摘要
目的研究流感病毒检测阴性的流感样病例(ILI)中肠道病毒(EV)的病原谱及其主要流行病毒型,为其防治提供基础科学依据。方法收集2017-2018年温州市ILI,利用荧光定量PCR技术检测流感病毒甲型和乙型,流感阴性病例进行EV检测;利用反转录–聚合酶链式反应(RT-PCR)扩增EV的VP1区序列,扩增产物进行基因测序和基因分型。对结果进行统计学分析,P<0.05为差异有统计学意义。结果共调查病例2 298例,流感病毒检测阳性488例(21.23%),流感病毒阴性1 810例(78.76%),其中,EV检测阳性254例(14.03%)。EV感染全年均有发生,流行高峰为4-7月(70.47%)。254例EV阳性标本中,测序成功并经基因序列比对获得基因分型的135例,可分为包含EV-A、EV-B和EV-C型的13个EV亚型,主要感染型别为柯萨奇病毒A组6型(Cox A6)、Cox A2和Cox A10,分别占24.44%、22.22%和13.33%。不同年份、月份、性别和年龄EV阳性率差异有统计学意义(χ~2=9.399、329.380、4.311、29.246,均P<0.05)。结论流感病毒检测阴性的ILI中EV是主要病原体之一,其病原谱复杂。应重点加强低年龄组病例的诊断和监测。
Objective To investigate the enterovirus(EV) spectrum and its main virus types in influenza-like illness(ILI)cases with negative influenza virus detection results, and provide basic scientific evidence for the prevention and treatment of EV infection. Methods The clinical samples of ILI cases were collected in Wenzhou of Zhejiang Province from 2017 to 2018 for the detections of influenza A and B viruses with real-time PCR(polymerase chain reaction). Then EV detection was performed for influenza negative cases. VP1 region sequence of EV was amplified by using reverse transcription PCR. The amplified products were subjected to gene sequencing and genotyping. Statistical analysis was conducted to evaluate the results. Results Among 2 298 ILI cases detected, 488(21.23%) were influenza virus positive, and 1 810(78.76%) were influenza virus negative, in which 254(14.03%) were EV positive. EV infections occur all the year round, but the incidence peak was during April-July with the cases accounting for 70.47%. In 254 EV positive cases, by gene sequencing, the genotypes of 135 cases were detected, including 13 EV subtypes of EV-A, EV-B and EV-C, in which Cox A6, Cox A2 and Cox A10 accounted for 24.44%, 22.22% and 13.33%, respectively. There were significant year, month, gender and age specific differences in EV positive rate(χ~2=9.399, 329.380, 4.311, 29.246, all P<0.05). Conclusion Enterovirus was one of the main pathogens in false influenza-like infection cases, and enterovirus spectrum was complex. It is necessary to strengthen the diagnosis and surveillance in low age group.
作者
孙宝昌
卢姝姝
吴矛矛
陈栋
Sun Baochangx;Lti Shushu;Wu Maomao;Chen Dong(Department of Microbiology,Wenzhou Prefectural Center for Disease Control and Prevention,Wenzhou 325000,Zhejiang,China;The Sixth People's Hospital of Wenzhou,Wenzhou 325015,Zhejiang,China)
出处
《疾病监测》
CAS
2019年第12期1096-1099,共4页
Disease Surveillance
基金
浙江省医药卫生项目(No.2017KY634)
温州市科技计划(No.Y20170148,Y20140600)~~
关键词
流感样病例
肠道病毒
病原谱
Influenza-like case
Eenterovirus
Pathogen spectrum
