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住院急性下呼吸道感染儿童的病毒病因学

Viral etiology in hospitalized children with acute lower respiratory tract infection.

作者信息

Hatipoğlu Nevin, Somer Ayper, Badur Selim, Unüvar Emin, Akçay-Ciblak Meral, Yekeler Ensar, Salman Nuran, Keser Melike, Hatipoğlu Hüsem, Siraneci Rengin

机构信息

Department of Pediatrics, Bakirköy Maternity and Children's Hospital, Istanbul, Turkey.

出版信息

Turk J Pediatr. 2011 Sep-Oct;53(5):508-16.

Abstract

This study was performed to investigate the viral etiological agents, age distribution and clinical manifestations of lower respiratory tract infection (LRTI) in hospitalized children. The viral etiology and clinical findings in 147 children (1 month to 5 years of age) hospitalized with acute LRTI were evaluated. Cell culture was used for isolation of influenza viruses and direct fluorescent antibody assay for parainfluenza viruses (PIVs), respiratory syncytial virus (RSV) and adenoviruses (ADVs). Reverse-transcriptase polymerase chain reaction was employed for human metapneumovirus (hMPV). One hundred and six of all patients (72.1%) were male, and 116 children (79.8%) were < or = 2 years. A viral etiology was detected in 54 patients (36.7%). RSV was the most frequently isolated (30 patients, 55.6%), and PIV (27.8%), hMPV (13%), influenza-A (9.3%), and ADV (5.6%) were also shown. Dual infection was detected in six patients. There were no statistically significant differences between the two groups (with isolated virus or no known viral etiology) with respect to symptoms, clinical findings, laboratory work-up, or radiological data. Length of hospital stay was also not different. Determination of the etiology of acute LRTI in children less than 5 years of age seems impossible without performing virological work-up, whether viral or nonviral in origin.

摘要

本研究旨在调查住院儿童下呼吸道感染(LRTI)的病毒病原体、年龄分布及临床表现。对147例因急性LRTI住院的儿童(年龄1个月至5岁)的病毒病因及临床发现进行了评估。采用细胞培养法分离流感病毒,用直接荧光抗体法检测副流感病毒(PIVs)、呼吸道合胞病毒(RSV)和腺病毒(ADVs)。采用逆转录聚合酶链反应检测人偏肺病毒(hMPV)。所有患者中106例(72.1%)为男性,116例儿童(79.8%)年龄小于或等于2岁。54例患者(36.7%)检测到病毒病因。RSV是最常分离出的病毒(30例,55.6%),还检出了PIV(27.8%)、hMPV(13%)、甲型流感病毒(9.3%)和ADV(5.6%)。6例患者检测到双重感染。两组(分离出病毒组或无已知病毒病因组)在症状、临床发现、实验室检查或放射学数据方面无统计学显著差异。住院时间也无差异。对于5岁以下儿童急性LRTI病因的确定,若不进行病毒学检查,似乎无法区分其病因是病毒源性还是非病毒源性。

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