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  • Title: [Observation on intestinal viral shedding time of hand, foot and mouth disease induced by coxsackievirus A6].
    Author: Zhao SY, Wang J, Teng S, Zhou J, Lin XY, Song W, Wu YD, Wei Y.
    Journal: Zhonghua Er Ke Za Zhi; 2017 May 04; 55(5):369-372. PubMed ID: 28482389.
    Abstract:
    Objective: To observe the intestinal viral shedding time in patients with hand, food and mouth disease (HFMD) induced by coxsackievirus A6 (CA6). Method: 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). Result: 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, P<0.05). Conclusion: 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. 目的： 观察柯萨奇病毒A组6型(CA6)所致手足口病患儿的肠道排毒时间。 方法： 采集2015年5—10月杭州市儿童医院收治的手足口病患儿的咽拭子标本及粪便标本，通过荧光定量PCR法进行病毒载量检测。对18例实验室确诊有CA6感染的手足口病患儿的肠道排毒情况进行追踪和随访，直至患儿粪便病毒转阴为止。并将其肠道排毒情况与既往研究(2012年5—9月)中杭州市儿童医院收治的65例肠道病毒71型(EV71)感染患儿、44例柯萨奇病毒A组16型(CA16)感染患儿的肠道排毒情况进行比较。 结果： CA6感染患儿的粪便病毒载量中位数为25×10(5)拷贝/ml(55×10(4)拷贝/ml, 9×10(6)拷贝/ml)。18例患儿在第1、2、3、4、5周的粪便病毒核酸转阴的例数分别为0例、4例、9例、3例、2例；第5周时粪便病毒核酸全部转阴。而EV71感染组、CA16感染组在第5周时的粪便病毒核酸阳性率分别为31%、27%。CA6感染与EV71、CA16感染患儿的粪便病毒核酸阳性率在随访期内的分布差异有统计学意义(χ(2)＝13.894、10.698，P<0.05)。 结论： CA6感染的手足口病患儿肠道排毒时间最长为5周，肠道排毒时间明显比感染EV71或感染CA16患儿的肠道排毒时间短。.
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