为监测2014年上海地区手足口病住院患儿的病原学分布及临床流行病学特征，本研究前瞻性地收集2014年复旦大学附属儿科医院住院的上海市手足口病患儿粪便标本及有关流行病学和临床资料，采用商品化一步法实时荧光定量反转录-聚合酶链反应(reverse transcriptase-polymerase chain reaction，RT-PCR)和套式PCR行肠道病毒检测，测序后再对病毒分型。2014年复旦大学附属儿科医院门诊共报告19 622例手足口病患儿，1 059例(5.4%)收入病房治疗。收集到547例患儿的粪便标本，448例(81.9%)肠道病毒核酸阳性。检出9种型别肠道病毒：EV71在2—7月呈优势流行；CA16在6—9月检出率较高；CA6在1—7月零星流行，主要集中在8—12月。162例(29.6%)有明确的与手足口病或疱疹性咽峡炎患者接触史。210例(19.8%)确诊为重症病例。EV71感染的重症比例为30.3%(70/231)，CA16感染的重症比例为1.2%(1/83)，CA6感染的重症比例为0.9%(1/115)。结果显示，2014年上海地区手足口病全年流行，夏秋季高发，大部分患儿无明确暴露史。多种肠道病毒共流行，EV71、CA6、CA16为2014年主要流行的肠道病毒，且交替优势流行，EV71仍是重症手足口病的主要病原体。

The purpose of the present study is to monitor the etiological and epidemiological characteristics of hospitalized children with hand, foot and mouth disease (HFMD) in Shanghai, 2014. The stool samples, epidemiological and clinical data of hospitalized children with HFMD in Children’s Hospital of Fudan University were collected in 2014. One-step real-time fluorescence quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and nested PCR were performed for enterovirus detection and typing. Among 19 622 children with HFMD, 1 059 (5.4%) were hospitalized and 547 inpatients were included into this study. Enterviruses were confirmed virologically in 448 (81.9%) children and nine types of enteroviruses were identified. EV71 was more prevalent during February and July; CA16 was relatively prevalent during June and September; CA6 was sporadic from January to July, but prevalent during August and December. One hundred and sixty-two (29.6%) cases had close contact with children suffering from HFMD or herpangina. Two hundred and ten (19.8%) cases were confirmed as severe cases with meningitis or encephalitis. The detection rates of EV71, CA16 and CA6 were 30.3% (70/231), 1.2% (1/83) and 0.9% (1/115)in severe cases, respectively. The results showed that HFMD was prevalent in Shanghai, 2014, and peaked in summer and autumn. Multiple enteroviruses co-circulated in HFMD children. Most cases had no definite exposure history. EV71, CA6 and CA16 were the predominant viruses causing the epidemics of HFMD in Shanghai, 2014, and EV71 remained the major cause for severe diseases.