Department of Pediatrics, Seoul National University Hospital, Seoul, Korea.
J Korean Med Sci. 2013 Jan;28(1):36-41. doi: 10.3346/jkms.2013.28.1.36. Epub 2013 Jan 8.
This study was performed to characterize respiratory viral infections in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Study samples included 402 respiratory specimens obtained from 358 clinical episodes that occurred in the 116 children of the 175 consecutive HSCT cohort at Seoul National University Children's Hospital, Korea from 2007 to 2010. Multiplex reverse-transcription polymerase chain reactions were performed for rhinovirus, respiratory syncytial virus (RSV), parainfluenza viruses (PIVs), adenovirus, human coronavirus (hCoV), influenza viruses and human metapneumovirus. Viruses were identified in 89 clinical episodes that occurred in 58 patients. Among the 89 clinical episodes, frequently detected viruses were rhinovirus in 25 (28.1%), RSV in 23 (25.8%), PIV-3 in 16 (18.0%), adenovirus in 12 (13.5%), and hCoV in 10 (11.2%). Lower respiratory tract infections were diagnosed in 34 (38.2%). Neutropenia was present in 24 (27.0%) episodes and lymphopenia was in 31 (34.8%) episodes. Sixty-three percent of the clinical episodes were hospital-acquired. Three patients died of respiratory failure caused by respiratory viral infections. Respiratory viral infections in pediatric patients who have undergone HSCT are common and are frequently acquired during hospitalization. Continuous monitoring is required to determine the role of respiratory viruses in immunocompromised children and the importance of preventive strategies.
本研究旨在描述接受造血干细胞移植（HSCT）的儿科患者的呼吸道病毒感染情况。研究样本包括 2007 年至 2010 年期间，韩国首尔国立大学儿童医院 175 例连续 HSCT 队列中的 116 名儿童发生的 358 例临床发作中获得的 402 份呼吸道标本。采用多重逆转录聚合酶链反应检测鼻病毒、呼吸道合胞病毒（RSV）、副流感病毒（PIV）、腺病毒、人类冠状病毒（hCoV）、流感病毒和人类偏肺病毒。在 58 名患者的 89 例临床发作中鉴定出病毒。在这 89 例临床发作中，经常检测到的病毒是鼻病毒 25 例（28.1%）、RSV 23 例（25.8%）、PIV-3 16 例（18.0%）、腺病毒 12 例（13.5%）和 hCoV 10 例（11.2%）。下呼吸道感染诊断为 34 例（38.2%）。24 例（27.0%）发作时存在中性粒细胞减少症，31 例（34.8%）发作时存在淋巴细胞减少症。63%的临床发作为医院获得性。3 名患者因呼吸道病毒感染导致呼吸衰竭而死亡。接受 HSCT 的儿科患者的呼吸道病毒感染很常见，并且经常在住院期间获得。需要进行持续监测以确定呼吸道病毒在免疫功能低下儿童中的作用以及预防策略的重要性。
