目的 探讨2017—2021年安阳市龙安区手足口病(HFMD)病原学变化。方法 采集2017年1月至2021年12月龙安区某市级医疗机构门诊及住院的HFMD患儿粪便标本655份和咽拭子标本345份,采用荧光定量RT-PCR法对标本进行肠道病毒核酸检测,根据标本检测结果分析病原学变化情况。结果 2017—2021年共检测1 000份标本,近5年手足口病病原学阳性检出率为27.56%~93.18%,每年不同型别病原学构成比不同,差异均有统计学意义(P值均<0.05)。其中2017年以CVA6型为主,2018年以EV71型为主,2019年以其他肠道病毒为主,2020年与2021年均以CVA16为主。男性患儿不同型别病毒的阳性检出率均略高于女性。0~3岁儿童标本,病原学阳性406份,占88.26%;10~12岁儿童标本,病原学阳性1份,仅占0.22%。655份粪便标本中,病原学阳性356份,检出率为54.35%,其中CVA16型占比最高,为32.58%;345份咽拭子标本中,病原学阳性104份,检出率为30.14%,其中EV71型、CVA16型占比较高,均为34.62%。不同类型的标本,手足口病肠道病毒阳性检出率差异有统计学意义(χ2=53.304,P<0.001)。结论 龙安区手足口病肠道病毒阳性检出率不断上升,其中CVA16型和EV71型肠道病毒为主要病原体。
Abstract
Objective To explore the etiological changes of hand-foot-mouth disease (HFMD) in Long'an District of Anyang City from 2017 to 2021. Methods From January 2017 to December 2021,655 fecal specimens and 345 throat swab specimens of outpatient and inpatient children with HFMD were collected from a municipal medical institution in Long'an District.The samples were detected by fluorescence quantitative RT-PCR,and the pathogenic changes were analyzed according to the test results of specimens. Results A total of 1 000 samples were detected from 2017 to 2021,and the positive detection rate of etiology of HFMD in recent 5 years was 27.56%-93.18%.The proportion of different types of pathogens was different in each year,and the differences were statistically significant (all P < 0.05).Among them,CVA6 was dominant in 2017,EV71 was dominant in 2018,other enteroviruses were dominant in 2019,and CVA16 was dominant in 2020 and 2021.The positive detection rate of different types of viruses of the male children was slightly higher than that of the female children.There were 406 samples of children aged 0-3 years,accounting for 88.26%,and 1 sample of children aged 10-12 years,accounting for only 0.22%.Of the 655 fecal specimens,356 were pathogenic positive,with a detection rate of 54.35%,of which CVA16 accounted for the highest proportion of 32.58%.Among 345 throat swab specimens,104 samples were positive for pathogens,and the detection rate was 30.14%,among which EV71 and CVA16 were relatively high,both accounting for 34.62%.There were significant differences in the positive detection rate of enterovirus in different types of specimens (χ2=53.304,P<0.001). Conclusion The positive detection rate of enterovirus in HFMD increased continuously in Long'an District,among which CVA16 and EV71 enteroviruses were the main pathogens.
关键词
手足口病 /
肠道病毒 /
粪便 /
咽拭子
Key words
Hand-foot-mouth disease /
Enterovirus /
Feces /
Throat swab
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