Emergence, Circulation, and Spatiotemporal Phylogenetic Analysis of Coxsackievirus A6-and Coxsackievirus A10-Associated Hand, Foot, and Mouth Disease Infections from 2008 to 2012 in Shenzhen, China
Emergence, Circulation, and Spatiotemporal Phylogenetic Analysis of Coxsackievirus A6-and Coxsackievirus A10-Associated Hand, Foot, and Mouth Disease Infections from 2008 to 2012 in Shenzhen, China
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DOI：
10.1128/jcm.01231-13
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发表时间：
2013-11-01
影响因子：
9.4
通讯作者：
Zhao, De-Jian
中科院分区：
文献类型：
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作者：
He, Ya-Qing;Chen, Long;Zhao, De-Jian
近年来，手足口病（HFMD）和其他传染病的零星爆发经常与某些人类肠道病毒（HEV）血清型有关。本研究探讨了中国深圳非 HEV71 和非柯萨奇病毒 A16 (CV-A16) 人类肠道病毒相关手足口病感染的患病率和遗传特征。收集2008年至2012年医院手足口病监测临床粪便标本2411份，采用实时逆转录PCR（RT-PCR）和RT-半嵌套PCR进行HEV检测，并基于VP1基因进行时空系统发育分析。共检测到 1,803 株（74.8%）菌株，包括 28 个不同血清型。过去5年，主要血清型是HEV71（60.0%），其次是CV-A16（21.2%）和两种不常见血清型CV-A6（13.0%）和CV-A10（3.3%）。然而，2010年至2012年间，CV-A6取代CV-A16成为第二常见血清型。作为一种新兴病原体，CV-A6于2012年在深圳成为与HEV71一样常见的手足口病病原体。系统发育分析显示，中国HEV71和CV-A16毒株几乎没有发生变异。中国CV-A6和CV-A10株的遗传特征表现出地域差异。在深圳传播的 CV-A6 和 CV-A10 毒株可能起源于欧洲。研究发现，由于进化压力和频繁重组，人类肠道病毒具有较高的突变率（HEV71、CV-A6、CV-A16 和 CV-A10 每年每个位点发生 3.2 x 10(-3) 至 6.4 x 10(-3) 次替换）。由于某些血清型对公众健康存在潜在威胁，本研究进一步探讨了手足口病流行病学监测的意义。
Sporadic hand, foot, and mouth disease (HFMD) outbreaks and other infectious diseases in recent years have frequently been associated with certain human enterovirus (HEV) serotypes. This study explored the prevalences and genetic characteristics of non-HEV71 and non-coxsackievirus A16 (CV-A16) human enterovirus-associated HFMD infections in Shenzhen, China. A total of 2,411 clinical stool specimens were collected from hospital-based surveillance for HFMD from 2008 to 2012. The detection of HEV was performed by real-time reverse transcription-PCR (RT-PCR) and RT-seminested PCR, and spatiotemporal phylogenetic analysis was performed based on the VP1 genes. A total of 1,803 (74.8%) strains comprising 28 different serotypes were detected. In the past 5 years, the predominant serotypes were HEV71 (60.0%), followed by CV-A16 (21.2%) and two uncommon serotypes, CV-A6 (13.0%) and CV-A10 (3.3%). However, CV-A6 replaced CV-A16 as the second most common serotype between 2010 and 2012. As an emerging pathogen, CV-A6 became as common a causative agent of HFMD as HEV71 in Shenzhen in 2012. Phylogenetic analysis revealed that little variation occurred in the Chinese HEV71 and CV-A16 strains. The genetic characteristics of the Chinese CV-A6 and CV-A10 strains displayed geographic differences. The CV-A6 and CV-A10 strains circulating in Shenzhen likely originated in Europe. It was found that human enteroviruses have a high mutation rate due to evolutionary pressure and frequent recombination (3.2 x 10(-3) to 6.4 x 10(-3) substitutions per site per year for HEV71, CV-A6, CV-A16, and CV-A10). Since certain serotypes are potential threats to the public health, this study provides further insights into the significance of the epidemiological surveillance of HFMD.