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Diagn Microbiol Infect Dis. 2013 Jun;76(2):162-7. doi: 10.1016/j.diagmicrobio.2013.02.011. Epub 2013 Mar 25.

A new factor influencing pathogen detection by molecular assay in children with both mild and severe hand, foot, and mouth disease.

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Department of Clinical Laboratory, YouAn Hospital Affiliated to Capital Medical University, Beijing 100069, China.


This study aimed to find novel information concerning pathogen detection and some probable coinfection factors in hand, foot, and mouth disease (HFMD). In this study, 1104 clinically diagnosed HFMD patients were included. Enterovirus 71 (EV71), coxsackievirus A16 (CA16), and 14 different respiratory pathogens were examined from nasopharyngeal swabs using polymerase chain reaction (PCR) or reverse transcriptase PCR (RT-PCR). To evaluate the immune activation in HFMD patients, 8 cytokines and IgM antibodies to EV71 and CA16 from mild and severe patients were detected. Our results indicated that the severity of HFMD may affect the pathogen detection. The lower positive rates of enterovirus and respiratory viruses in severe HFMD cases by RT-PCR were probably related to stronger immune response. Therefore, immunological tests such as ELISA are essential supplements to PCR or RT-PCR in order to increase pathogen diagnosis in HFMD, especially in severe cases.

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