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目的探讨福州地区手足口病(HFMD)病原谱构成及肠道病毒71型(EV71)的基因特征。方法采集临床诊断为手足口病患者的咽拭子或肛拭子标本1 235例,通过real-time PCR法确定所有标本的肠道病毒型别。获取EV71型分离株,并对VP1基因片段进行测序,利用DNAStar和Mega 5.1软件进行核苷酸、氨基酸同源性分析并构建系统发生树。结果共检测出932份肠道病毒阳性标本,其中EV71、柯萨奇A16型(Cox A16)和其他肠道病毒的阳性率分别为34.5%(426/1 235)、9.8%(121/1 235)、31.2%(385/1 235)。40株EV71型分离株的VP1基因核苷酸同源性为91.0%~100.0%,氨基酸同源性为95.0%~100.0%。40株病毒基因在系统发生树上与C4基因亚型最为相近,属于C4a基因亚型。结论 EV71是引起福州地区手足口病流行的主要病原体,EV71型病毒株均属于C4a基因亚型,与同期中国大陆EV71参考株基因型相似。
Objective To investigate the genetic makeup of HFMD and the genetic characteristics of enterovirus 71 (EV71) in Fuzhou. Methods A total of 1 235 throat swabs or rectal swabs were collected from patients with clinically diagnosed hand-foot-mouth disease. The enterovirus types of all specimens were determined by real-time PCR. The EV71 isolate was obtained and the VP1 gene fragment was sequenced. Nucleotide and amino acid homology analysis was performed using DNAStar and Mega 5.1 software and phylogenetic tree was constructed. Results A total of 932 positive samples of enterovirus were detected. The positive rates of EV71, Cox A16 and other enteroviruses were 34.5% (426/1 235), 9.8% (121/1 235 ), 31.2% (385/1 235). The VP1 gene of 40 EV71 isolates had nucleotide homology of 91.0% -100.0% and amino acid homology of 95.0% -100.0%. 40 virus genes in the phylogenetic tree and C4 gene subtype most similar, belonging to the C4a gene subtype. Conclusion EV71 is the major causative agent of HFMD in Fuzhou area. EV71 strain belongs to C4a genotype, which is similar to the genotype of EV71 reference strain in mainland of China.