2011-2012年杭州市手足口病的病原构成及肠道病毒71型的分子流行病学特征

摘要

Objective To understand the etiological characteristics of hand foot and mouth disease (HFMD) and the molecular epidemiological characteristics of enterovirus 71 (EV71) in Hangzhou.Methods Stool specimens and related clinical data were collected from 210 suspected HFMD cases.Real-time RT-PCR was conducted to detect EV71 and coxsackie virus A16 (Cox A16).The positive specimens were used for VP1 gene sequencing.Results The real-time RT-PCR assay indicated that the positive rates of EV71,Cox A16 and other enterovirus in 210 specimens from suspected HFMD cases were 60.95％ (128/210),21.43％ (45/210) and 9.05％ (19/210) respectively.The sequence analysis showed that the VP1 gene of 10 EV71 strains shared homology of 95.7％-98.0％ with JX509922,JX509924,JX509926,JX509927,JX509928 and JX509929 strains.The phylogenetic analysis revealed that 10 EV71 strains belonged to subtype C4a.Conclusion EV71 and Cox A16 were the major pathogens of HFMD in Hangzhou.It is necessary to improve the surveillance of EV71 and Cox A16,especially EV71,for the better prevention and control of HFMD.%目的 探讨杭州市手足口病病原谱构成及其肠道病毒71型(human enterovirus 71,EV71)的分子特征.方法 采集210例疑似手足口病感染者的粪便标本及其相关临床资料,采用实时荧光定量反转录聚合酶链反应(real time RT-PCR)方法进行初步检测,利用RT-PCR扩增部分EV71和柯萨奇病毒A组16型(coxsackievirus A16,Cox A16)阳性样本VP1基因区并测序分析.结果 荧光定量RT-PCR检测表明,210例疑似感染者的粪便中,EV71、Cox A16和其他肠道病毒的阳性率分别为60.95％ (128/210)、21.43％ (45/210)和9.05％ (19/210).10株EV71病毒VP1区核酸序列与JX509922、JX509924、JX509926、JX509927、JX509928和JX509929的同源性最高为95.7％～98.0％,且均属于EV71中C4a亚型.结论 EV71和Cox A16是杭州市儿童手足口病的主要病原体.因此加强EV71和Cox A16的监测特别是EV71的检测,有助于更好地预防和控制手足口病.