Ferone Eduardo A, Berezin Eitan N, Durigon Giuliana S, Finelli Cristiane, Felício Maria C C, Storni Juliana G, Durigon Edison L, Oliveira Danielle B L de
Pediatric Pneumology Unit, Department of Pediatrics and Child Care, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Pediatric Pneumology Unit, Department of Pediatrics and Child Care, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil; Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
J Pediatr (Rio J). 2014 Jan-Feb;90(1):42-9. doi: 10.1016/j.jped.2013.05.005. Epub 2013 Oct 19.
To characterize and compare clinical, epidemiological, and laboratory aspects of infants with acute lower respiratory infection (ALRI) associated with the detection of adenovirus (ADV) or respiratory syncytial virus (RSV).
A preliminary respiratory infection surveillance study collected samples of nasopharyngeal aspirate (NPA) for viral research, linked to the completion of a standard protocol, from children younger than two years admitted to a university hospital with ALRI, between March of 2008 and August of 2011. Polymerase chain reaction (PCR) was used for eight viruses: ADV, RSV, metapneumovirus, Parainfluenza 1, 2, and 3, and Influenza A and B. Cases with NPA collected during the first 24 hours of admission, negative results of blood culture, and exclusive detection of ADV (Gadv group) or RSV (Grsv group) were selected for comparisons.
The preliminary study included collection of 1,121 samples of NPA, 813 collected in the first 24 hours of admission, of which 50.3% were positive for at least one virus; RSV was identified in 27.3% of cases surveyed, and ADV was identified in 15.8%. Among the aspects analyzed in the Gadv (n = 58) and Grsv (n = 134) groups, the following are noteworthy: the higher mean age, more frequent prescription of antibiotics, and the highest median of total white blood cell count and C-reactive protein values in Gadv.
PCR can detect persistent/latent forms of ADV, an aspect to be considered when interpreting results. Additional studies with quantitative diagnostic techniques could elucidate the importance of the high frequency observed.
对检测出腺病毒（ADV）或呼吸道合胞病毒（RSV）的急性下呼吸道感染（ALRI）婴儿的临床、流行病学和实验室特征进行描述并比较。
一项初步的呼吸道感染监测研究收集了2008年3月至2011年8月间因ALRI入住大学医院的两岁以下儿童的鼻咽抽吸物（NPA）样本用于病毒研究，样本采集与一份标准方案的完成相关联。采用聚合酶链反应（PCR）检测8种病毒：ADV、RSV、偏肺病毒、副流感病毒1型、2型和3型以及甲型和乙型流感病毒。选取入院后24小时内采集NPA样本、血培养结果为阴性且仅检测出ADV（ADV组）或RSV（RSV组）的病例进行比较。
初步研究共收集了1121份NPA样本，其中813份在入院后24小时内采集，其中50.3%的样本至少对一种病毒呈阳性；在接受调查的病例中，27.3%检测出RSV，15.8%检测出ADV。在ADV组（n = 58）和RSV组（n = 134）分析的各方面中，以下情况值得注意：ADV组的平均年龄较高、抗生素处方更频繁，且总白细胞计数和C反应蛋白值的中位数最高。
PCR可检测到ADV的持续/潜伏形式，这在解释结果时应予以考虑。采用定量诊断技术的进一步研究可能会阐明所观察到的高频率的重要性。
