Regamey Nicolas, Kaiser Laurent, Roiha Hanna L, Deffernez Christelle, Kuehni Claudia E, Latzin Philipp, Aebi Christoph, Frey Urs
Pediatric Respiratory Medicine, University Children's Hospital of Berne, Berne, Switzerland.
Pediatr Infect Dis J. 2008 Feb;27(2):100-5. doi: 10.1097/INF.0b013e31815922c8.
Acute respiratory infections (ARI) are a major cause of morbidity in infancy worldwide, with cough and wheeze being alarming symptoms to parents. We aimed to analyze in detail the viral aetiology of ARI with such symptoms in otherwise healthy infants, including rhinoviruses and recently discovered viruses such as human metapneumovirus (HMPV), coronavirus NL63 and HKU1, and human bocavirus (HBoV).
We prospectively followed 197 unselected infants during their first year of life and assessed clinical symptoms by weekly standardized interviews. At the first ARI with cough or wheeze, we analyzed nasal swabs by sensitive individual real time polymerase chain reaction assays targeting 16 different respiratory viruses.
All 112 infants who had an ARI had cough, and 39 (35%) had wheeze. One or more respiratory viruses were found in 88 of 112 (79%) cases. Fifteen (17%) dual and 3 (3%) triple infections were recorded. Rhino- (23% of all viruses) and coronaviruses (18%) were most common, followed by parainfluenza viruses (17%), respiratory syncytial virus (RSV) (16%), HMPV (13%), and HBoV (5%). Together rhinoviruses, coronaviruses, HMPV, and HBoV accounted for 60% (65 of 109) of viruses. Although symptom scores and need for general practitioner (GP) consultations were highest in infants infected with RSV, they were similar in infants infected with other viruses. Viral shedding at 3 weeks occurred in 20% of cases.
Rhinoviruses, coronaviruses, HMPV, and HBoV are common pathogens associated with respiratory symptoms in otherwise healthy infants. They should be considered in the differential diagnosis of the aetiology of ARI in this age group.
急性呼吸道感染（ARI）是全球婴儿发病的主要原因，咳嗽和喘息是令家长担忧的症状。我们旨在详细分析健康婴儿出现此类症状的ARI的病毒病因，包括鼻病毒以及最近发现的病毒，如人偏肺病毒（HMPV）、冠状病毒NL63和HKU1，以及人博卡病毒（HBoV）。
我们前瞻性地跟踪了197名未经过挑选的婴儿的第一年生活，并通过每周标准化访谈评估临床症状。在首次出现咳嗽或喘息的ARI时，我们通过针对16种不同呼吸道病毒的敏感个体实时聚合酶链反应检测法分析鼻拭子。
所有112名患ARI的婴儿都有咳嗽，39名（35%）有喘息。112例病例中的88例（79%）发现了一种或多种呼吸道病毒。记录到15例（17%）双重感染和3例（3%）三重感染。鼻病毒（占所有病毒的23%）和冠状病毒（18%）最为常见，其次是副流感病毒（17%）、呼吸道合胞病毒（RSV）（16%）、HMPV（13%）和HBoV（5%）。鼻病毒、冠状病毒、HMPV和HBoV共同占病毒的60%（109例中的65例）。虽然感染RSV的婴儿症状评分和全科医生（GP）会诊需求最高，但感染其他病毒的婴儿症状评分和会诊需求相似。2周龄时病毒脱落的情况在20%的病例中出现。
鼻病毒、冠状病毒、HMPV和HBoV是健康婴儿呼吸道症状的常见病原体。在该年龄组ARI病因的鉴别诊断中应考虑这些病毒。
