van der Zalm Marieke M, Uiterwaal Cuno S P M, Wilbrink Berry, de Jong Brita M, Verheij Theo J M, Kimpen Jan L L, van der Ent Cornelis K
Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands.
Pediatr Infect Dis J. 2009 Jun;28(6):472-6. doi: 10.1097/inf.0b013e318195e26e.
Respiratory virus infections are the most important trigger of respiratory illnesses in childhood. Data on the occurrence and the clinical impact of respiratory pathogens in the general population of infants are scarce. Therefore, we described the occurrence and clinical impact of respiratory pathogens in infants with respiratory tract infections during the first year of life.
In a prospective birth cohort study, infants were followed from birth through the first year of life with daily questionnaires about respiratory symptoms. Nose and throat swabs were collected during episodes with respiratory symptoms. Polymerase chain reaction was used to detect an extensive panel of respiratory pathogens.
The parents reported a median of 5 respiratory episodes per infant per year. A total of 668 respiratory samples were collected in 305 infants. One or more respiratory pathogens were detected in 85% of the samples. The most common respiratory pathogens were human rhinovirus (HRV) (73% of the samples), respiratory syncytial virus (RSV) (11%), and coronavirus (8%). HRV infections were associated with a prolonged period of symptoms compared with RSV (P = 0.03). Infections with RSV were associated with more physician visits than HRV infections (P = 0.06).
We found a high prevalence of respiratory pathogens among infants with parent-reported respiratory illnesses in the first year of life, with HRV being the most prevalent. Although RSV infections seemed to be responsible for the most severe symptoms compared with HRV, the overall burden of disease was highest for HRV infections.
呼吸道病毒感染是儿童期呼吸道疾病最重要的触发因素。关于普通婴儿群体中呼吸道病原体的发生情况及其临床影响的数据较为匮乏。因此，我们描述了一岁以内患有呼吸道感染的婴儿中呼吸道病原体的发生情况及其临床影响。
在一项前瞻性出生队列研究中，从出生开始对婴儿进行随访，直至一岁，每天通过问卷询问呼吸道症状。在出现呼吸道症状时采集鼻拭子和咽拭子。采用聚合酶链反应检测一系列广泛的呼吸道病原体。
家长报告每名婴儿每年呼吸道发作的中位数为5次。305名婴儿共采集了668份呼吸道样本。85%的样本中检测到一种或多种呼吸道病原体。最常见的呼吸道病原体是人鼻病毒（HRV）（占样本的73%）、呼吸道合胞病毒（RSV）（11%）和冠状病毒（8%）。与RSV相比，HRV感染与症状持续时间延长相关（P = 0.03）。RSV感染比HRV感染导致更多的就医次数（P = 0.06）。
我们发现，在家长报告有呼吸道疾病的一岁以内婴儿中，呼吸道病原体的患病率很高，其中HRV最为普遍。尽管与HRV相比，RSV感染似乎导致最严重的症状，但HRV感染的总体疾病负担最高。
