Bosis S, Esposito S, Niesters H G M, Zuccotti G V, Marseglia G, Lanari M, Zuin G, Pelucchi C, Osterhaus A D M E, Principi N
Institute of Paediatrics, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
Clin Microbiol Infect. 2008 Jul;14(7):677-84. doi: 10.1111/j.1469-0691.2008.02016.x.
In order to evaluate the infectious agents associated with the first episode of severe acute wheezing in otherwise healthy infants and to define the role of each of them in recurrences, 85 patients in Italy, aged <12 months, hospitalized because of a first acute episode of wheezing, were prospectively enrolled between 1 October 2005 and 31 March 2006. Upon enrollment, nasopharyngeal swabs were collected for the real-time PCR detection of respiratory syncytial virus (RSV) types A and B, influenza virus types A and B, adenovirus, parainfluenza viruses types 1, 2, 3 and 4, rhinovirus, human metapneumovirus, human coronavirus types 229E, OC43, NL63, and HKU1, bocavirus, enterovirus, and paraechovirus; nasopharyngeal aspirates were also obtained to detect atypical bacteria. At least one infectious agent was identified in 76 children (89.4%). RSV was the most frequently detected pathogen and its prevalence was significantly higher than that of the other pathogens in both age groups, and significantly higher in the children aged 3-12 months than in those aged <3 months. Only the children with RSV infection experienced recurrent wheezing. Viral load was significantly higher in children with than in those without recurrent wheezing. This study shows that RSV is the main reason for hospitalization during the first wheezing episode in infants, and that it appears to be the only pathogen associated with a high frequency of recurrences. A high viral load seems to be strictly related to the likelihood of recurrence.
为了评估健康婴儿首次严重急性喘息发作相关的感染因子，并确定它们在复发中各自的作用，2005年10月1日至2006年3月31日期间，对意大利85名年龄小于12个月、因首次急性喘息发作住院的患儿进行了前瞻性研究。入组时，采集鼻咽拭子用于实时PCR检测A、B型呼吸道合胞病毒（RSV）、A、B型流感病毒、腺病毒、1、2、3和4型副流感病毒、鼻病毒、人偏肺病毒、229E、OC43、NL63和HKU1型人冠状病毒、博卡病毒、肠道病毒和副埃可病毒；还获取鼻咽抽吸物以检测非典型细菌。76名儿童（89.4%）至少检出一种感染因子。RSV是最常检测到的病原体，其患病率在两个年龄组中均显著高于其他病原体，在3至12个月龄儿童中显著高于小于3个月龄儿童。只有RSV感染的儿童出现喘息复发。复发喘息儿童的病毒载量显著高于未复发儿童。本研究表明，RSV是婴儿首次喘息发作住院的主要原因，且似乎是与高复发频率相关的唯一病原体。高病毒载量似乎与复发可能性密切相关。
