Graat Judith M, Schouten Evert G, Heijnen Marie-Louise A, Kok Frans J, Pallast Esther G M, de Greeff Sabine C, Dorigo-Zetsma J Wendelien
Division of Human Nutrition and Epidemiology, Wageningen University, Bomenweg 4, P.O. Box 8129, 6703 HD, Wageningen, The Netherlands.
J Clin Epidemiol. 2003 Dec;56(12):1218-23. doi: 10.1016/s0895-4356(03)00171-9.
BACKGROUND/OBJECTIVES: Community-based elderly studies concerning microbiology of acute respiratory infections are scarce. Data on subclinical infections are even totally absent, although asymptomatic persons might act as a source of respiratory infections.
In a 1-year community-based study, we prospectively investigated the possible virologic cause of acute respiratory infections in 107 symptomatic case episodes and 91 symptom-free control periods. Participants, persons >/=60 years, reported daily the presence of respiratory symptoms in a diary. Virologic assessment was performed by polymerase chain reaction (PCR) and serology.
In 58% of the case episodes a pathogen was demonstrated, the most common being rhinoviruses (32%), coronaviruses (17%), and influenzaviruses (7%). The odds ratio for demonstrating a virus in cases with symptoms vs. controls without symptoms was 30.0 (95% confidence interval 10.2-87.6). In 4% of the symptom-free control periods a virus was detected.
This study supports the importance of rhinovirus infections in community-dwelling elderly persons, whereas asymptomatic elderly persons can also harbor pathogens as detected by PCR, and thus might be a source of infection for their environment.
背景/目的：关于社区老年人急性呼吸道感染微生物学的研究较少。关于亚临床感染的数据甚至完全缺失，尽管无症状者可能是呼吸道感染的一个来源。
在一项为期1年的社区研究中，我们前瞻性地调查了107例有症状病例发作和91个无症状对照期内急性呼吸道感染可能的病毒学病因。参与者为年龄≥60岁的人群，他们每天通过日记报告呼吸道症状的出现情况。通过聚合酶链反应（PCR）和血清学进行病毒学评估。
在58%的病例发作中检测到病原体，最常见的是鼻病毒（32%）、冠状病毒（17%）和流感病毒（7%）。有症状病例中检测到病毒与无症状对照相比的优势比为30.0（95%置信区间10.2 - 87.6）。在4%的无症状对照期检测到病毒。
本研究支持鼻病毒感染在社区居住老年人中的重要性，而无症状老年人也可能携带通过PCR检测到的病原体，因此可能是其周围环境的感染源。
