BackgroundRotavirus (RV), norovirus (NoV), human enteric adenovirus (HAdV), human astrovirus (HAstV), and sapovirus (SaV) are important viral causes of acute gastroenteritis (AGE) in children. However, limited information is available regarding AGE in Yunnan, Southwest China.MethodsTo investigate the prevalence of group A rotavirus (RVA), norovirus genogroups I (GI) and II (GII), and HAdV, HAstV, and SaV in children aged <5 years hospitalized with AGE between 2020 and 2022.ResultsStool samples were collected from 612 children hospitalized with AGE. A total of 266 of the 612 children presented with AGE (43.46%; 266/612). RVA was detected in 28.76% (176 of 612) of the children. Rotavirus G9P[8] was the most frequent genotype in 2020 and 2021. In 2022, G8P[8] became the dominant genotype combination circulating in Yunnan Province. The norovirus positivity rate was present in 11.93% (73/612) of the 612 samples. Of the 45 GII successfully sequenced samples, GII.4 was the dominant genotype, accounting for 51.11% (23 of 45), followed by GII.3 [P12] (28.89%; 13 of 45). The positivity rates for SaV, HAstV, and HAdV were 2.94% (18/612), 3.43% (21/612), and 4.74% (29/612), respectively. HAdV-F41 was the predominant genotype and non-enteric HAdV-C2 and HAdV-A12 were also observed in Yunnan. Male children had a higher incidence of AGE than female children upon infection with RV, NoV, and HAdV. The highest incidence of AGE was observed among children aged between 12 and 23 months (62.50%; 120/192), followed by children aged between 24 and 35 months (52.44%; 43/82). The incidence rate of the infection peaked (78.62%; 125/159) in the first 3 months of the year, followed by the next 3 months (66.67%; 70/105).ConclusionsRV and NoV remained the most important agents causing AGE. RV G8P[8] became the dominant circulating genotype instead of G9P[8] in Yunnan in 2022. The authors suggest that monitoring should be strengthened to prevent outbreaks caused by RV G8P[8]. New vaccines, such as the RV G8P[8] genotype, should be considered.

Background Hongta District of Yuxi city is located in the central region of Yunnan Province, Southwest China. Previous studies have shown a high prevalence of enteric infectious diseases in the area, which may be related to sewage discharge. However, there has been no systematic analysis of the microbiome in sewage in this area. In this study, we investigated environmental sewage in Hongta District, Yuxi city, Yunnan Province. Methods Surveillance was conducted in Hongta District, Yuxi city, for a period of one year. At both its urban and rural sites, sewage samples were collected for metagenomic sequencing. Results The results revealed that in the sewage samples, bacteria accounted for 98.31% of the total microbiome, followed by Archaea (1.05%), Viruses (0.30%) and Eukaryota (0.34%). At the phylum level, Proteobacteria was the taxon with the highest relative abundance, accounting for 57.57% of all samples, followed by Firmicutes (17.17%), Bacteroidetes (12.23%), Actinobacteria (7.10%), and Synergistetes (1.45%). At the genus level, the taxa with the highest relative abundances of all the microbiomes were Acidovorax (6.63%), Pseudomonas (4.98%), Acinetobacter (4.23%), Comamonas (3.85%), and Aliarcobacter (2.78%). The diversity of the samples grouped by site and rainfall formed their own clusters, but only the compositions of different taxa grouped by rainfall significantly differed (P = 0.038 at the family, P = 0.019 at the genus and P = 0.005 at the species level). In general, the abundance of several taxa at the family, genus and species levels in the dry season group was higher (P < 0.05) than that in the rainy season group according to the Kruskal–Wallis test. The relative abundance s of most virulence genes were higher at urban sites than at rural sites, while those in the rainy season was higher than those in the dry season. The distribution of antibiotic resistance genes (ARGs) in urban and rural sewage was significantly different (P = 0.018). The relative abundance of multidrug resistance genes in urban sewage was higher than that in rural sewage, and the relative abundance of most resistance genes in the dry season group was higher than that in the rainy season group. Conclusions In general, the abundance and distribution features of the sewage microbial communities in the Hongta District of Yuxi city were affected by site and rainfall factors, with significant regional and temporal specificity. Strengthening the surveillance of environmental sewage and improving discharge methods are highly important for ensuring public health security.

The aim of this study was to determine the epidemiology, incidence and genetic diversity of classic human astrovirus (HAstV) in inpatient children under 5 years of age for acute gastroenteritis (AGE). A hospital-based surveillance study was conducted across Yunnan Province to investigate the incidence of HAstV among AGE patients. Viral RNA was extracted from stool samples collected from January 2015 to December 2023 from hospitalized children under 5 years of age with AGE. Demographic and clinical data were collected and analysed. The RNA of eligible stool samples (n = 2501) was screened via real-time RT‒PCR assays for the presence of classical HAstV via a real-time PCR diagnostic kit for rapid detection of HAstV (XABT, China). The positive HAstV samples (Ct < 25) were subjected to next-generation sequencing (NGS), and phylogenetic analysis was performed for genotypic characterization. A total of 2501 stool samples from hospitalized children < 5 years old were analysed for the presence of classic HAstV from 2015 to 2023. HAstV RNA was detected in 4.88

This study investigated the etiology of hand, foot and mouth disease (HFMD) in Yunnan Province, China, in 2023 by sequencing the complete VP1 region of enteroviruses. A total of 185 enteroviruses were identified from 429 stool samples collected from nine prefectures/cities in Yunnan Province in 2023. These findings revealed that CVA16 was the most prevalent serotype, followed by CVA4, CVA6, CVA10 and EV-A71. Phylogenetic analysis revealed that among the 76 CVA16 strains, 73 strains were subgenotype B1a, and 3 strains were B1b. Among the 32 CVA4 strains, 31 strains were subgenotype C2, and only 1 strain was C5. All 25 CVA6 strains belong to subgenotype D3a, all 22 CVA10 strains are genotype C, and all 11 EV-A71 strains are of the C4a subgenotype. HFMD genotypes and sub-genotypes are crucial for public surveillance and outbreak response, and can inform vaccine development.

Background: There is ample evidence to suggest that patients infected with SARS-CoV-2 Omicron variant may experience liver dysfunction. However, the impact of pre-infection liver function on postinfection mortality rates remains inadequately researched. Methods: Data from 847 hemodialysis (HD) patients, diagnosed with Omicron across six HD centers between December 2022 and February 2023, were analyzed. Initial liver function assessments were conducted, following which patients were monitored for mortality outcomes. The stepwise multivariable Cox regression analysis and receiver operating characteristic (ROC) curves were utilized to identify the predictors of mortality. Results: From the total, 98 patients (11.6%) succumbed, with a majority (80/98) within a month postinfection. The deceased patients were observed to be mostly older males with an increased prevalence of diabetes and tumors, signifying higher AST and C-reactive protein levels. These patients also exhibited lower hemoglobin, albumin, and prealbumin levels. An elevated AST [per 1 IU increment; HR 1.04 (95% CI 1-1.04), p = 0.026], AST/ALT ratio [per 1 increment; HR 1.52 (95% CI 1.27-2.36), p = 0.004], and reduced prealbumin [per 10 mg/L increment; HR 0.93 (95% CI 0.9-0.96), p < 0.001] were discovered to be independent indicators of an increased mortality risk. Notably, AST, AST/ALT ratio, and prealbumin proved significant predictors of mortality (AUC values were 0.59, 0.65, and 0.79 respectively). Conclusions: This study underscores that pre-infection liver function, specifically AST, AST/ALT ratio, and prealbumin levels, substantially influence the mortality rates in HD patients following Omicron infection. Therefore, careful consideration of these liver function parameters could guide superior patient management strategies and potentially decrease mortality rates within this at-risk population.

Objective:To study the prevalence of hand, foot and mouth disease (HFMD) in Lijiang city from 2018 to 2020, and to analyze genetic characteristics of the VP1 region of EV-A71 isolates in 2020.Methods:Fecal specimens of HFMD cases from 2018 to 2020 in Lijiang city were collected for viral RNA detection. The viral culture was performed for EV-A71 positive samples and the VP1 region was amplified. The obtained sequences and the reference sequences were used to construct the phylogenetic tree.Results:From 2018 to 2020, the reported HFMD cases in Lijiang were mainly children under 5 years old. Male cases were more than female cases each year, but there was no statistically significant difference between the detection rates of male and female cases. EV-A71, CV-A16 and other EVs were the dominant pathogens of HFMD in Lijiang city. There was one EV-A71 positive case (0.48%, 1/210) in 2018 and no detection of the virus in 2019. In 2020, there were 159 positive cases (66.53%, 159/239). Phylogentic analysis indicated that all EV-A71 strains in Lijiang city belonged to C4a genotype and the similarities of nucleotide and amino acid sequences ranged from 99.44% to 100% and from 99.65% to 100%, respectively. Compared to the reference strains from Panzhihua city, the similarities of nucleotide and amino acid sequences ranged from 99.10% to 100% and from 98.99% to 100%, respectively. In all EV-A71 strains from Lijiang city, the amino acid substitutions of S283T and A293S were observed. Both sites were the frequent mutation sites of the strains in the mainland of China. There was no mutation in the amino acid sequence of B-cell epitope.Conclusions:Other EVs, CV-A16 and EV-A71 emerged alternately as the predominant pathogens of HFMD prevalence in Lijiang city from 2018 to 2020. All epidemic strains of EV-A71 in 2020 were C4a genotype with closely relationship with the strains from Panzhihua city, indicating possible importation of the virus from Panzhihua city.

Objective:To understand the detection status of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and common respiratory pathogens among imported cases of SARS-CoV-2 infection in Yunnan province, so as to provide scientific basis for the treatment and response of multiple infections in the coronavirus disease 2019 epidemics.Methods:Seventy four samples from imported cases of SARS-CoV-2 infection in Yunnan province from April 18, 2021 to April 24, 2022 were randomly selected. TaqMan array cards (TAC) was used for screening of 41 commonly detected respiratory pathogens.Results:One or more respiratory pathogens were detected in 56 specimens, and the detection rate of Haemophilus influenza was the highest. The difference in positive rates of various pathogens was statistically significant ( x2=235.790, P<0.05). In different groups of disease severity, the differences in detection rates were statistically significant for EB virus ( x2=6.358, P=0.038) and human herpesvirus 6 ( x2=5.044, P=0.049). The difference in detection rates of enterovirus in different age groups were statistically significant ( x2=7.843, P=0.041). Conclusions:In the present study, one or more respiratory pathogens were detected in 75.68% (56/74) of SARS-CoV-2 infected patients. The high detection rate may be attributed to age group, disease severity, detection method and spatiotemporal differences.

目的 分析云南省保山市2022年手足口病(hand,foot and mouth disease)病原监测结果,并对主要流行株柯萨奇病毒A16型(coxsackievirus A16,CVA16)基因特征进行分析,为手足口病防控提供科学依据.方法 对2022年云南省保山市送到云南省手足口病实验室的标本进行处理,提取病毒核酸,用引物(MD91/OL68-1)扩增肠道病毒(Entero-virus,EV)VP4/VP2结合区基因并测序,序列在GenBank进行BLAST搜索确定病毒型别,再用各型病毒的相关引物扩增VP1区全序并测序,使用肠道病毒在线定型工具(Enterovirus Genotyping Tool Version 1.0)进行病毒型别鉴定.按参考文献下载肠道病毒标准序列,制作进化树,进行基因特征分析,对检测结果进行统计学分析.结果 本研究对保山市2022年手足口病临床诊断标本307例进行检测,实验室确诊280例,检出率91.21％(280/307),其中CVA16为55.05％(169/307),肠道病毒71 型(Enterovirus A71,EV-A71)为3.58％(11/307),其他肠道病毒为 32.57％(100/307).对送检的206份手足口病例标本,扩增肠道病毒VP4/VP2结合区和VP1区基因测序和鉴定,获得29株肠道病毒,肠道病毒阳性率为14.08％(29/206),均为A组病毒,未检测到B、C、D组病毒.送检病毒株分为3个血清型,其中CVA16有27株,占93.10％(27/29);EV-A71 有 1 株,占 3.45％(1/29);柯萨奇病毒 A10型(coxsackievirus A10,CVA10)有 1 株,占 3.45％(1/29).保山市2022年手足口病病例CVA16型基因的VP4/VP2结合区、VP1区检测阳性率为13.11％(27/206),基因进化分析表明27株CVA16为B1a亚型,并可分为2个进化分支.结论 2022年云南省保山市手足口病主要流行毒株为CVA16基因型,属于B1a亚型,该亚型又可分为2个分支,2022年保山市存在2个传播链流行.今后应加强监测,提高监测质量,掌握病毒流行特征.

Objective To determine the epidemiology and pathogenic spectrum of hand, foot, and mouth disease（HFMD） in Kunming city.Methods We obtained data from HFMD cases reported in 2021 in Kunming from the Chinese Infectious Disease Reporting System for a descriptive analysis. We collected samples from a subset of HFMD cases and used real-time RT-PCR to test for enterovirus 71（EV71）, coxsackievirus A16（CVA16）, CVA6, and other EVs, which were further amplified and genotyped using one step RT-PCR. We constructed a phylogenetic tree of the VP1 genes of the isolates and reference strains to determine genetic relationships.Results The overall incidence per 100 000 population of reported HFMD was 103.72（8 804 cases） in 2021 in Kunming, with age-specific incidences of 8 724.75, 1 649.25, 29.08, and 9.35 among 0-4-, 5-9-, 10-14-, and ≥15-year-olds; and incidences of 524.10 and 965.68 in urban and suburban areas. Among 852 tested samples, 538（63.15%） were positive for an EV, and among these, CVA16, CVA6, EV71, CVA4, CVA2, CVA10, echovirus 18（E18）, CVA9, E30, CVA5, CVA12, E21, and non-genotyped EV accounted for 38.66%（208 strains）, 30.86%（166 strains）, 2.97%（16 strains）, 2.97%（16 strains）, 1.30%（7 strains）, 1.12%（6 strains）, 0.74%（4 strains）, 0.37%（2 strains）, 0.37%（2 strains）, 0.19%（1 strain）, 0.19%（1 strain）, 0.19%（1 strain）, and 20.07%（108 strains）. Dominant sub-genotypes of CVA16, CVA6, EV71, and CVA4 were B1a, D3a, C4a, and C2; CVA16 B1a and EV71 strains were genetically close to corresponding strains in Southeast Asian countries, while CVA6 and CVA4 strains were close to corresponding strains in other areas of China.Conclusions The HFMD incidence was high among children under 5 years of age and in suburban areas of Kunming in 2021. The EV spectrum of HFMD was diverse, with dominant genotypes changing from EV71 to CVA16, CVA6, and CVA4.

Objective:To analyze the non-enterovirus A71 (non-EVA71) and non-coxsackievirus A16 (non-CVA16) enteroviruses causing hand, foot and mouth disease (HFMD) in Kunming and Qujing of Yunnan Province in 2021 by sequencing the VP4/VP2 and VP1 genes and to analyze the phylogenetic characteristics of the VP1 gene of CVA2, aiming to provide reference for the prevention and control of CVA2.Methods:The samples were made and extracted strictly according to the Laboratory Manual for Hand, Foot and Mouth Disease (China Center for Disease Control and Prevention, 2018 Edition). VP4/VP2 junction regions were firstly amplified and sequenced by MD91/OL68-1 primers. These sequences were firstly edited and then "blasted" on the GenBank to determine the virus serotype. To analyze the phylogenetic characteristics of CVA2, the entire VP1 gene sequences were amplified in two segments using enterovirus species A primers. Virus serotype was again confirmed online by "Enterovirus Genotyping Tool Version 0.1". The sequences of the reference virus genotypes/sub-genotypes were downloaded according to the reference. The phylogenetic trees were constructed by Mega5.2 software and the genetic characteristics were analyzed.Results:A total of 749 non-EVA71 and non-CVA16 enteroviruses were detected in the two areas in 2021. Group A enteroviruses were the main pathogens, with CVA16 as the predominant virus, and a small number of group B enteroviruses were reported. Only five strains of CVA2 were detected with a detection rate of 0.67% (5/749), indicating that CVA2 was a rare pathogen for HFMD in the two areas. The sequencing and serotyping results were consistent using the two genomic regions of VP4/VP2 junction region and VP1 region. Phylogenetic analysis showed that three Kunming strains belonged to genotype A, while two Qujing strains belonged to genotype D.Conclusions:The detection rate of CVA2 in Kunming and Qujing was 0.67% in 2021. CVA2 was a rare pathogen for HFMD in the two regions. Phylogenetic analysis showed genotypes A and D spread in Kunming and Qujing, respectively, but had not caused epidemics. To our knowledge, this was the first report of genotype A of CVA2 in China. Strengthening the laboratory surveillance especially molecular epidemiological surveillance is valuable for the monitor and analysis of transmission source for CVA2.

Objective:To analyze the etiological distribution and phylogenetic characteristics of hand, foot and mouth disease (HFMD) in Qujing city of Yunnan Province in 2020.Methods:Stool samples were collected from HFMD cases in Qujing city in 2020 and virus RNA was extracted directly from treated stool suspensions. Virus VP4 gene sequences were firstly amplified using MD91/OL68-1 primer pairs and sequenced, then the virus serotypes were determined by BLAST search on the GenBank. Virus entire VP1 gene sequences were amplified and sequenced. Virus serotypes were identified online using Enterovirus Genotyping Tool Version 0.1. Sequences of reference virus genotypes/sub-genotypes were downloaded according to references. Phylogenetic trees were constructed by MEGA5.2 software and the genetic characteristics were analyzed.Results:A total of 47 strains of enteroviruses (EVs) were detected with a detection rate of 10.22% (47/460). The detected viruses were coxsackievirus A4 (CVA4, 0.65%, 3/460), CVA6 (7.83%, 36/460), CVA10 (0.87%, 4/460) and CVA16 (0.87%, 4/460). All were enterovirus species A (EVA), while other group viruses were not detected. The predominant virus was CVA6, accounting for 7.83% (36/460). EVA71 was not detected. CVA4 strains of C2 and C4 subgenotypes were co-circulating strains in Qujing city. CVA6 subgenotype D3a and CVA16 subgenotype B1a were also circulated in Qujing city. All CVA10 strains were in a separate lineage.Conclusions:Similar to the previous situation in China, the detection rates of EVA71 and CVA16 were very low, even zero. This study showed that CVA6 was the predominant virus, indicating a HFMD outbreak caused by CVA6 in Qujing city in 2020. The phylogenetic analysis showed CVA10 isolates belonged to a separate lineage, which might be unique to Qujing city. Laboratory and molecular epidemiological surveillance of non-EVA71 and non-CVA16 viruses, especially CVA6 and CVA10 should be strengthened in the future.

Objective:To analyze the etiological characteristics of hand, foot and mouth disease (HFMD) cases and to investigate the genetic characteristics of VP1 region of coxsackievirus A6 (CVA6) and CVA16 strains in Wenshan prefecture of Yunnan Province in 2020.Methods:Virus RNA was extracted directly from stool samples of children with HFMD in Wenshan prefecture of Yunnan Province in 2020. Enterovirus (EV) VP4/VP2 junction region was amplified using MD91/OL68-1 primers and sequenced, and then the serotypes of EV isolates were preliminarily identified. Amplification and sequencing of the complete VP1 gene were performed. A phylogenetic tree was constructed by MEGA 5.2 software with the reference strains from GenBank. Genetic and molecular epidemiological characteristics of CVA6 and CVA16 were analyzed.Results:Thirty-two strains of EV and one strain of astrovirus MLB1 were detected in 317 specimens with an overall virus detection rate of 10.41% (33/317). Among the 32 EV strains, 31 (96.88%) were enterovirus species A (EVA) and one (3.12%) was EVB. EVC and EVD were not detected. CVA6 was the predominant EV, accounting for 62.50% (20/32), followed by CVA16 (18.75%, 6/32), CVA4 (9.37%, 3/32) and CVA10 (3.12%, 1/32). EVA71 was not detected. The phylogenetic analysis showed 20 CVA6 strains belonged to D3a sub-genotype and could be further divided into three clusters. Six CVA16 strains belonged to B1a sub-genotype, which was one of the predominant genotypes circulating in China, and could be divided into two clusters.Conclusions:The detection rate of pathogens causing HFMD in Wenshan prefecture in 2020 was 10.41% and the most common etiologic agents were CVA6 and CVA16. Based on the genetic analysis of the VP1 gene, the predominant genotype circulating in Wenshan prefecture in 2020 was CVA6 D3a sub-genotype, followed by CVA16 B1a sub-genotype. EVA71 was not detected.

目的 对2020年云南省曲靖地区手足口病(hand,foot and mouth disease,HFMD)病例中的柯萨奇病毒A组6型(Coxsackievirus A6,CV-A6)VP1区基因特征进行分析.方法 (1)直接从HFMD病例粪便标本中提取人类肠道病毒(human enteroviruses,EVs)RNA,先用MD91/OL68-1引物对病毒VP4/VP2结合区基因进行逆转录-聚合酶链反应(Reverse-Transcription Polymerase Chian Reaction,RT-PCR)和测序,确定病毒型别,再用各型病毒的相关引物扩增VP1区全序并测序,按测序定型标准对EVs进行VP1区定型;(2)按文献下载基因库中CV-A6病毒VP1区基因参考序列,用MEGA 5.2软件构建系统进化树,进行基因特征和分子流行病学分析.结果 2020年共从曲靖地区HFMD病例500份标本中检测到49株EVs,EVs阳性率为9.80％(49/500).49株EVs 中,A 组病毒(enterovirus species A,EV-A)48份,占阳性总数的97.96％(48/49),B 组病毒(enterovirus species B,EV-B)1 份,占2.04％(1/49).A 组病毒共4个血清型,其中 CV-A4 3株,占6.12％(3/49);CV-A636株,占73.47％(36/49);CV-A105株,占 10.20％(5/49);CV-A164株,占8.16％(4/49).B 组病毒只检测到1株,一个血清型(CV-B4).用MEGA5.2软件对36株CV-A6病毒的VP1基因完整序列(915bp)和Yang Song、Mizuta K等发表的26株参考株序列共62株病毒作基因进化分析,曲靖地区36株均为D3a亚型.结论 2020年云南省曲靖地区HFMD流行以CV-A6(占73.47％)为主.基因进化分析表明,跟以往中国内地的情况一样,云南省曲靖地区2020年流行的CV-A6为D3a基因亚型,加强CV-A6病毒的实验室和分子流行病学监测是今后曲靖地区乃至云南省HFMD监测的重要工作.

探讨2018-2019年云南省15 702例手足口病(Hand,foot and mouth disease,HFMD)病原学和流行病学分布特征,为手足口病防控工作提供依据.应用实时荧光定量PCR方法检测手足口病临床诊断病例标本中的EV-A71(Enterovirus 71,EV-A71)、CVA16(Coxsackievirus A16,CVA16)和其他肠道病毒.15 702份标本的病原检出率为75.78％(11 899/15 702),以其他肠道病毒为主,占阳性标本的48.85％(5 813/11 899);其次为CVA16,占阳性标本的40.98％(4876/11 899);EV-A71感染较少.手足口病病例每月均有报告,高峰出现在4-7月.男性多于女性,性别比约为1.44∶1.病例主要集中在1岁组和2岁组,分别占30.72％(4 824/15 702)和23.66％(3 715/15 702).不同标本类型的阳性检出率存在统计学差异(x2=128.857,P＜0.001),粪便＞咽拭子、肛拭子.不同病例类型的标本阳性检出率不同,重症病例明显高于轻症病例,有统计学意义.共分离毒株403株,其中CVA16 152株、EV-A7158株、CVA6 112株、CVA10 53株,其他28株.CVA16毒株的VP1基因核苷酸与氨基酸序列同源性分别为85.8％～100％和98.6％～100％,EV-A71毒株的VP1基因核苷酸与氨基酸序列同源性分别为95.1％～100％和98.7％～100％.2018-2019年云南省15 702例手足口病病原主要由CVA16和其他肠道病毒感染引起,应加强手足口病病原体的监测和分型鉴定,为进一步制订手足口病防控措施提供依据.

目的 分析云南省2021年手足口病(Hand,foot,and mouth disease,HFMD)病例埃可病毒18型(Echovirus 18,E18)分离株基因特征.方法 从2021年云南省2个市州HFMD病例粪便标本中分离E18;对VP1区基因进行扩增、测序和拼接,获得全序列;构建E18分离株与GenBank中参考株的系统进化树,分析基因特征.结果 从HFMD病例中获得8株E18分离株,其完整VP1区序列的核苷酸、氨基酸同源性分别为96.75％-99.77％、97.21％-100％;与原型株Metcalf相比的核苷酸、氨基酸同源性分别为77.24％-78.63％、91.99％-93.73％.基于VP1区分型,8株分离株均属于基因型5分支2,且在VP1区存在特有的氨基酸位点变异(T80A、I240V、T274S和H281R).结论 本研究E18分离株属于基因型5,可能在环境中循环了一段时间.需进一步加强HFMD病例E18监测和分子生物学特征研究.

目的 了解云南省病毒性腹泻患儿轮状病毒基因型特征并探索其流行规律,为轮状病毒感染防控提供参考依据.方法 2016年1月至2020年12月云南省病毒性腹泻监测点采集腹泻样本894份,送云南省疾病预防控制中心进行轮状病毒抗原检测,阳性样本用PCR方法进行G/P基因分型,并用轮状病毒VP7基因测序进行进化分析.结果 2016-2020年共收集病毒性腹泻病例894例.2岁年龄组幼儿轮状病毒检出率较高,为32.32％(32/99);轮状病毒检出率有上升趋势,气温较低月份轮状病毒高发,12～2月检出率高达47.92％(138/288).该地轮状病毒有多个基因型,主要的基因型是G9P[8]、G3P[8],分别占总基因型的72.15％(158/219)、8.68％(19/219),2020年云南省首次检出G4P[4]基因型.结论 云南省病毒性腹泻监测发现轮状病毒高发,尤其在气温较低的月份,并有多种基因型分布.应加强幼儿轮状病毒疫苗的接种工作,加强监测,谨防新的型别轮状病毒引起的暴发.

目的 了解云南省2009-2019年手足口病重症的流行分布特点、病原谱构成及变迁,探索重症病例的影响因素.方法 手足口病病例信息来源于"传染病报告信息管理系统"手足口个案,对重症病例的流行病学及病原学特征进行描述;采用多因素logistic回归分析重症病例的危险因素.结果 2009-2019年,云南省手足口病重症病例占报告手足口病例总数的1.37％,年均重症率1.97/10万;重症手足口发病呈现季节性,高峰时间为3-8月,5岁及以下儿童占全部重症的97.71％,散居儿童高于幼托儿童,男性多于女性.感染EV-A71的病例发展为重症的风险最高,自2013年起,其他肠道病毒的病原构成逐年持续增加.男性(OR=1.128,95％CI:1.083～1.175)、低年龄(0～12月龄,OR=2.279,95％CI:2.031～2.557;13～24 月龄 OR=2.326,95％CI:2.095～2.582)、EV-A71 感染(OR=14.834,95％CI:14.122～15.583)、诊断时病程较长(1 天OR=1.578,95％CI:1.459～-1.708;2 天OR=2.709,95％CI:2.504～2.931;3天及以上OR=4.623,95％CI:4.294～4.978)与重症手足口病发病风险增加相关.结论 性别、年龄、病毒分型、诊断时病程是重症手足口病的影响因素,注重小年龄组儿童看护人的健康宣教,加大医护人员培训早期识别重症手足口病和EV-A71疫苗在偏远且病原流行州市的推广是防治重症手足口病的有力措施.

Objective:To understand the pathogenic spectrum of hand, foot and mouth disease (HFMD) and the genetic characteristics of coxsackievirus A6 (CV-A6) strains in Kunming from 2016 to 2018.Methods:The specimens of HFMD patients were collected from HFMD surveillance system of Yunnan from 2016 to 2018. Real-time RT-PCR was used for the detection of CV-A16, enterovirus A71 (EV-A71) and other EVs. VP1 genes of other positive samples were amplified by routine RT-PCR and sequenced. The phylogenetic tree of CV-A6 was constructed by MEGA 5.2 software with the reference strains from Genbank and the molecular epidemiological characteristics were analyzed.Results:Pathogenic surveillance results of Kunming from 2016 to 2018 showed that there were 2 318 cases with HFMD, among whom 417 had EV-A71 infection, 883 had CV-A16 infection, and 1 018 had other EVs infection. In 2016, CV-A16 was the dominant pathogen (50.26%) . In 2017 and 2018, the dominant pathogens were other EVs, accounting for 56.06% and 54.03%, respectively. A total of 57 CV-A6 strains isolated from other EVs belonged to sub-genotype D3a.Conclusions:From 2016 to 2018, the main pathogens of HFMD in Kunming were CV-A16 and other EVs. The surveillance of other EVs in routine monitoring should be strengthened, and the continuing prevalence of CV-A6 needs to be paid more attention.

目的 探究昆明市慢性丙型肝炎患者抑郁、焦虑状况及影响因素.方法 随机选取2013年1月至2018年12月昆明市传染病监测系统报告的慢性丙型肝炎患者480例作为研究对象,采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评估慢性丙型肝炎患者抑郁、焦虑程度,通过单因素分析与Logistic回归分析筛选影响患者抑郁、焦虑的相关因素.结果 480例慢性丙型肝炎患者中男/女为320/160,平均年龄(45.40±3.72)岁,病程0.5～12.0年,平均(7.63±2.45)年.患者SDS评分为(47.81±9.69)分、SAS评分为(42.62±9.53)分,其中SDS≥53分的有124例(25.83％),SAS≥50分的有110例(22.92％).Logistic回归分析显示:初中及以下文化程度(OR=2.986)、中间型性格(OR=1.895)、内向型性格(OR=1.869)、人均月收入＜1000元(OR=3.735)、感到被歧视(OR=1.447)是影响患者抑郁的独立危险因素,知晓预防措施(OR=0.326)为保护因素;中间型性格(OR=1.957)、内向型性格(OR=2.043)及感到被歧视(OR=1.862)是影响患者焦虑的危险因素,知晓预防措施(OR=0.387)为保护因素.结论 昆明市慢性丙型肝炎患者抑郁、焦虑评分处于较高水平,文化程度低、性格内向、收入低、感到被歧视是影响抑郁、焦虑的危险因素,知晓预防措施为保护性因素.

埃可病毒11型(Echovirus 11,ECHO11)属于肠道病毒B组,是最常见的人类肠道病毒(Human enterovirus,HEV)之一,常引起儿童无菌性脑膜炎、脑炎和急性迟缓性麻痹等疾病.为了对云南省手足口病(Hand,foot,and mouth disease,HFMD)监测中分离到的4株ECHO11毒株的VP1基因进行序列分析,并为云南地区ECHO11的进化及流行趋势等研究提供基础数据,本研究对收集到的HFMD病例标本进行病毒分离培养和鉴定,对鉴定为ECHO11的毒株VP1基因测定其完整序列,与GenBank上其他参考株的VP1区序列构建遗传进化树进行基因分析.结果显示,4株ECHO11型毒株分属A1和D5两个基因亚型,分别与各自基因亚型参考株的同源性为最高.D5基因亚型ECHO11分离株在进化树上聚集为3簇,提示存在多个传播链,其D5-1簇的VP1区氨基酸在多个位点上与同基因亚型的其他簇参考株存在特异突变.本研究揭示,云南地区存在两种不同基因亚型的ECHO11流行情况,特别是D5亚型的出现,提示我国周边流行的ECHO11基因型已进入中国大陆,应密切关注其流行变异情况,为今后制定由ECHO11引起的HFMD的公共卫生策略提供依据.