVA6型病毒的VP1基因之间核苷酸同源性为92.9％-100.0％,氨基酸同源性为98.4％～100.0％,都属于D3亚型.结论 2015-2018年上海市普陀地区引起手足口病的病原体主要有CVA6、CVA16、EV71和CVA10,CVA6已成为上海市普陀地区手足口病的主要病原体,其中优势基因型为D3亚型.“,”Objective To investigate the pathogenic spectrum of hand,foot,and mouth disease in Putuo district of Shanghai from 2015 to 2018,and to analyze the genetic characteristics of the VP 1 gene of coxsackievirus A6 (CVA6),so as to understand the molecular epidemiological characteristics of CVA6 in this region.Methods Real-time RT-PCR methods were used to detect enteroviruses (EV) and virus genotypes in the collected samples.The VP1 genes of identified CVA6 were sequenced and analyzed.Results From 2015 to 2018,942 specimens of hand,foot,and mouth disease were analyzed among which 522 (55.36％) were EV positive,332 (63.60％) were coxsackievirus A6,110 (21.07％) were coxsackievirus A16 (CVA16),56 (10.73％) were enterovirus 71 (EV71),11 (2.11％) were coxsackievirus A10 (CAV10)and 13 (2.49％) were other enteroviruses.The nucleotide and amino acid sequence similarities of VP1 gene in 20 CVA6 strains ranged from 92.9％ to 100.0％ and 98.4％ to 100.0％,respectively.All strains belonged to genotype D cluster 3.Conclusions The pathogens causing hand,foot,and mouth disease in Putuo district of Shanghai from 2015 to 2018 were mainly CVA6,CVA16,EV71 and CVA10.CVA6 was the predominant pathogen of hand,foot,and mouth disease in Putuo district of Shanghai,especially D3 sub-genotype.