CAJ | 학술논문

目的通过病毒分离和鉴定了解2007-2008年春夏北京地区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.方法分别于2007年4-8月及2008年5-9月收集256例手足口病患儿的咽拭子和疱疹液标本共356份,其中咽拭子255份(包括10份重症患儿标本),疱疹液标本101份.将所有标本接种Vero细胞进行病毒分离,分离阳性的毒株用RT-PCR进行鉴定;对10份重症患儿标本除病毒分离外,还直接进行RT-PCR检测病毒核酸.结果 256例被检测患儿中188例为肠道病毒阳性,阳性率为73.4%.356份标本中共分离到239株肠道病毒,总阳性率为67.1%.其中疱疹液标本分离阳性率为75.2%(76/101),咽拭子标本分离阳性率63.9%(163/255),但两种标本接种细胞后出现病变的速度没有差别.重症患儿标本病毒分离阳性率50%(5/10).2007年的45例病毒分离株经肠道病毒通用引物PCR检测均为阳性,分型PCR显示,其中CA16占95.6%(43/45),EV71占4.4%(2/45);而2008年的143例病毒分离株经肠道病毒通用引物PCR检测142例为阳性,PCR分型显示,EV71占82.4%(117/142),CA16占16.8%(24/142).10份重症患儿标本直接分型检测结果均为EV71.结论北京儿童手足口病病原体以EV71和CAV16为主,2007年与2008年流行的优势型别不同,2007年主要为CA16,而2008年主要为EV71.本组重症手足口病患儿的病原均为EV71.
목적 통과병독분리화감정료해2007-2008년춘하북경지구수족구병적병원학특정,위수족구병방치공작제공과학의거.방법 분별우2007년4-8월급2008년5-9월수집256례수족구병환인적인식자화포진액표본공356빈,기중인식자255빈(포괄10빈중증환인표본),포진액표본101빈.장소유표본접충Vero세포진행병독분리,분리양성적독주용RT-PCR진행감정;대10빈중증환인표본제병독분리외,환직접진행RT-PCR검측병독핵산.결과 256례피검측환인중188례위장도병독양성,양성솔위73.4%.356빈표본중공분리도239주장도병독,총양성솔위67.1%.기중포진액표본분리양성솔위75.2%(76/101),인식자표본분리양성솔63.9%(163/255),단량충표본접충세포후출현병변적속도몰유차별.중증환인표본병독분리양성솔50%(5/10).2007년적45례병독분리주경장도병독통용인물PCR검측균위양성,분형PCR현시,기중CA16점95.6%(43/45),EV71점4.4%(2/45);이2008년적143례병독분리주경장도병독통용인물PCR검측142례위양성,PCR분형현시,EV71점82.4%(117/142),CA16점16.8%(24/142).10빈중증환인표본직접분형검측결과균위EV71.결론 북경인동수족구병병원체이EV71화CAV16위주,2007년여2008년류행적우세형별불동,2007년주요위CA16,이2008년주요위EV71.본조중증수족구병환인적병원균위EV71.
Objective To investigate the etiological agents of hand, foot and mouth disease (HFMD) in children in spring and summer from 2007 to 2008 in Beijing and the characteristics of the disease by virus isolation and to provide the scientific evidence for prevention and treatment for HFMD. Methods During April to August, 2007 and May to September, 2008, 356 clinical specimens including 255 throat swabs and 101 vesicle fluids were collected from 256 patients with HFMD who visited the Children's Hospital Affiliated to Capital Institute of Pediatrics and children with severe HFMD with neural system complications from Ditan Hospital and Youan Hospital All of the specimens were inoculated into Vero cells for virus isolation. After the cell pathogenic effects (CPE) appeared, the isolates were identified by RT-PCR with the universal primers within 5'untranslated region of enterovirus and typed by specific primers for VP1 gene of EV71 and CA16, respectively. The throat swabs from all of 10 severe HFMD were tested for enterovirus by RT-PCR addition to virus isolation. Results Out of 256 patients, 188 were positive for enterovirus by virus isolation, with the overall positive rate of 73.4%. Among the 356 clinical specimens collected from these 256 patients, 239 enterovirus strains were isolated with the overall positive rate of 67.1%. The positive rate for virus isolation from vesicle fluid samples was 75.2% which was higher than the positive rate of isolation from throat swabs (63.9%), but the time for CPE appearing in cell culture showed no significant difference. The positive rate of virus isolation from throat swabs from children with severe HFMD was 50% (5/10) which was lower than overall positive rate (73.4%) from regular HFMD. The RT-PCR typing for virus isolates revealed that among 45 enterevirus strains isolated from the specimens collected in 2007 by the universal primer pairs, 43 were CAI6 (95.6%, 43/45) and 2 were EV71 (4.4%, 2/45), whereas for the specimens collected in 2008, out of 143 enterovirus isolates by PCR with universal primers, 117 were EV71 (82.4%, 117/142) and 24 were CA16 (16.8%, 24/142). All of 10 severe cases were positive for EV71 by RT-PCR directly from clinical specimens. Conclusion CA16 and EVT1 were the etiological pathogens of HFMD in Beijing during 2007 to 2008 HFMD seasons. The dominant type of enterovirus was different between 2007 and 2008. Enterovirus type CA16 was predominant in 2007, whereas EV71 was predominant in 2008. All of severe cases of HFMD in children in this study were caused by EV71.