摘要
目的阐明2015年青岛地区手足口病（HFMD）流行特征和病原谱变化及3种主要肠道病毒分离株的基因特征。方法描述性分析2015年青岛地区手足口病病例的年龄、月份分布情况。用荧光RT-PCR法对2015年青岛地区HFMD患者咽拭子标本进行肠道病毒通用、肠道病毒71型、柯萨奇病毒A16型和柯萨奇病毒A6型，对阳性分离株进行VPl基因全长序列扩增及基因序列测定．以MEGA7．0软件进行系统发育及分子特征分析。结果2015年共检测1176例手足口病病例，其中肠道病毒阳性率为68．4％，主要病原构成为CA6（41．4％）、EV71（31．6％）和CAl6（15．3％）。5岁及以下儿童占总病例数的80．3％。CA6占3岁以下儿童肠道病毒构成的48．9％。其中EV71流行亚型为C4a，CAl6优势流行亚型为Blb。CA6优势流行亚型为A基因组。结论CA6、EV71和CAl6是导致2015年青岛地区手足口病流行的3种主要病原。2015年CA6超过EV71成为第一致病原，主要感染3岁以下儿童。EV71的流行亚型不变。CAl6优势流行亚型为Blb。CA6优势分离株主要是A基因组。并且内部进化为多个小的分支，与A基因组内部的2013年青岛分离株处于不同分支。
Objective To investigate the etiology of hand, foot and mouth disease （HFMD） and to analyze the genetic characteristics of three prevalent enteroviruses in Qingdao in 2015. Methods City- wide surveillance data in 2015 were used to analyze the epidemiological characteristics of HFMD in Qingdao. RNA samples extracted from throat swab of HFMD cases were examined for general enteroviruses （EVs） such as enterovirus 71 （EV71）, coxsackievirus AI6 （CAI6） and CA6 by real-time RT-PCR. Full-length VP1 genes of EV-positive specimens were amplified and sequenced. Sequencing results were phylogenetically analyzed using MEGA 7.0 software package. Results A total of 804 patients with HFMD were identified from 1 176 patients in 2015. CA6 （41.4%）, EV71 （31.6%） and CA16 （15.3%） were the predominant EVs causing HFMD. Children 5 years of age and under accounted for 80.3% of the 804 HFMD cases. CA6 was responsible for 48.9% of HFMD cases in children under 3 years old. The epidemic subtypes of EV71 and CA16 in Qingdao were CAa and Blb, respectively. Twenty-eight randomly selected CA6 strains were all classified into type A genome. Conclusion CA6, EVT1 and CA16 were the prevalent pathogens causing HFMD in Qingdao in 2015. CA6 became the most predominant pathogen, mainly targeting children under 3 years old. CAa remained the prevailing subtype of EV71, while different from the co-prevalence of Bla and Bib subtypes in the past, Blb became the predominant subtype of CA16. CA6 strains circulating in Qingdao in 2015 mainly belonged to type A genome and evolved into multiple smaller branches. However, CA6 strains isolated in Oingdao in 2015 and 2013 located in different branches.
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2017年第12期903-909,共7页
Chinese Journal of Microbiology and Immunology
关键词
手足口病
肠道病毒
系统进化分析
VPl基因
Hand, foot and mouth disease
Enterovirus
Phylogenetic analysis
VP1 gene
作者简介
汪照国，Email：wzg-003@163．com，电话：0532．85651204
