The Comparison Between RT-PCR And FQ-PCR Test Methods And Analysis Of Epidemic Characteristics Of HFMD In Bozhou

Objectives:Hand-foot-and-mouth disease (HFMD)is a common infective disease ininfant period,which is caused by enterovirus.Human enterovirus?1(EV71) andcoxsakievirusA16(CoxA16) are the most two common causes of HFMD. Clinicalmanifestations of HFMD infants includ fever, skin herpes, Oral mucosa ulcer. HFMD isSelf-limited disease,and most patient have a good prognosis,but still a few infants canget some Serious diseases,such as myocarditis，pulmonary edema, asepticmeningitis，even death.In recent years,there are a few outbreak of HFMD in Malaysia, Taiwan of China,Singapore，Australia.Those cause serious complications,even death,which was causedby EV71.There were many outbreaks in China, The accumulated report HFMD nearly25000cases,in which nearly34children died.Shandong province had11489cases in thebeginning of April2009,in which serious cases had260and15cases weredied,epidemic is still in the development. In2010，the HFMD ofifcial reports to reachmore than1.77millions.Bozhou is the epidemic district of China,so it has great signiifcance in HFMDprevention, detection and treatment process to research epidemiological feature ofHFMD,how to detect agents early, rapidly. How to evaluate the risk of Suffering from severe even and giving promptly correct intervention are very importantof improving disease prognosis and survival in patients.This study was condueted toinvestigate the casual causes of HFMD in children during an epidemic from January toDecember of2011in Bozhou, in order to know the intestinal virus infection situation inBozhou, and study how to detect pathogens of HFMD early, quickly and accurately andprovidethe basis for the comprehensive prevention of HFMD and dynamic monitoringof intestinal virus.Methods:252specimens which include188throat swabs,53feces,7vesicle fluids and4cerebrospiral fluids, were collected from193patients who got HFMD inCDCmanages area of Bozhou province in2011. We detect the specific nucleic acid fragmentof EV,EV71and CA16using fluorescence quantitative retrovirus polymerase chainreaction(FQ-PCR). We compare the positive rate of252different kinds of specimenrespectively from193clinically diagnosed cases,and judge whether the detection rate ofdifferent specimens with statistics difference,to find one kind of clinical laboratoryspecimen which is convenient and easily to get.Detect the124swabs from188withreverse transcription polymerase chain reaction (RT-PCR)，and compared thedifference of positive rate between RT-PCR and FQ-PCR.send the inconsistentspecimens to Beijing Huatai pioneer biological co.，LTD to do sequencing. Collect theclinical epidemiological data of HFMD kids，do statistics analysis using the SPSS13.0，the comparison of two sample rate with fisher’s/pairing chi-square test, several samplerate comparison with line by list chi-square test.Results：(1)Swab specimens virus detection rate was75.00%(106/188)，feces detection rate was81.13%(43/53)，herpes fluid specimen detection rate85.71%(6/7)，cerebrospinal fluiddetection rate25%(l/4).This study shows that herpes fluid specimen virus detectionrate is the highest.(2)In252specimens,191for intestinal general virus positive, of which106specimens were EV71positive,25specimens were CA16positive,60specimens CA16and EV71are both positive.EV71positive detection rate is significantly higher than CA16andmixed infection positive detection rate (x2=63.369，P=0.000<0.05)，CA16separateinfection is infrequent and often with the popularity of EV71.(3)Take joint sampling of53cases of clinical diagnosis in this study. Differentcombinations of swab specimens,feces，cerebrospinal lfuid，herpes fluid specimen haddifferent detection positive rate, joint sampling can inproved detection positive rate.(4)Compared the positive detection rate of CA16and EV71detected by FQ-PCR andRT-PCR respectively, differences are significant statistical significance (x2were99.2,101.98，P is equal to0.000<0.05).(5)141specimens were EV71positive or CA16positive or both positive in this study(total positive detection rate was75.00%). but the virus nucleic acid positive detectionrate in different time phase were different, and show statistically significant.Conclusion：(1)EV71and CA16were the major pathogenic virus of HFMD in Bozhou in2011.(2)EV71was the most popular pathogenic virus in Bozhou in2011,and CA16infectedaccompany with EV71usually.(3)All of the HFMD patients got rashes on hand，foot and mouth. Clinicians canHardly distinguish these two viruses through clinical manifestations.(4)herpes fluid specimen virus detection rate is the highest, excrement，urine,andpharyngeal swab specimens is the second, cerebrospinal fluid is the lowest, but thedifference had no sense of statistics between detection rate comparison(x2=6.888，P=0.076>0.05).(5)The comparison of detection positive rate between RT-PCR and FQ-PCR hadsignificant difference. FQ-PCR detection sensitivity is higher, and can detect thevirus specific copy number, so it can be used for the HFMD pathogenic earlydiagnosis, and RT-PCR more suitable for the large-scale epidemic early routineinspection.