摘要目的:分析2010-2023年广州市≥6岁人群手足口病流行特征，为科学有效防控大年龄组人群手足口病提供依据。方法:收集广州市2010-2023年≥6岁人群手足口病发病数据，描述疾病的三间分布特征和病原构成变化，并以镇街为单位进行空间自相关分析和热点分析，探索病例的空间聚集分布模式。结果:2010-2023年，广州市≥6岁人群手足口病报告病例中，男女性别比为1.49∶1。≥6岁人群的年平均报告发病率为25.75/10万，报告发病率呈上升趋势。每年发病呈双峰分布，5-7月为发病主高峰，9-10月为次高峰。手足口病发病率在各镇街间呈不均匀分布，热点区域集中在主城区及其周边的城乡接合部。优势毒株在不同年份间频繁更迭，2010年肠道病毒71型（EV71）占主导地位，2011-2016年以其他肠道病毒和柯萨奇病毒（CV）-A16为主，自2017年起，CV-A6逐渐成为优势病原。结论:2010-2023年广州市≥6岁人群手足口病患者发病率整体呈上升趋势，热点区域集中在主城区及其周边的城乡接合部。病原构成发生明显变化，EV71占比整体呈下降趋势，而CV-A6逐渐成为优势病原。应重视该年龄段人群手足口病的防控工作，特别是在流行热点区域加强防控措施。

abstractsObjective:The purpose of this study was to analyze the epidemiological characteristics of hand, foot, and mouth disease (HFMD) among individuals aged 6 years and above in Guangzhou from 2010 to 2023, with the intention that a scientific basis be provided for effective prevention and control measures in older age groups.Methods:Data on HFMD incidence among individuals aged 6 years and above in Guangzhou from 2010 to 2023 were collected and analyzed. Descriptive epidemiological methods were used to analyze the distributions and pathogen components of HFMD cases in Guangzhou residents aged 6 years and above. Spatial autocorrelation analysis and Getis-Ord Gi* analysis were conducted to identify the spatial clustering patterns of HFMD at the street town level. Results:From 2010 to 2023, the gender ratio of HFMD cases in persons aged 6 and above was 1.49∶1 in Guangzhou. The average annual incidence rate of HFMD among individuals aged 6 years and above in Guangzhou was 25.75 per 100 000. Furthermore, the reported incidence rate indicated an increased tendency. The annual incidence showed a bimodal distribution, with the main peak occurring from May to July and the secondary peak from September to October. HFMD incidence rates vary by townships, with hotspots clustered in urban and urban-rural regions. The dominant pathogen shifts from year to year. Enterovirus 71 (EV71) was the prevalent strain in 2010, followed by other enteroviruses and Coxsackievirus (CV)-A16 from 2011 to 2016. Since 2017, CV-A6 has steadily become the major pathogen.Conclusions:The incidence of HFMD cases among individuals aged 6 years and above in Guangzhou increased generally from 2010 to 2023, with hotspots localized in urban and urban-rural areas. The pathogen composition altered dramatically, with the proportion of EV71 dropping overall, while CV-A6 eventually became the dominating strain. Therefore, it is imperative to focus on the prevention and control of HFMD in this age group, especially by strengthening measures in areas with high prevalence.