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为了解北京地区儿童手足口病（Hand foot and mouth disease, HFMD）病原学及流行病学特征，本研究收集了2019年1月-2024年12月儿童HFMD病例咽拭子样本进行分析。采用柯萨奇病毒A组16型（CVA16）/A组6型（CVA6）/肠道病毒A组71型（EV-A71）/肠道病毒（EV）通用四通道Real-time PCR方法进行核酸检测；并对通用引物阳性样本VP1区进行测序及分型。结果显示，2019-2024年共纳入的1935例HFMD患儿（重症病例6例）男女性别比为1.73:1，年龄分布为0～3岁患儿占比28.32%,3～6岁患儿占比37.52%，大于6岁患儿占比34.16%。肠道病毒（Enterovirus, EVs）总检出率为87.18%(1687/1935)，病原谱以CVA6(66.69%)和CVA16(23.83%)为主，其余型别（CVA10、CVA4、CVA5等）占比均低于1.5%，未分型占比6.64%。年度动态分析显示，CVA6为绝对优势型别，2019-2024年的检出率分别为38.05%、79.56%、62.38%、67.42%、87.03和17.48%；其次为CVA16，检出率分别为37.02%、2.19%、15.36%、19.10%、1.18%和37.86%;EV-A71仅于2019和2023年检出3例。本研究揭示，2019-2024年，北京地区HFMD患儿以3～6岁为主，男性患儿明显多于女性；CVA6持续保持优势地位，CVA16作为第二优势型别与CVA6交替流行；EV-A71仅有零星检出。儿童HFMD相关EV病原谱持续动态变化，需加强病原检测及监测，尤其关注儿童感染及型别交替流行趋势，为HFMD诊疗及防控提供基础数据。
Abstract：This study aimed to investigate the etiological and epidemiological characteristics of hand, foot and mouth disease(HFMD) in children in Beijing from 2019 to 2024. Throat swab samples were collected from pediatric HFMD cases between January 2019 and December 2024. Real-time PCR assays were used to detectCoxsackievirus A16(CVA16), Coxsackievirus A6(CVA6), Enterovirus A71(EV-A71), and general enteroviruses(EVs). VP1 gene fragments of EV-positive samples were amplified by RT-PCR and sequenced for molecular typing. A total of 1,935 HFMD cases were included, of which 6 were severe. The male-to-female ratio was 1.73:1. Children under 3 years of age accounted for 28.32%, those aged 3-6 years for 37.52%, and those older than 6 years for 34.16%. The overall EV detection rate was 87.18%(1,687/1,935). The pathogen spectrum was dominated by CVA6(66.69%) and CVA16(23.83%), while other serotypes(CVA10, CVA4, CVA5, etc.) each accounted for < 1.5%, and 6.64% remained untyped. Annual trends indicated that CVA6 consistently predominated, with detection rates of 38.05%, 79.56%, 62.38%, 67.42%, 87.03%, and 17.48% from 2019 to 2024, respectively. CVA16 was the second most prevalent serotype, with detection rates of 37.02%, 2.19%, 15.36%, 19.10%, 1.18%, and 37.86%. EV-A71 was sporadically detected, with only 3 cases identified in 2019 and 2023. These findings reveal that from 2019 to 2024, HFMD cases in Beijing were predominantly observed in children aged 3-6 years, with a significantly higher incidence in males. CVA6 remained the dominant circulating serotype, alternating with CVA16, while EV-A71 was rarely detected. The continuous dynamic changes in the HFMD-associated enterovirus spectrum highlight the need for strengthened pathogen surveillance, particularly with regard to pediatric infections and serotype shifts, to provide essential data for HFMD diagnosis, treatment, and prevention.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250228
中图分类号:R725.1;R181.3
引用信息:
[1]张瀚文,付艺亮,李飞,等.2019-2024年北京地区儿童手足口病病原学监测及流行病学分析[J].病毒学报,2025,41(06):1702-1709.DOI:10.13242/j.cnki.bingduxuebao.250228.
基金信息:
北京市自然科学基金-大兴创新联合基金（项目号：L256024）,题目：儿童发热伴出疹性疾病病毒病原学研究及新型诊断体系建立; 北京市自然科学基金-海淀原始创新联合基金重点研究专题（项目号：L242052）,题目：脑炎/脑膜炎患者中肠道病毒病原学及疾病负担研究; 国家重点研发计划（项目号：2023YFC2306002）,题目：重要病毒变异规律及预测预警研究子课题二重要病毒关键突变位点功能分子机制研究; 北京市首都卫生系统高层次卫生技术人才（项目号：学科骨干-03-38）,题目：新生儿肠道病毒感染病原学及其临床表型研究~~