Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Department of Paediatrics, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Trop Biomed. 2021 Mar 1;38(1):150-153. doi: 10.47665/tb.38.1.026.
Hand, foot, and mouth disease (HFMD) is a common childhood disease caused by enteroviruses. In 2018, a HFMD outbreak in Malaysia affected over 76,000 children. In this study, we used RT-qPCR and CODEHOP PCR to detect the causative agents in 89 clinically diagnosed HFMD patients in Kuala Lumpur and Selangor. Most (62.9%) of the children were below 3 years old. PCR with either assay detected enteroviruses in 84.2% (75/89) and CODEHOP PCR successfully typed 66.7% (50/75) of the enteroviruses. Sequencing of CODEHOP amplicons showed co-circulation of multiple enteroviruses with coxsackievirus A6 (CV-A6) and A16 as the predominant serotypes, but not the neurovirulent enterovirus A71. CV-A6 infection was more common in children less than 12 months old (p=0.01) and was more likely to cause vesicles in the gluteal area (p=0.01) compared to other enteroviruses. Establishing a robust identification method during HFMD outbreaks is important for patient management and public health responses.
手足口病（HFMD）是一种由肠道病毒引起的常见儿童疾病。2018 年，马来西亚爆发了一次手足口病疫情，影响了超过 76000 名儿童。在这项研究中，我们使用 RT-qPCR 和 CODEHOP PCR 检测了吉隆坡和雪兰莪 89 名临床诊断为 HFMD 的患者的病原体。大多数（62.9%）儿童年龄在 3 岁以下。两种检测方法的 PCR 均检测到 84.2%（75/89）的肠道病毒，而 CODEHOP PCR 成功对 66.7%（50/75）的肠道病毒进行了分型。CODEHOP 扩增子的测序显示，多种肠道病毒同时流行，柯萨奇病毒 A6（CV-A6）和 A16 是主要的血清型，但并非神经毒力肠道病毒 A71。CV-A6 感染在 12 个月以下的儿童中更为常见（p=0.01），与其他肠道病毒相比，更有可能导致臀部出现水疱（p=0.01）。在手足口病疫情期间建立强大的鉴定方法对于患者管理和公共卫生应对至关重要。
