Department of Pediatrics, Columbia University, New York, New York, USA.
Infect Control Hosp Epidemiol. 2012 Jun;33(6):545-50. doi: 10.1086/665727. Epub 2012 Apr 16.
Viral respiratory pathogens cause outbreaks in pediatric long-term care facilities (LTCFs), but few studies have used viral diagnostic testing to identify the causative pathogens. We describe the use of such testing during a prolonged period of respiratory illness and elucidate the epidemiology of human metapneumovirus (hMPV) at our LTCF.
Retrospective study of influenza-like illness (ILI).
A 136-bed pediatric LTCF from January 1 through April 30, 2010.
The ILI case definition included fever, cough, change in oropharyngeal secretions, increase in oxygen requirement, and/or wheezing.
During the study period, 69 episodes of ILI occurred in 61 (41%) of 150 residents. A viral pathogen was detected in 27 (39%) of the episodes, including respiratory syncytial virus (RSV) (n = 3), influenza A virus (not typed; n = 2), parainfluenza virus (n =2), adenovirus (n = 1), and hMPV (n = 19). Twenty-seven of the residents with ILI (44%) required transfer to acute care hospitals (mean length of hospitalization, 12 days; range, 3-47 days). Residents with tracheostomies were more likely to have ILI (adjusted odds ratio [OR], 3.99 [95% confidence interval {CI}, 1.87-8.53]; P = .0004). The mortality rate for residents with ILI was 1.6%. Residents with hMPV were younger (P = .03), more likely to be transferred to an acute care facility (OR, 3.73 [95% CI, 1.17-11.95]; P = .02), and less likely to have a tracheostomy (adjusted OR, 0.19 [95% CI, 0.047-0.757]; P = .02 ).
Diverse pathogens, most notably hMPV, caused ILI in our pediatric LTCF during a prolonged period of time. Viral testing was helpful in characterizing the epidemiology of ILI in this population.
病毒呼吸道病原体导致儿科长期护理机构（LTCF）爆发，但很少有研究使用病毒诊断检测来确定致病病原体。我们描述了在呼吸道疾病延长期间使用此类检测，并阐明了我们 LTCF 中的人类偏肺病毒（hMPV）的流行病学。
流感样疾病（ILI）的回顾性研究。
2010 年 1 月 1 日至 4 月 30 日，一家有 136 张床位的儿科 LTCF。
ILI 的病例定义包括发热、咳嗽、口咽分泌物改变、增加氧气需求和/或喘息。
在研究期间，150 名居民中有 69 名（41%）发生了 69 次 ILI。在 27 次发作中检测到病毒病原体，包括呼吸道合胞病毒（RSV）（n = 3）、甲型流感病毒（未分型；n = 2）、副流感病毒（n = 2）、腺病毒（n = 1）和 hMPV（n = 19）。有 ILI 的 27 名居民（44%）需要转移到急性护理医院（平均住院时间为 12 天；范围为 3-47 天）。有气管造口术的居民更有可能发生 ILI（调整后的优势比[OR]，3.99[95%置信区间{CI}，1.87-8.53]；P =.0004）。ILI 居民的死亡率为 1.6%。患有 hMPV 的居民年龄更小（P =.03），更有可能转移到急性护理机构（OR，3.73[95%CI，1.17-11.95]；P =.02），并且不太可能有气管造口术（调整后的 OR，0.19[95%CI，0.047-0.757]；P =.02）。
多种病原体，尤其是 hMPV，在我们的儿科 LTCF 长时间内引起 ILI。病毒检测有助于描述该人群中 ILI 的流行病学。
