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巴西米纳斯吉拉斯州乌贝兰迪亚市临床医院收治儿童中呼吸道合胞病毒A组和B组的流行情况及临床特征

Prevalence and clinical aspects of respiratory syncytial virus A and B groups in children seen at Hospital de Clínicas of Uberlândia, MG, Brazil.

作者信息

Oliveira T F M, Freitas G R O, Ribeiro L Z G, Yokosawa J, Siqueira M M, Portes S A R, Silveira H L, Calegari T, Costa L F, Mantese O C, Queiróz D A O

机构信息

Laboratório de Virologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2008 Aug;103(5):417-22. doi: 10.1590/s0074-02762008000500002.

Abstract

Respiratory syncytial virus (RSV) is well recognized as the most important pathogen causing acute respiratory disease in infants and young children, mainly in the form of bronchiolitis and pneumonia. Two major antigenic groups, A and B, have been identified; however, there is disagreement about the severity of the diseases caused by these two types. This study investigated a possible association between RSV groups and severity of disease. Reverse transcription-polymerase chain reaction was used to characterize 128 RSV nasopharyngeal specimens from children less than five years old experiencing acute respiratory disease. A total of 82 of 128 samples (64.1%) could be typed, and, of these, 78% were group A, and 22% were group B. Severity was measured by clinical evaluation associated with demographic factors: for RSV A-infected patients, 53.1% were hospitalized, whereas for RSV B patients, 27.8% were hospitalized (p = 0.07). Around 35.0% of the patients presented risk factors for severity (e.g., prematurity). For those without risk factors, the hospitalization occurred in 47.6% of patients infected with RSV A and in 18.2% infected with RSV B. There was a trend for RSV B infections to be milder than those of RSV A. Even though RSV A-infected patients, including cases without underlying condition and prematurity, were more likely to require hospitalization than those infected by RSV B, the disease severity could not to be attributed to the RSV groups.

摘要

呼吸道合胞病毒(RSV)是引起婴幼儿急性呼吸道疾病的最重要病原体,主要表现为细支气管炎和肺炎。已确定了两个主要抗原组,A组和B组;然而,关于这两种类型引起的疾病严重程度存在分歧。本研究调查了RSV组与疾病严重程度之间的可能关联。采用逆转录聚合酶链反应对128例患有急性呼吸道疾病的5岁以下儿童的RSV鼻咽标本进行特征分析。128份样本中共有82份(64.1%)可以分型,其中78%为A组,22%为B组。通过与人口统计学因素相关的临床评估来衡量疾病严重程度:感染RSV A的患者中,53.1%住院,而感染RSV B的患者中,27.8%住院(p = 0.07)。约35.0%的患者存在疾病严重程度的危险因素(如早产)。对于那些没有危险因素的患者,感染RSV A的患者中有47.6%住院,感染RSV B的患者中有18.2%住院。RSV B感染有比RSV A感染更轻的趋势。尽管感染RSV A的患者,包括无基础疾病和早产的病例,比感染RSV B的患者更有可能需要住院治疗,但疾病严重程度不能归因于RSV组。

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