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目的了解2014年湖南省郴州市手足口病病原谱和优势毒株的基因特征,为郴州市手足口病的防治提供科学依据。方法采集2014年郴州市手足口病监测病例标本,应用荧光PCR方法检测HEV71、CVA16、CVA6、CVA10和其他肠道病毒。未能分型的其他HEV阳性标本进行RT-PCR扩增,通过基因测序鉴定病原体型别。结果共检测854份标本,阳性检出率为55.62%。病原谱中已知型别的前5位分别为CVA16(28.00%)、HEV71(25.05%)、CVA6(13.89%)、CVA10(12.42%)、CVB5(0.84%),仍有20.63%的其他HEV未分型。不同月份、不同年龄组、不同病例类型的病原体型别的构成比差异均有统计学意义(均P<0.05);男女性别的病原体型别的构成比差异无统计学意义(P>0.05)。郴州市的6株CVA16分离株均为B1基因亚型。结论 2014年郴州市的手足口病流行毒株显示了一定的季节性分布特征,主要的几种优势毒株相互交替流行,并与人群的免疫基础相互作用体现在月份和年龄组的分布上。郴州市的CVA16分离株与国内流行株的基因型别一致。
Objective To understand the genetic characteristics of HFMD and dominant strains in Chenzhou City of Hunan Province in 2014 and provide a scientific basis for prevention and treatment of HFMD in Chenzhou City. Methods The specimens of HFMD in Chenzhou were collected in 2014 and HEV71, CVA16, CVA6, CVA10 and other enteroviruses were detected by fluorescence PCR. Other HEV-positive specimens that failed to genotype were amplified by RT-PCR and pathogen types were identified by gene sequencing. Results A total of 854 specimens were detected, the positive detection rate was 55.62%. The top five known types of pathogens were CVA16 (28.00%), HEV71 (25.05%), CVA6 (13.89%), CVA10 (12.42%) and CVB5 (0.84% Not classified. There were significant differences in the constituent ratios of pathogens in different months, different age groups and different case types (both P <0.05). There was no significant difference in the constituent ratio of the pathogen types between men and women (P> 0.05). Six strains of CVA16 in Chenzhou City were all B1 gene subtypes. Conclusions In 2014, the epidemic strains of HFMD in Chenzhou City showed some seasonal distribution characteristics. The main dominant strains alternated each other and interacted with the immunocompetence of the population in the distribution of months and age groups. Chenzhou CVA16 isolates and domestic popular genotypes consistent.