Mação Patrícia, Dias Andrea, Azevedo Lúcia, Jorge Arminda, Rodrigues Carlos
Serviço de Pediatria, Centro Hospitalar Cova da Beira, Covilhã, Portugal.
Acta Med Port. 2011 Dec;24 Suppl 2:407-12. Epub 2011 Dec 31.
Bronchiolitis is the most common lower respiratory infection in children under 2 years old. Respiratory syncytial virus (RSV) is the most frequently involved etiologic agent.
To identify different viruses causing bronchiolitis and try to correlate them with demographic and clinical variables. To analyze diagnostic and therapeutic approache.
We conducted a prospective study, between November 2008 and March 2009 (5 months), including children < 2 years with bronchiolitis. Screening for RSV, parainfluenza 1-3 and adenovirus used immunofluorescence tests and screening for influenza A and B, human metapneumovirus (MPvh), human bocavirus (hBoV) and RSV used polymerase chain reaction (PCR) techniques. Data were analysed by using SPSS®.
We included 78 children with 8.5 months mean age (83% < 12 months), 60% were male. The average duration of the disease was 15+5 days. Were on antibiotics 19.2%, because of concomitant acute otitis media (10.2%) or bacterial pneumonia (9%). 53% required hospital admission and the average length of stay was 7 days. Along hospitalization 95% of children required supplemental oxygen, 61% intravenous rehydration and 22% chest physiotherapy. Viral testing was positive in 59/75 children: RSV (69.3%), BoVh (22.7%), MPVh (4%), parainfluenza 3 (27%) and influenza A (2.6%). Co-infection with two viruses was detected in 23% of children. In 88% of children with positive samples for BoVh it has been detected RSV infection simultaneously. Children with co-infection (RSV + BoVh) required more often hospitalization compared with children infected with RSV alone (80% vs 60%, p=0.028), without significant differences in oxygen supplementation need and length of disease.
RSV was the main etiologic agent and oxygen supplementation requirement justified the majority of hospitalizations. There was a high rate of co-infection with RSV and BoVh, but without longer disease. BoVh infection alone was uncommon.
细支气管炎是2岁以下儿童最常见的下呼吸道感染。呼吸道合胞病毒（RSV）是最常见的病原体。
识别引起细支气管炎的不同病毒，并尝试将它们与人口统计学和临床变量相关联。分析诊断和治疗方法。
我们在2008年11月至2009年3月（5个月）期间进行了一项前瞻性研究，纳入了2岁以下患有细支气管炎的儿童。采用免疫荧光试验筛查RSV、副流感病毒1 - 3型和腺病毒，采用聚合酶链反应（PCR）技术筛查甲型和乙型流感病毒、人偏肺病毒（MPVh）、人博卡病毒（hBoV）和RSV。使用SPSS®软件进行数据分析。
我们纳入了78名儿童，平均年龄8.5个月（83%小于12个月），60%为男性。疾病平均持续时间为15±5天。19.2%的患儿使用了抗生素，原因是并发急性中耳炎（10.2%）或细菌性肺炎（9%）。53%的患儿需要住院治疗，平均住院时间为7天。住院期间，95%的患儿需要补充氧气，61%需要静脉补液，22%需要胸部物理治疗。75名患儿中59名病毒检测呈阳性：RSV（69.3%）、hBoV（22.7%）、MPVh（4%）、副流感病毒3型（27%）和甲型流感病毒（2.6%）。23%的患儿检测到两种病毒合并感染。在hBoV检测呈阳性的患儿中，88%同时检测到RSV感染。与仅感染RSV的患儿相比，合并感染（RSV + hBoV）的患儿更常需要住院治疗（80%对60%，p = 0.028），在氧气补充需求和疾病持续时间方面无显著差异。
RSV是主要病原体，补充氧气需求是大多数住院治疗的原因。RSV和hBoV合并感染率高，但疾病持续时间未延长。单独的hBoV感染不常见。
