Hengst M, Häusler M, Honnef D, Scheithauer S, Ritter K, Kleines M
1Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Aachen.
Klin Padiatr. 2008 Sep-Oct;220(5):296-301. doi: 10.1055/s-0028-1083806.
Apart from established pathogens of lower respiratory tract infections, such as respiratory syncytial virus (RSV), an increasing number of additional agents has been identified in recent years. In 2005 the human bocavirus (hBoV) has been isolated from respiratory tract samples and has been reported worldwide with frequencies ranging from 1.5 to 18.3% in respiratory samples from children with airway infections.
We investigated 173 specimens of a total number of 162 children who were inpatients with severe respiratory tract infections most of whom required oxygen therapy.
We analyzed respiratory tract samples (83% nasopharyngeal washes, 15% tracheal secretions, 2% bronchoalveolar lavages) for adenoviruses, influenza A und B viruses, parainfluenzaviruses types 1 to 3 and RSV using antigen-specific immunofluorescence assays. Additionally we tested human metapneumovirus (hMPV) and hBoV using a PCR assay.
35.8% specimens were negative in all assays, 54.3% were positive for RSV and 9.8% were positive for adeno-, influenza-, parainfluenzaviruses or hMPV. HBoV could be detected in 17 specimens (9.8%), defining HBoV to be the second most frequent pathogen. Nine of these patients showed a coinfection with RSV, one with parainfluenza virus. Viral loads did range from 2x10 (2) to 5.6x10 (10) genome equivalents/ml with higher viral loads being observed in the first days after disease onset. Most children were infected in the months between December and April. Half of the patients with isolated HBoV infection showed rhinopharyngitis, a third suffered from pulmonary obstruction and nearly every second required oxygen therapy. However, no HBoV-specific symptoms were found.
HBoV is a common pathogen causing viral respiratory tract infection in infants and young children. Among the here reported patients HBoV was the second most frequent identified pathogen. X-ray studies frequently revealed peribronchial and pneumonic infiltrates with only moderately elevated laboratory inflammatory markers. So far, no HBoV-specific clinical symptoms are known. Additional questions for example related to the way of transmission and optimal treatment remain to be investigated in prospective studies.
除了已知的下呼吸道感染病原体，如呼吸道合胞病毒（RSV）外，近年来还发现了越来越多的其他病原体。2005年，人类博卡病毒（hBoV）从呼吸道样本中分离出来，在全球范围内有报道称，在患有气道感染的儿童呼吸道样本中，其检出率在1.5%至18.3%之间。
我们调查了162名患有严重呼吸道感染的住院儿童的173份样本，其中大多数儿童需要吸氧治疗。
我们使用抗原特异性免疫荧光测定法分析呼吸道样本（83%为鼻咽冲洗液，15%为气管分泌物，2%为支气管肺泡灌洗）中的腺病毒、甲型和乙型流感病毒、1至3型副流感病毒和RSV。此外，我们使用聚合酶链反应（PCR）测定法检测人偏肺病毒（hMPV）和hBoV。
35.8%的样本在所有检测中均为阴性，54.3%的样本RSV呈阳性，9.8%的样本腺病毒、流感病毒、副流感病毒或hMPV呈阳性。17份样本（9.8%）中检测到hBoV，这表明hBoV是第二常见的病原体。其中9名患者同时感染了RSV，1名患者同时感染了副流感病毒。病毒载量范围为2×10（2）至5.6×10（10）基因组当量/毫升，在疾病发作后的头几天观察到较高的病毒载量。大多数儿童在12月至4月之间被感染。半数单纯感染hBoV的患者表现为鼻咽炎，三分之一患有肺梗阻，几乎每两名患者中就有一名需要吸氧治疗。然而，未发现hBoV特异性症状。
hBoV是引起婴幼儿病毒性呼吸道感染的常见病原体。在本报告的患者中，hBoV是第二常见的病原体。X线检查经常显示支气管周围和肺部浸润，实验室炎症标志物仅轻度升高。到目前为止，尚无hBoV特异性临床症状。例如，与传播方式和最佳治疗相关的其他问题仍有待前瞻性研究进行调查。
