Department of Pediatrics, Madigan Army Medical Center, BLDG 9040 Fitzsimmons Drive, Tacoma, WA 98431, United States.
J Clin Virol. 2010 Sep;49(1):16-20. doi: 10.1016/j.jcv.2010.06.013. Epub 2010 Jul 21.
The epidemiology of respiratory tract infections (RTIs) in a daycare cohort has not been explored using molecular techniques.
(1) Determine the overall incidence of RTIs in a daycare cohort using real-time reverse transcriptase polymerase chain reaction (RT-PCR). (2) Determine the relative incidence and impact of specific respiratory viruses, and characterize and compare clinical features associated with these pathogens.
In this prospective cohort study conducted from February 2006 to April 2008, nasal swabs were obtained from symptomatic children ages 0-30 months enrolled in fulltime daycare. RT-PCR was performed to detect respiratory syncytial virus (RSV), human metapneumovirus (MPV), influenza (Flu) viruses A and B, parainfluenza (PIV), adenovirus (AdV), human coronaviruses (CoV) and rhinovirus (RhV). Symptom diaries were completed for each illness.
We followed 119 children (mean age 10 months; range 2-24 months) for 115 child years. The mean annual incidence of RTI per child was 4.2 the first year and 1.2 the second year of the study. At least 1 virus was identified in 67% RTIs. Co-infections were common (27% RTIs), with RhV, CoV, and AdV the most common co-pathogens. PIV was identified in 12% of RTIs with a high incidence of PIV4. The viruses with the greatest impact on our population were RSV, RhV and AdV.
Using molecular techniques, viruses were identified in approximately twice as many RTIs as previously reported in a daycare cohort. Infections with newly identified viruses, such as HMPV and CoV subtypes were less frequent and severe than infections with RSV, AdV and RhV.
利用分子技术，尚未对日托人群中的呼吸道感染（RTI）的流行病学进行探索。
（1）使用实时逆转录聚合酶链反应（RT-PCR）确定日托人群中 RTI 的总体发生率。（2）确定特定呼吸道病毒的相对发生率和影响，并对与这些病原体相关的临床特征进行描述和比较。
在这项于 2006 年 2 月至 2008 年 4 月进行的前瞻性队列研究中，对参加全日制日托的 0-30 月龄有症状的儿童采集鼻拭子。使用 RT-PCR 检测呼吸道合胞病毒（RSV）、人偏肺病毒（MPV）、流感（Flu）病毒 A 和 B、副流感病毒（PIV）、腺病毒（AdV）、人类冠状病毒（CoV）和鼻病毒（RhV）。为每次疾病都完成了症状日记。
我们对 119 名儿童（平均年龄 10 个月；范围 2-24 个月）进行了 115 个儿童年的随访。第一年每个儿童的 RTI 年发生率为 4.2，第二年为 1.2。在 67%的 RTI 中至少鉴定出 1 种病毒。合并感染很常见（27%的 RTI），最常见的合并病原体是 RhV、CoV 和 AdV。在 12%的 RTI 中发现了 PIV，其中 PIV4 的发病率很高。对我们人群影响最大的病毒是 RSV、RhV 和 AdV。
使用分子技术，在日托人群中，通过病毒鉴定出的 RTI 大约是以前报道的两倍。与 RSV、AdV 和 RhV 相比，新发现的病毒（如 HMPV 和 CoV 亚型）的感染较少且较不严重。
