Positive Rates of Viral Culture in Three Types of Specimens during an Outbreak of Hand-Foot-Mouth Disease (HFMD) in Taiwan, 1998

1998年台灣地區手口足症流行期間三種不同檢體病毒培養陽性率之比較

游雅言(Ya-Yan Yu)；施木青(Mu-Chin Shih)；曹龍彥(Lon-Yen Tsao)；黃凱琳(Kai-Lin Hwang)；張雅雯(Ya-Wen Chang)

病毒培養分離率 ； 手口足症 ； 腸病毒 ； 腸病毒71型 ； viral culture positive rates ； outbreak ； hand-foot-mouth disease(HFMD) ； enteroviruses ； EV71

The Changhua Journal of Medicine

6卷3期（2001 / 07 / 01）

142 - 149

英文

背景：供研究的檢體是收集自1998年台灣地區手口足症(Hand-Foot-Mouth Disease, HFMD)流行期間，在彰化基督教醫院因有手口足症或咽峽炎而住院的56名患者。總共收集了154個檢體，包括了53個糞便／肛門拭子，53個喉頭拭子以及48個腦脊髓液檢體。研究目的是探討實驗室中培養病毒的技巧以及三種不同檢體別病毒分離率的比較。 方法：這些檢體都接種至細胞中作病毒培養，病毒的偵測確認是根據反轉錄－聚合連鎖反應(RT-PCR)以及序列分析。 結果：在這些檢體中，三種檢體的病毒分離率分別是：喉頭拭子58.5%，糞便／肛門拭子49.1%，腦脊髓液檢體12.5%。56名患者中有38名培養出病毒(67.9%)。培養出來的病毒種類包括：腸病毒71型81.6%(31/38)，克沙奇病毒A16型5.3%(2/38)，克沙奇病毒B2型2.6%(l/38)，伊科病毒6型2.6%(l/38)，伊科病毒7型7.9%(3/38)。 結論：根據以上的數據顯示，1998年台灣地區爆發的手口足症疫情中，三種檢體的病毒分離率以喉頭拭子最高，且造成手口足症或咽峽炎最重要的腸病毒株為腸病毒71型。

Background: The purpose of this study was to describe laboratory techniques used for viral detection and compare culture positive rates among three types of specimens collected from 56 patients during an outbreak in Taiwan, 1998. A total of 154 specimens including 53 stool/rectal swabs, 53 throat swabs, and 48 CSF specimens were obtained from 56 hospitalized pediatric patients with either Hand-Foot-Mouth Disease (HFMD) or herpangina seen in Changhua Christian Hospital (CCH). Methods: These specimens were passed in cell culture and attempts to detect the presence of viral agents were made by RT-PCR and sequencing techniques. Results: Of the specimens studied, 58.5% of throat-swab samples were culture positive, whereas 49.1% of stool/rectal swabs and only 12.5% of CSF specimens were culture positive. Overall, virus detection was successful in 67.9%(38/56) of the patients studied. Enterovirus strains detected among the culture positives included the following: enterovirus (EV) 71, 81.6%(31/38), Coxsackievirus Al6, 5.3%(2/38), Coxsackievirus B2, 2.6%(1/38), Echovirus 6, 2.6%(1/38) and Echovirus 7, 7.9%(3/38). Propagation of enterovirus in either rhabdomyosarcoma (RD) cells or Vero cells yielded similar culture results. Conclusion: Based on the data shown above, we concluded that throat-swab specimens yielded the highest culture positive rate for any enteroviruses and the most prevalent enterovirus strain identified in HFMD/herpangina patients during an outbreak of HFMD in Taiwan, 1998 was EV71.