Richard Nathalie, Komurian-Pradel Florence, Javouhey Etienne, Perret Magali, Rajoharison Alain, Bagnaud Audrey, Billaud Geneviève, Vernet Guy, Lina Bruno, Floret Daniel, Paranhos-Baccalà Gláucia
Service d'Urgence et de Réanimation Pédiatriques, Hôpital Edouard Herriot, Lyon, France.
Pediatr Infect Dis J. 2008 Mar;27(3):213-7. doi: 10.1097/INF.0b013e31815b4935.
Bronchiolitis is a major cause of morbidity and mortality in early childhood worldwide. The presence of more than one pathogen may influence the natural history of acute bronchiolitis in infants.
To investigate the relevance of dual viral infection in infants with severe bronchiolitis hospitalized in a short-term unit compared with those in a pediatric intensive care unit (PICU).
One hundred eighty infants <1 year old hospitalized with bronchiolitis in a short-term unit (n = 92) or admitted to the PICU (n = 88) during 2 consecutive winter seasons 2003/2004 and 2004/2005 were evaluated. Molecular biology and standard methods were used to diagnose human respiratory viruses in nasal/throat swabs and nasal aspirates. Clinical data related to host factors and viral prevalence were compared among infants requiring or not PICU support.
A viral agent was identified in 96.1% of infants with bronchiolitis. Respiratory syncytial virus (70.6% and 73.6%, respectively in the short-term unit and PICU) and rhinovirus (18.5% and 25.3%, respectively in the short-term unit and PICU) were the main detected respiratory viruses in infants hospitalized in both units. No significant difference in viral prevalence was observed between the populations studied. From multivariate analysis, infants with coinfections were 2.7 times (95% CI: 1.2-6.2) more at risk for PICU admission than those with a single infection. Respiratory syncytial virus and rhinovirus were the viruses most frequently identified in mixed infections in infants hospitalized with bronchiolitis.
Dual viral infection is a relevant risk factor for the admission of infants with severe bronchiolitis to the PICU.
细支气管炎是全球幼儿发病和死亡的主要原因。多种病原体的存在可能会影响婴儿急性细支气管炎的自然病程。
研究在短期病房住院的重症细支气管炎婴儿与入住儿科重症监护病房（PICU）的婴儿相比，双重病毒感染的相关性。
对2003/2004年和2004/2005年连续两个冬季在短期病房住院（n = 92）或入住PICU（n = 88）的180名1岁以下细支气管炎婴儿进行了评估。采用分子生物学和标准方法对鼻/咽拭子和鼻吸出物中的人类呼吸道病毒进行诊断。比较了需要或不需要PICU支持的婴儿中与宿主因素和病毒流行率相关的临床数据。
96.1%的细支气管炎婴儿中鉴定出病毒病原体。呼吸道合胞病毒（短期病房和PICU分别为70.6%和73.6%）和鼻病毒（短期病房和PICU分别为18.5%和25.3%）是两个病房住院婴儿中主要检测到的呼吸道病毒。在所研究的人群中，病毒流行率没有显著差异。多因素分析显示，合并感染的婴儿入住PICU的风险是单一感染婴儿的2.7倍（95%CI：1.2 - 6.2）。呼吸道合胞病毒和鼻病毒是细支气管炎住院婴儿混合感染中最常鉴定出的病毒。
双重病毒感染是重症细支气管炎婴儿入住PICU的一个相关危险因素。
