分析2013至2015年北京大学北京地坛医院教学医院手足口病住院患者的病原体类型及分布特点，为手足口病的诊疗及预防提供关键性的指导。

收集2015年北京大学北京地坛医院教学医院儿科收治的手足口病住院患者共84例的咽拭子及粪便标本，提取病毒RNA，采用实时荧光聚合酶链反应（real time-PCR）法，进行肠道病毒（EV）通用型、肠道病毒71（EV71）型及柯萨奇A16（CoxA16）型肠道病毒核酸检测，并与2013年和2014年度本院手足口病病原学结果进行对比分析。

2015年手足口病患者的EV阳性率为86.9%（73/84），其中EV71型肠道病毒占44.05%（37/84），非EV71非CoxA16型肠道病毒占40.48%（34/84），CoxA16型肠道病毒占2.38%（2/84）。与2013年相比，2015年非EV71非CoxA16型肠道病毒感染率显著下降（χ² = 10.20、P = 0.001），差异具有显著统计学意义，而EV71型感染率显著升高（χ² = 28.38、P < 0.001），差异具有极显著统计学意义；与2014年相比，2015年非EV71非CoxA16型肠道病毒感染率显著升高（χ² = 15.50、P < 0.001），差异均具有极显著统计学意义；EV71型感染率有所下降，但差异无统计学意义（χ² = 1.89、P = 0.019）。

2013至2015年手足口病病原学分布变化较大，2013年本院手足口病患者以非EV71非CoxA16型肠道病毒感染为主；2014年以EV71型肠道病毒感染为主；2015年以EV71型和非EV71非CoxA16型肠道病毒感染为主，在未来的手足口病防控中应在重视EV71型肠道病毒感染的同时，重视非EV71非CoxA16型肠道病毒感染。

To investigate the pathogens types and distribution features among pediatric patients with hand, foot and mouth diseases (HFMD) in Beijing Ditan Hospital, Peking University Teaching Hospital, from 2013 to 2015, and to provide crucial guidance for the diagnosis, treatment and prevention of HFMD.

The throat swabs of 84 cases hospitalized in division of pediatrics in our Hospital in 2015 were collected. Real-time fluorescence quantitative (real time-PCR) kits with universal enterovirus (EV) primers, Coxsackievirus A16 (CoxA16)-specifi primers and enterovirus 71 (EV71)-specifi primers were used to detect the samples after RNA extraction. The etiology results of HFMD of 2015 were compared with 2013 and 2014 in our hospital, repectively.

In 2015, the positive rate of EV was 86.9% (73/84), the EV71 accounted for 44.05% (37/84) and the non-EV71, non-CoxA16 enteroviruses accounted for 40.48% (34/84), the CoxA16 enteroviruses accounted for 2.38% (2/84). Compared with 2013, the infection rate of non-EV71, non CoxA16 enteroviruses decreased significantly in 2015 (χ² = 10.20, P = 0.001); the infection rate of EV71 enteroviruses increased significantly (χ² = 28.38, P < 0.001). Compared with 2014, the infection rate of non-EV71 and non-CoxA16 enteroviruses increased significantly in 2015, with extremely significant difference (χ² = 15.50, P < 0.001); the infection rate of EV71 enteroviruses decreased, with significant difference (χ² = 1.89, P = 0.019).

From 2013 to 2015, the changes of distribution and variation of pathogens of HFMD were significant. In 2013, the etiology of pediatric patients with HFMD in our hospital was dominated by EV71 enteroviruses; but in 2014, the EV71 prevailed again. In 2015, the etiology was dominated by EV71, non-EV71 and non-CoxA16 enteroviruses. In prevention and control of HFMD, the non-EV71 and non-CoxA16 enteroviruses infection and EV71 enteroviruses infection should be considered.