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目的了解南昌地区儿童手足口病(HFMD)的病原学构成,为该地区HFMD的流行病学防控提供基础。方法收集2014年4至12月临床送检疑似HFMD患者咽拭子标本,运用荧光定量RT-PCR检测肠道病毒通用型(EV)、肠道病毒71型(EV71)和柯萨奇病毒A16型(CVA16)核酸;每季度按照等距抽样的方法选取一定量的非EV71、非CVA16型的其他EV标本,利用VP4区分型引物进行巢式PCR,产物通过测序和Gen Bank Blast比对进行分型鉴定。结果 2014年4至12月共检测到EV阳性病例19 059例,其中EV71、CVA16和其他EV检出率分别为23.22%(4 425/19 059)、11.36%(2 166/19 059)、65.42%(12 468/19 059)。其他EV抽样检测结果显示,第2季度CVA10占比最高,为24.39%(10/41),其次是CVA4和CVA6,各占19.51%(8/41);第3季度CVA6占比最高,为73.08%(95/130),其次是CVA10和CVA4,分别占11.54%(15/130)和6.15%(8/130);而第4季度CVA6占比94.74%(36/38),其次是CVA10占5.26%(2/38)。结论 2014年第2至第4季度非EV71、非CVA16型的其他EV检出率最高,且CVA6为2014年第3和第4季度南昌地区引起HFMD的优势病毒株。
Objective To understand the etiological composition of HFMD in Nanchang area and provide the basis for the epidemiological control of HFMD in this area. Methods Throat swab specimens from patients with suspected HFMD were collected from April to December 2014, and the total enterovirus (EV), enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) nucleic acid. A certain amount of non-EV71 non-CVA16 other EV specimens were selected quarterly according to the method of equidistant sampling. The nested PCR was performed using the VP4 differentiating primers. The products were sequenced and genotyped by Gen Bank Blast Identification. Results A total of 19 059 EV positive cases were detected from April to December 2014, of which EV71, CVA16 and other EV were detected in 23.22% (4 425/19 059), 11.36% (2 166/19 059) and 65.42 % (12 468/19 059). Other EV sampling results showed that CVA10 accounted for the highest proportion of 24.39% (10/41) in Q2, followed by CVA4 and CVA6, accounting for 19.51% (8/41) respectively. In Q3, CVA6 accounted for the highest proportion of 73.08 % (95/130), followed by CVA10 and CVA4, accounting for 11.54% (15/130) and 6.15% (8/130) respectively. In the fourth quarter, CVA6 accounted for 94.74% (36/38), followed by CVA10 5.26% (2/38). Conclusions In the second quarter to the fourth quarter of 2014, the detection rates of other EVs of non-EV71 and non-CVA16 were the highest, and CVA6 was the predominant strain of HFMD in Nanchang in the third and fourth quarters of 2014.