Amin Nadia M, El Basha Noussa R, El Rifai Nihal M, El Baz Mohamed S, Draz Iman H, El Kholy Amani A, Sherif May M
Departments of aPediatrics bClinical Pathology, New University Children's Hospital (Abu El Reish), Faculty of Medicine, Cairo University, Cairo, Egypt.
J Egypt Public Health Assoc. 2013 Apr;88(1):52-6. doi: 10.1097/01.EPX.0000427636.90615.ad.
Viral respiratory infections are associated with nearly 80% of asthma exacerbation episodes. These can have severe adverse outcomes in patients with established asthma.
The aim of the study was to identify the viral causes of acute respiratory infection that precipitate acute asthma exacerbation in Egyptian asthmatic children.
The current prospective study was conducted in Cairo University Children's Hospitals from December 2010 to December 2011. All asthmatic children (n=130) aged 2-12 years admitted with asthma exacerbation due to severe lower respiratory tract infection were included. All cases were subjected to nasopharyngeal or throat swabs that were analyzed for common respiratory viruses, including respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza B (Flu B), human parainfluenza virus (hPIV), influenza A (H1N1), and adenovirus (ADV) using the real-time PCR technique. All patients were followed up to record the outcome.
PCR analysis was positive for one respiratory virus in 54 asthmatic patients (41.5%) and was negative in 76 patients (58.5%), with a high predominance of RSV (51.9%) and hMPV (25.9%) especially in winter and early spring months. Hypoxia was detected in all patients with RSV infection; of these patients, 21.4% were admitted to the ICU, 14.3% required mechanical ventilation, and 14.3% died. In contrast, among those with hMPV infection, hypoxia was detected in 71.4%; none required ICU admission or mechanical ventilation.
Viral etiology of lower respiratory tract infections constitutes an important cause of acute asthma exacerbation in asthmatic children admitted to children's hospitals in Cairo, supporting the need for large-scale multicentric studies on asthmatic patients over multiple years using a wider-panel PCR for detection of respiratory viruses.
病毒性呼吸道感染与近80%的哮喘加重发作相关。这在已确诊哮喘的患者中可能会产生严重不良后果。
本研究旨在确定埃及哮喘儿童中引发急性哮喘加重的急性呼吸道感染的病毒病因。
本前瞻性研究于2010年12月至2011年12月在开罗大学儿童医院进行。纳入所有因严重下呼吸道感染而哮喘加重入院的2至12岁哮喘儿童（n = 130）。所有病例均采集鼻咽或咽喉拭子，采用实时PCR技术分析常见呼吸道病毒，包括呼吸道合胞病毒（RSV）、人偏肺病毒（hMPV）、乙型流感病毒（Flu B）、人副流感病毒（hPIV）、甲型流感病毒（H1N1）和腺病毒（ADV）。对所有患者进行随访以记录结果。
54例哮喘患者（41.5%）的PCR分析显示一种呼吸道病毒呈阳性，76例患者（58.5%）呈阴性，其中RSV（51.9%）和hMPV（25.9%）占比很高，尤其是在冬季和早春月份。所有RSV感染患者均检测到低氧血症；其中21.4%入住重症监护病房（ICU），14.3%需要机械通气，14.3%死亡。相比之下 hMPV感染患者中，71.4%检测到低氧血症；无人需要入住ICU或进行机械通气。
下呼吸道感染的病毒病因是开罗儿童医院收治的哮喘儿童急性哮喘加重的重要原因，这支持了有必要开展大规模多中心研究，对哮喘患者进行多年随访，并使用更广泛的PCR检测呼吸道病毒。
