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目的了解重庆渝东北地区儿童手足口病的病原学特征,为手足口病防治工作提供科学依据。方法收集2010年4～12月268例临床手足口病患儿的肛拭子、咽拭子、疱疹液标本共336份,采用Real-timeRT-PCR检测肠道病毒核酸及进行型别鉴定。结果 336份标本中检出193份肠道病毒阳性,总阳性率为57.44%,其中疱疹液、肛拭子、咽拭子标本阳性率分别为79.24%、67.44%、47.21%,泡疹液阳性检出率最高。268例患儿中检出146例肠道病毒阳性,阳性率为54.48%,其中CoxA16感染最高,占53.42%,其次为EV71型,占41.10%。重症患儿肠道病毒阳性检出率为68.75%,均为EV71型。男性发病多于女性,男女之比为1.47︰1,其差异无统计学意义(χ2=0.530,P=0.466)。肠道病毒阳性病例主要集中在5岁及以下儿童,占92.47%。结论 2010年渝东北地区手足口病流行的病原体主要为Cox-A16、EV71,重症病例系由EV71病毒感染所致。疱疹液标本中核酸阳性检出率最高。
Objective To understand the etiological characteristics of hand-foot-mouth disease in Chongqing-Chongqing northeast region and to provide a scientific basis for the prevention and treatment of hand-foot-mouth disease. Methods A total of 336 samples of anal swab, throat swab and herpes fluid from 268 children with clinical hand-foot-mouth disease were collected from April 2010 to December 2010. Real-time RT-PCR was used to detect enterovirus nucleic acid and genotype identification. Results A total of 193 enterovirus positive samples were detected in 336 samples with a total positive rate of 57.44%. The positive rates of herpes fluid, anal swab and throat swab were 79.24%, 67.44% and 47.21% The highest detection rate. Of the 268 cases, 146 cases were positive for enterovirus, the positive rate was 54.48%. The highest infection was CoxA16 (53.42%), followed by EV71 (41.10%). The positive rate of enterovirus in critically ill children was 68.75%, all of which were EV71. Men than women incidence, male to female ratio was 1.47: 1, the difference was not statistically significant (χ2 = 0.530, P = 0.466). Enterovirus positive cases are mainly concentrated in children 5 years of age and below, accounting for 92.47%. Conclusion The pathogens of HFMD in northeastern Chongqing in 2010 are mainly Cox-A16 and EV71, and severe cases are caused by EV71 virus infection. Herpes fluid samples in the highest positive detection rate of nucleic acid.