2019年至2022年中国成都手足口病门诊病例的临床、病因学和流行病学研究：一项回顾性研究

Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study.

作者信息

Xia Maoyao, Zhu Yu, Liao Juan, Zhang Shirong, Yang Denghui, Gong Peng, Zhang Shihang, Jiang Guiyu, Cheng Yue, Meng Jiantong, Chen Zhenhua, Liao Ye, Li Xiaojing, Zeng Yilan, Zhang Chaoyong, Long Lu

机构信息

Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, China.

West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

BMC Public Health. 2024 Dec 18;24(1):3427. doi: 10.1186/s12889-024-20909-8.

DOI:10.1186/s12889-024-20909-8

PMID:39695459

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11654434/

Abstract

BACKGROUND

The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiological investigations concerning mild outpatient cases remain scarce, resulting in inadequate descriptions of their clinical, etiological, and epidemiological characteristics. Our study aimed to analyze the clinical, etiological, and epidemiological characteristics of HFMD outpatients in Chengdu from 2019 to 2022 while identifying potential risk factors associated with the progression of outpatients requiring hospitalization.

METHODS

A retrospective study was conducted to summarize the clinical, etiological, and epidemiological characteristics of outpatient HFMD cases in Chengdu from 2019 to 2022. Risk factors associated with progression to hospitalization of HFMD outpatients were evaluated using binomial logistic regression analysis.

RESULTS

The study included 1,073 coxsackievirus A6 (CVA6), coxsackievirus A10 (CVA10), and coxsackievirus A16 (CVA16) HFMD nucleic acid test-positive outpatients. Among these, only 45 outpatients (4.19%) progressed to hospitalization. The median ages for CVA6, CVA10, and CVA16 infections were 25.23, 28.13, and 38.45 months, respectively (P < 0.001). CVA6 (76.51%, 821/1,073) has become the main serotype among outpatients in Chengdu, with the proportions from the second half of 2019 to 2022 being 45.59%, 95.17%, 77.67% and 80.71% respectively. EV-A71 cases even disappeared. Patients infected with CVA10 had a significantly higher likelihood of hospitalization (P < 0.05), while the presence of oral rash served as a protective factor (P < 0.05).

CONCLUSIONS

Our study highlights the critical need for enhanced surveillance of multiple HFMD pathogens, predominantly caused by the prevalent serotype CVA6. Clinically, enhanced surveillance of CVA10 is imperative to mitigate the hospitalization rate associated with HFMD.

摘要

背景

2016年肠道病毒A71型（EV - A71）疫苗在中国的引入，使得重症手足口病（HFMD）病例大幅下降，如今轻症门诊病例占该国手足口病病例的大多数。然而，关于轻症门诊病例的流行病学调查仍然很少，导致对其临床、病因和流行病学特征的描述不足。我们的研究旨在分析2019年至2022年成都手足口病门诊患者的临床、病因和流行病学特征，同时确定与需要住院治疗的门诊患者病情进展相关的潜在危险因素。

方法

进行一项回顾性研究，总结2019年至2022年成都手足口病门诊病例的临床、病因和流行病学特征。使用二项逻辑回归分析评估与手足口病门诊患者住院病情进展相关的危险因素。

结果

该研究纳入了1073例柯萨奇病毒A6型（CVA6）、柯萨奇病毒A10型（CVA10）和柯萨奇病毒A16型（CVA16）手足口病核酸检测呈阳性的门诊患者。其中，只有45例门诊患者（4.19%）进展为住院治疗。CVA6、CVA10和CVA16感染的中位年龄分别为25.23、28.13和38.45个月（P < 0.001）。CVA6（76.51%，821/1073）已成为成都门诊患者中的主要血清型，2019年下半年至2022年的比例分别为45.59%、95.17%、77.67%和80.71%。EV - A71病例甚至消失。感染CVA10的患者住院可能性显著更高（P < 0.05），而口腔皮疹的出现是一个保护因素（P < 0.05）。