Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA.
Influenza Other Respir Viruses. 2012 Jan;6(1):71-7. doi: 10.1111/j.1750-2659.2011.00265.x. Epub 2011 May 31.
Molecular testing for viral pathogens has resulted in increasing detection of multiple viruses in respiratory secretions of ill children. The clinical impact of multiple virus infections on clinical presentation and outcome is unclear.
To compare clinical characteristics and viral load between children with multiple virus versus single virus illnesses.
PATIENTS/METHODS: Eight hundred and ninety-three residual nasal wash samples from children treated for respiratory illness at Children's Hospital, Seattle, from September 2003 to September 2004 were evaluated by quantitative PCR for respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza (Flu), parainfluenza, adenoviruses, and coronaviruses (CoV). Illness severity and patient characteristics were abstracted from medical charts.
Coinfections were identified in 103 (18%) of 566 virus-positive samples. Adenovirus was most commonly detected in coinfections (52%), followed by CoV (50%). Illnesses with a single virus had increased risk of oxygen requirement (P = 0·02), extended hospital stays (P = 0·002), and admissions to the inpatient (P = 0·02) or intensive care units (P = 0·04). For Adv and PIV-1, multiple virus illnesses had a significantly lower viral load (log(10) copies/ml) than single virus illnesses (4·2 versus 5·6, P = 0·007 and 4·2 versus 6·9, P < 0·001, respectively). RSV, Flu-A, PIV-3, and hMPV viral loads were consistently high whether or not another virus was detected.
Illnesses with multiple virus detections were correlated with less severe disease. The relationship between viral load and multiple virus infections was virus specific, and this may serve as a way to differentiate viruses in multiple virus infections.
病毒病原体的分子检测导致从患病儿童的呼吸道分泌物中越来越多地检测到多种病毒。多种病毒感染对临床表现和结果的临床影响尚不清楚。
比较患有多种病毒与单一病毒疾病的儿童的临床特征和病毒载量。
患者/方法：2003 年 9 月至 2004 年 9 月，从西雅图儿童医院治疗呼吸道疾病的 893 例剩余鼻冲洗样本通过定量 PCR 评估呼吸道合胞病毒 (RSV)、人偏肺病毒 (hMPV)、流感 (Flu)、副流感病毒、腺病毒和冠状病毒 (CoV)。从病历中提取疾病严重程度和患者特征。
在 566 个病毒阳性样本中的 103 个（18%）中发现了合并感染。合并感染中最常检测到的病毒是腺病毒（52%），其次是 CoV（50%）。单一病毒感染的疾病有更高的氧气需求风险（P=0·02）、延长住院时间（P=0·002）、住院（P=0·02）或重症监护病房（P=0·04）的风险。对于 Adv 和 PIV-1，多种病毒感染的病毒载量（log(10) 拷贝/ml）明显低于单一病毒感染（4·2 与 5·6，P=0·007 和 4·2 与 6·9，P<0·001）。无论是否检测到另一种病毒，RSV、Flu-A、PIV-3 和 hMPV 的病毒载量都很高。
检测到多种病毒的疾病与疾病严重程度较轻相关。病毒载量与多种病毒感染之间的关系是病毒特异性的，这可能是区分多种病毒感染中病毒的一种方法。
