2016年北京市朝阳区手足口病相关非EV71非CVA16型肠道病毒病原学特征
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摘要
目的确定2016年北京市朝阳区引起手足口病的非EV71非CVAl6型肠道病毒的病原谱、优势病毒型别、流行特征。方法收集2016年朝阳区日常监测手足口病患者的咽拭子或粪便标本样本共875份。经荧光定量PCR确定非EV71非CVA16型肠道病毒阳性样本230份;经普通PCR扩增5’非翻译区和VP2区并测序确定病毒型别;对CVA10型病毒扩增完整VP1基因序列,进行聚类分析。结果 2016年朝阳区日常监测非EV71非CVA16型肠道病毒阳性标本230份,确定分型167份,包括:117份CVA6、29份CVA10、16份CVA4、2份CVA12及CVA5、CVA21、CVB4各1份;本地区CVA10完整VP1区核苷酸序列一致性为91.1%～100.0%(均值95.7%),与CVA10原始株(Genbank序列号AY421767)的核苷酸序列一致性为76.0%～77.1%(均值76.6%),核苷酸一致性>75%,属于同一血清型;聚类结果显示本地区CVA10聚为5簇。结论 2016年朝阳区引起手足口病的非EV71非CVA16型肠道病毒病原谱至少包括CVA6、CVA10、CVA4、CVA12、CVA5、CVA21和CVB4,其中CVA6为优势病毒型别。
Objective To explore the pathogenic spectrum, predominant type, characteristics of epidemiology and genotypes of non-EV71, non-CVA16 enteroviruses(EV-U) that caused hand-foot-mouth disease(HFMD) in Chaoyang district of Beijing in 2016. Methods Throat swabs and stool specimen were collected from 875 HFMD cases. 230 EV-U samples were determined as positive for enterovirus but negative for EV71 and CVA16 by quantitative real-time PCR. The 5'untranslated regions(5'UTR) and VP2 fragments were amplified by PCR. The positive PCR products were sequenced and the genotype was identified by DNA sequence BLAST. The VP1 gene of CVA10 were amplified and sequenced. Results 163 cases of 230 EV-U were identified that the pathogens consist of 117 CVA6, 29 CVA10, 16 CVA4, 2 CVA12, 1 CVA5, 1 CVA21 and 1 CVB4. The nucleotide homology of the VP1 gene of CVA10 was 91.1%-100.0 %(average:95.7%). The nucleotide homology of the VP1 gene was 76.0%-77.1 %(average:76.6%)compared with the original strain. All the VP1 sequences form cluster A.1 to A.5. Conclusions The pathogens of non-EV71, non-CVA16 enteroviruses included CVA6, CVA10, CVA4, CVA12, CVA5, CVA21, CVB4. CVA6 was the predominant type.
Objective To explore the pathogenic spectrum, predominant type, characteristics of epidemiology and genotypes of non-EV71, non-CVA16 enteroviruses(EV-U) that caused hand-foot-mouth disease(HFMD) in Chaoyang district of Beijing in 2016. Methods Throat swabs and stool specimen were collected from 875 HFMD cases. 230 EV-U samples were determined as positive for enterovirus but negative for EV71 and CVA16 by quantitative real-time PCR. The 5'untranslated regions(5'UTR) and VP2 fragments were amplified by PCR. The positive PCR products were sequenced and the genotype was identified by DNA sequence BLAST. The VP1 gene of CVA10 were amplified and sequenced. Results 163 cases of 230 EV-U were identified that the pathogens consist of 117 CVA6, 29 CVA10, 16 CVA4, 2 CVA12, 1 CVA5, 1 CVA21 and 1 CVB4. The nucleotide homology of the VP1 gene of CVA10 was 91.1%-100.0 %(average:95.7%). The nucleotide homology of the VP1 gene was 76.0%-77.1 %(average:76.6%)compared with the original strain. All the VP1 sequences form cluster A.1 to A.5. Conclusions The pathogens of non-EV71, non-CVA16 enteroviruses included CVA6, CVA10, CVA4, CVA12, CVA5, CVA21, CVB4. CVA6 was the predominant type.
引文
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[2] 王海滨,雷娜,赵剑虹,等.2013年北京市朝阳区柯萨奇A6型病毒分子流行病学研究[J].首都公共卫生,2016,10(1):16-20.
[3] MIRAND A,HENQUELL C,AIRCHIMBAUD C,et al.Outbreak of hand,foot and mouth disease/herpangina associated with coxsackievirus A6 and A10 infections in 2010,France:a large citywide,prospective observational study [J].Clin Microbiol & Infec,2012,18(5):E110.
[4] BRACHO M A,GONZáLEZ-CANDELAS F,VALERO A,et al.Enterovirus co-infections and onychomadesis after hand,foot,and mouth disease,Spain,2008 [J].Emerg Infect Dis,2011,17(12):2223-2231.
[5] GOPALKRISHNA V,PATIL P R,PATIL G P,et al.Circulation of multiple enterovirus serotypes causing hand,foot and mouth disease in India [J].J Med Microbiol,2012,61(Pt 3):420.
[6] 张颖,甄若楠,谢华萍,等.2010-2015年广州地区手足口病Cox A6,Cox A4和Cox A10的病原监测和流行分析[J].疾病监测,2016,31(10):817-823.
[7] 林虹.2014-2015年宁夏手足口病流行病及病原学研究[D].银川:宁夏医科大学,2016.
[8] 王海滨,雷娜,姜晓红,等.北京市朝阳区手足口病非EV71、非CoxA16肠道病毒的基因型[J].现代预防医学,2014,41(9):1699-1703.
[9] 朱冰,钟家禹,夏慧敏,等.2008年广州地区手足口病的病原学研究[J].中华儿科杂志,2010,48(2):127-130.
[10] 和鹏,陈纯,狄飚,等.2011年广州市手足口病病原谱分析[J].热带医学杂志,2012,12(5):613-616.
[11] 汪照国,刘晓琳,杨婷婷,等.2008-2009年青岛地区手足口病病原学的调查分析[J].病毒学报,2011,27(5):438-441.
[12] KLEIN M,CHONG P.Is a multivalent hand,foot,and mouth disease vaccine feasible?[J].Hum Vacc Immunother,2015,11(11):2688-2704.
[13] 王永全,吉彦莉,曲梅.北京地区与手足口病相关的非EV71、非CoxA16型肠道病毒的分子特征分析[J].国际病毒学杂志,2011,18(6):75-79.
[14] LU Q B,ZHANG X A,WO Y,et al.Circulation of Coxsackievirus A10 and A6 in hand-foot-mouth disease in China,2009-2011 [J].PloS One,2012,7(12):e52073.
[15] HAYMAN R,SHEPHERD M,TARRING C,et al.Outbreak of variant hand-foot-and-mouth disease caused by coxsackievirus A6 in Auckland,New Zealand [J].J Paediatr Child H,2014,50(10):751.