Infectious Diseases and Clinical Microbiology Unit of the Division of Internal Medicine and Division of Microbiology, Unidad de Enfermedades Infecciosas y Microbiología Clinica, Servicio de Medicina Interna, Hospital Universitario La Paz-IDIPAZ, Paseo de la Castellana 261, 28046 Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 2011 Dec;30(12):1497-502. doi: 10.1007/s10096-011-1248-4. Epub 2011 May 10.
It is not known whether influenza-like illnesses (ILI) in pregnant women caused by influenza virus, specifically, those caused by the 2009 Influenza A H1N1 virus (nH1N1), can be clinically distinguished from those caused by other agents. From 1st July 2009 until 20th September 2009, an observational study including all pregnant women presenting at Hospital Universitario La Paz with an ILI was carried out. A specific reverse-transcriptase polymerase chain reaction (RT-PCR) for nH1N1 in nasopharyngeal swabs was prospectively carried out in all patients. Retrospectively, samples were analysed for multiple respiratory virus panel (RT-PCR microarray). Clinical, demographical and other microbiological variables were evaluated as well. A total of 45 pregnant women with ILI were admitted. Of these, 14 (31.1%) women had nH1N1 infection and 11 with a non-influenza ILI (35.48%) were positive for other viruses (five rhinovirus, four parainfluenza virus, one bocavirus and one adenovirus). In 20 patients, no aetiologic agent was identified. The clinical course of nH1N1 was mild, without deaths or severe complications. No significant differences were found when comparing the clinical presentation and course of patients with and without nH1N1 infection. Six women with nH1N1 infection received oseltamivir. Influenza and non-influenza ILI were clinically indistinguishable among pregnant women. Many ILI in pregnant women remain undiagnosed, despite undergoing an RT-PCR microarray for several respiratory viruses.
目前尚不清楚孕妇中由流感病毒引起的流感样疾病(ILI),特别是由 2009 年甲型 H1N1 流感病毒(nH1N1)引起的 ILI,是否能够在临床上与由其他病原体引起的 ILI 相区别。从 2009 年 7 月 1 日至 2009 年 9 月 20 日,对所有在拉巴斯大学医院因 ILI 就诊的孕妇进行了一项观察性研究。对所有患者的鼻咽拭子均进行了 nH1N1 的特定逆转录聚合酶链反应(RT-PCR)检测。回顾性分析了多种呼吸道病毒检测板(RT-PCR 微阵列)。还评估了临床、人口统计学和其他微生物学变量。共有 45 例 ILI 孕妇住院。其中,14 例(31.1%)为 nH1N1 感染,11 例非流感 ILI(35.48%)为其他病毒阳性(5 例为鼻病毒,4 例为副流感病毒,1 例为博卡病毒,1 例为腺病毒)。在 20 例患者中,未确定病因。nH1N1 的临床过程较轻,无死亡或严重并发症。比较 nH1N1 感染和无 nH1N1 感染患者的临床表现和病程,未发现显著差异。6 例 nH1N1 感染患者接受了奥司他韦治疗。流感和非流感 ILI 在孕妇中临床表现难以区分。尽管对几种呼吸道病毒进行了 RT-PCR 微阵列检测,但仍有许多孕妇的 ILI 未得到诊断。