摘要
目的分析2013-2014年宁波农村地区手足口病(HFMD)病原学流行特征及规律,为手足口病的预防控制提供病原学依据。方法选取2013年1月-2014年12月宁波农村地区临床诊断为HFMD的患儿334例为研究对象,采用实时荧光定量PCR方法对研究对象标本进行肠道病毒通用型(EV)、肠道病毒71型(EV71)、柯萨奇病毒A组16型(CoxA16)核酸检测,并运用SPSS19.0进行描述性流行病学分析。结果采集到的334例HFMD病例生物学标本,阳性检出率为73.05%,其中EV71、CoxA16和其他EV比例分别占17.62%、17.62%和64.75%;两年间HFMD病原构成差异有统计学意义(P<0.05),EV71在春夏季感染率高,CoxA16在夏秋季感染率高,其他EV四季普遍易感,差异有统计学意义(P<0.05);不同性别、职业及<5岁人群的HFMD病原构成基本相同,感染各型病原的风险差异无统计学意义;重症病例EV71感染率高于普通病例,EV71感染者重症病例发生率最高,差异均有统计学意义(P<0.05)。结论该地区不同特征人群EV71、CoxA16及其他EV的感染率主要受总体优势病原影响。EV71、CoxA16及其他EV的感染流行季节有差异,且病原类型与患儿临床病情轻重程度有关,在HFMD流行季节开展病原监测有助于指导临床治疗,避免不良预后的发生。
OBJECTIVE To investigate the etiological characteristics of hand, foot, and mouth disease （HFMD） in rural areas of Ningbo from 2013 to 2014 and analyze the distribution regularity so as to provide etiological basis for prevention and control of the HFMD. METHODS A total of 334 children who were diagnosed with HFMD in rural areas of Ningbo from Jan 2013 to Dec 2014 were recruited as the study objects. The real-time fluorescence quanti- tative PCR was employed to detect the specific nucleotides of the enterovirus （EV）, enterovirus 71 （EVT1）, and Coxsaekie virus group A 16 （CoxA16） ; the descriptive epidemiological analysis was performed by using SPSS19.0 software. RESULTS The biological specimens were collected from the 334 children, the positive rate of detection was 73.05% ;the EVT1, CoxA16 and other EV accounted for 17. 62%, 17. 62%, and 64. 75%, respectively. There was significant difference in the constituent ratio of the pathogens causing the HFMD in the two years （P〈 0.05）. The incidence of EV71 infection was high in the spring and summer, the incidence of CoxA16 infection was high in the summer and autumn, and the other EV infection was prevalent in the four seasons （P〈0.05）. The constituent ratio of the pathogens causing the HFMD was basically the same among the children with different genders, occupations, or less than 5 years of age; there was no significant difference in the risk of the infections caused by the pathogens. The incidence of EV71 infection was higher in the severe cases than in the common ca- ses, the incidence of EVT1 infection was the highest in the severe cases, and there was significant difference（P〈 0.05）. CONCLUSION The incidence of the EV71, CoxA16, and other EV infections in the different populations in this area is mainly affected by the overall predominant pathogens; the prevalence of the EV71, CoxA16, and other EV infections varies in the seasons. The severity of the clinical illness condition is associated with the species of the pathogens. The etiological surveillance of the seasonal prevalence of HFMD may facilitate the clinical treat- ment and avoid the adverse outcomes.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第21期4961-4964,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技基金资助项目(2009A190)
宁波市鄞州区科技局第二批科技计划基金资助项目[(2012)90号]
