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[柯萨奇病毒A6所致手足口病肠道病毒排毒时间观察]

[Observation on intestinal viral shedding time of hand, foot and mouth disease induced by coxsackievirus A6].

作者信息

Zhao S Y, Wang J, Teng S, Zhou J, Lin X Y, Song W, Wu Y D, Wei Y

机构信息

Department of Infectious Diseases, Hangzhou Children's Hospital, Hangzhou 310014, China.

出版信息

Zhonghua Er Ke Za Zhi. 2017 May 4;55(5):369-372. doi: 10.3760/cma.j.issn.0578-1310.2017.05.012.

Abstract

To observe the intestinal viral shedding time in patients with hand, food and mouth disease (HFMD) induced by coxsackievirus A6 (CA6). Throat swab specimens and stool specimens of HFMD children were collected from those admitted to Hangzhou Children's Hospital between May and October 2015, while fluorescence quantitative PCR was used to detect the viral load.Eeighteen cases of HFMD children were followed up, who were confirmed as CA6 infection via laboratory tests.Stool specimen was collected every 4-7 days, and fluorescence PCR was used for virus nucleic acid detection until the stool viral nucleic acids of infected children turned to be negative.The intestinal virus shedding time of CA6-infected HFMD was compared with the intestinal virus shedding time of 65 children with enterovirus 71 (EV71) infection and 44 children with coxsackievirus A16 (CA16) infection of the previous studies (from May to September 2012). The median stool viral load was 25×10(5) copies/ml (55×10(4) copies/mL, 9×10(6) copies/ml) in CA6-infected children.The numbers of stool virus nucleic acid turning negative were 0 case, 4 cases, 9 cases, 3 cases and 2 cases in 18 children at 1st, 2nd, 3rd, 4th, 5th weeks. At 5th week, the stool virus nucleic acid of children in CA6 group all turned to be negative.The positive rates of stool virus nucleic acid in EV71 group and CA16 group at the 5th week, however, were 31% and 27% respectively.There were statistically significant differences in distribution of positive rate of stool virus nucleic acid between CA6 infected children with EV71 and CA16 infected children (χ(2)=13.894, 10.698, <0.05). The longest intestinal virus shedding time for CA6-infected HFMD children was 5 weeks, which is obviously shorter than that of EV71- infected children and CA16-infected children.

摘要

观察柯萨奇病毒A6(CA6)所致手足口病(HFMD)患儿肠道病毒排毒时间。收集2015年5月至10月期间入住杭州儿童医院的HFMD患儿的咽拭子标本和粪便标本,采用荧光定量PCR检测病毒载量。对18例HFMD患儿进行随访,经实验室检测确诊为CA6感染。每4 - 7天采集粪便标本,采用荧光PCR进行病毒核酸检测,直至感染患儿粪便病毒核酸转为阴性。将CA6感染的HFMD患儿的肠道病毒排毒时间与之前研究(2012年5月至9月)中65例肠道病毒71型(EV71)感染患儿和44例柯萨奇病毒A16(CA16)感染患儿的肠道病毒排毒时间进行比较。CA6感染患儿粪便病毒载量中位数为25×10⁵拷贝/ml(55×10⁴拷贝/mL,9×10⁶拷贝/ml)。18例患儿在第1、2、3、4、5周粪便病毒核酸转阴例数分别为0例、4例、9例、3例和2例。第5周时,CA6组患儿粪便病毒核酸均转为阴性。然而,EV71组和CA16组在第5周时粪便病毒核酸阳性率分别为31%和27%。CA6感染患儿与EV71和CA16感染患儿粪便病毒核酸阳性率分布差异有统计学意义(χ² = 13.894,10.698,P < 0.05)。CA6感染的HFMD患儿最长肠道病毒排毒时间为5周,明显短于EV71感染患儿和CA16感染患儿。

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