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目的掌握2012年度北京大学北京地坛医院教学医院手足口病住院患儿的病原体分布情况与变化趋势,为手足口病的防治提供科学依据。方法本研究收集北京大学北京地坛医院教学医院儿科2012年度211例手足口病住院患儿的咽拭子标本,提取病毒RNA,采用实时荧光聚合酶链反应(RT-PCR)法,进行肠道病毒(EV)通用型、肠道病毒71(EV71)型和柯萨奇A16(CoxA16)型肠道病毒核酸检测。EV(+)标本判为EV阳性,EV(+)EV71(+)标本判为EV71阳性,EV(+)CoxA16(+)标本判为CoxA16阳性,EV(+)且EV71(-)CoxA16(-)标本判为非EV71非CoxA16型肠道病毒阳性。结果 2012年度211例本院手足口病住院患儿中EV阳性标本共118例,占55.92%。病毒分型结果显示,非EV71非CoxA16型肠道病毒阳性标本共46例,占22.81%;EV71阳性标本共45例,占21.32%;CoxA16阳性标本共27例,占12.80%。病原学分布分析结果显示,5~7月份为发病高峰期;不同年龄、性别组患儿之间病原体构成无显著差异;患儿入院前3 d肠道病毒检出率较3 d后高;不同型别肠道病毒感染患儿之间平均住院天数差异无统计学意义。结论 2012年度本院手足口病住院患儿不同型别EV感染率由高到低依次为:非EV71非CoxA16型肠道病毒、EV71、CoxA16,非EV71非CoxA16型肠道病毒感染率较往年具有升高趋势,尚待进一步研究。
Objective To grasp the distribution and trend of pathogens in hand, foot and mouth disease inpatients of Beijing Ditan Hospital Teaching Hospital of Peking University in 2012, and provide a scientific basis for the prevention and treatment of hand-foot-mouth disease. Methods In this study, 211 cases of throat swabs in hospitalized children with hand-foot-mouth disease were collected from Pediatric Department of Teaching Hospital of Beijing Ditan Hospital in Peking University in 2012. The viral RNA was extracted and real-time fluorescent polymerase chain reaction (RT-PCR) (EV), enterovirus 71 (EV71), and CoxA16 enterovirus nucleic acids. The EV (+) EV71 (+) specimen was EV71 positive, EV (+) CoxA16 (+) specimen was CoxA16 positive, EV (+) and EV71 (-) CoxA16 (- ) Specimens were non-EV71 non-CoxA16 enterovirus positive. Results A total of 118 EV positive specimens were found in 211 hospitalized HFMD patients in 2012, accounting for 55.92%. The results of virus typing showed that non-EV71 non-CoxA16 enterovirus positive specimens were 46 cases, accounting for 22.81%; EV71 positive specimens were 45 cases, accounting for 21.32%; CoxA16 positive specimens were 27 cases, accounting for 12.80%. The etiological distribution analysis showed that the incidence peaked from May to July; there was no significant difference in the pathogen composition between children of different ages and sex groups; the detection rate of enterovirus in children 3 d before admission was higher than that in the third day; There was no significant difference in average length of stay between children with type enterovirus infection. CONCLUSIONS: The prevalences of EV in different types of hospitalized HFMD patients in 2012 are: non-EV71 non-CoxA16 enterovirus, EV71, CoxA16, non-EV71 non-CoxA16 enterovirus infection rate than in previous years Rising trend, pending further study.