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目的为了解排除流感的儿童流感样病例的肠道病毒感染状况,以减少对手足口病患儿的误诊,提高儿童流感样病例(ILI)标本的采集质量。方法随机抽取88份已排除流感的儿童流感样病例标本,以实时荧光RT-PCR法进行人肠道病毒(EV)核酸检测并分型。对EV核酸阳性率按季节、年龄、性别和采样人进行分类统计分析。结果检出EV71型核酸阳性6份、CoxA6型2份、CoxA10型1份、其它型别17份,EV核酸总阳性率为29.55%(26/88)。EV核酸阳性率由高到低的季节依次为:2012年第四季度(47.83%)、2013年二季度(40.00%)、2012年三季度(20.83%)和2013年一季度(9.52%)。5岁以下与6岁以上病例标本的EV核酸阳性率依次为36.76%(25/68)和5.00%(1/20)。男女病例标本的EV核酸阳性率分别为30.91%(17/55)和27.27%(9/33)。医生与护士采集标本的EV核酸阳性率分别为9.09%(3/33)和41.82%(23/55)。结论儿童流感样病例应同手足口病进行鉴别诊断,流感监测哨点医院应提高病例的样本采集质量。
Objective To understand the status of enterovirus infection in children with influenza-like illness excluding influenza and to reduce the misdiagnosis of children with hand-foot-mouth disease and to improve the collection quality of childhood flu-like illness (ILI) specimens. Methods A total of 88 samples of influenza-like illness were collected from children with influenza, and the human enterovirus (EV) nucleic acid was detected by real-time fluorescence RT-PCR. The positive rates of EV nucleic acids were classified and analyzed by season, age, gender and sampler. Results Six positive samples of EV71, two copies of CoxA6, one copy of CoxA10 and 17 copies of other types were obtained. The total positive rate of EV nucleic acid was 29.55% (26/88). The sequences of the highest positive rate of EV nucleic acid were as follows: the fourth quarter of 2012 (47.83%), the second quarter of 2013 (40.00%), the third quarter of 2012 (20.83%) and the first quarter of 2013 (9.52%). The positive rate of EV nucleic acid was 36.76% (25/68) and 5.00% (1/20) in patients under 5 years old and 6 years old respectively. The EV positive rates of male and female cases were 30.91% (17/55) and 27.27% (9/33) respectively. The positive rates of EV nucleic acids collected by doctors and nurses were 9.09% (3/33) and 41.82% (23/55), respectively. Conclusions Children with influenza-like illness should be differentiated from hand-foot-mouth disease. Influenza surveillance sentinel hospitals should improve the quality of sample collection.