Hasman Hatice, Pachucki Constance T, Unal Arife, Nguyen Diep, Devlin Troy, Peeples Mark E, Kwilas Steven A
Department of Immunology & Microbiology, College of Medicine, Rush University, 1653 W. Congress Parkway, Chicago, IL 60612, USA.
Sisli Etfal Training and Research Hospital, Department of Infectious Disease and Clinical Microbiology, Sisli, Istanbul, Turkey.
J Med Microbiol. 2009 Apr;58(Pt 4):408-413. doi: 10.1099/jmm.0.006098-0.
Influenza viruses cause significant morbidity and mortality in adults each winter. At the same time, other respiratory viruses circulate and cause respiratory illness with influenza-like symptoms. Human respiratory syncytial virus (HRSV), human parainfluenza viruses (HPIV) and human metapneumovirus have all been associated with morbidity and mortality in adults, including nosocomial infections. This study evaluated 154 respiratory specimens collected from adults with influenza-like/acute respiratory illness (ILI) seen at the Edward Hines Jr VA Hospital, Hines, IL, USA, during two successive winters, 1998-1999 and 1999-2000. The samples were tested for ten viruses in two nested multiplex RT-PCRs. One to three respiratory viruses were detected in 68 % of the samples. As expected, influenza A virus (FLU-A) infections were most common (50 % of the samples), followed by HRSV-A (16 %). Surprisingly, HPIV-4 infections (5.8 %) were the third most prevalent. Mixed infections were also relatively common (11 %). When present, HPIV infections were approximately three times more likely to be included in a mixed infection than FLU-A or HRSV. Mixed infections and HPIV-4 are likely to be missed using rapid diagnostic tests. This study confirms that ILI in adults and the elderly can be caused by HRSV and HPIVs, including HPIV-4, which co-circulate with FLU-A.
每年冬季，流感病毒都会在成人中引发严重的发病和死亡情况。与此同时，其他呼吸道病毒也在传播，并导致出现流感样症状的呼吸道疾病。人类呼吸道合胞病毒（HRSV）、人副流感病毒（HPIV）和人偏肺病毒都与成人的发病和死亡有关，包括医院感染。本研究评估了1998 - 1999年和1999 - 2000年连续两个冬季期间，在美国伊利诺伊州海恩斯市爱德华·海因斯 Jr 退伍军人医院就诊的患有流感样/急性呼吸道疾病（ILI）的成人患者所采集的154份呼吸道标本。在两次巢式多重逆转录聚合酶链反应（RT-PCR）中对样本进行了十种病毒的检测。68%的样本检测到一至三种呼吸道病毒。正如预期的那样，甲型流感病毒（FLU-A）感染最为常见（占样本的50%），其次是HRSV-A（16%）。令人惊讶的是，HPIV-4感染（5.8%）是第三大常见感染。混合感染也相对常见（11%）。当存在混合感染时，HPIV感染被纳入混合感染的可能性大约是FLU-A或HRSV的三倍。使用快速诊断测试可能会漏诊混合感染和HPIV-4。本研究证实，成人和老年人的ILI可能由HRSV和HPIVs引起，包括与FLU-A共同传播的HPIV-4。
