Akhras Nour, Weinberg Jason B, Newton Duane
Department of Pediatrics and Communicable Diseases.
Department of Pediatrics and Communicable Diseases, ; Department of Microbiology and Immunology.
Infect Dis Rep. 2010 Aug 11;2(2):e12. doi: 10.4081/idr.2010.e12. eCollection 2010 Aug 4.
Human metapneumovirus (hMPV) is a recently discovered virus that causes respiratory illness in children that can lead to hospitalization. Our study was undertaken to further understand hMPV-associated illness, compare clinical characteristics of hMPV and respiratory syncytial virus (RSV), and establish the utility of routine screening for hMPV. We retrospectively identified hMPV-associated illnesses described among children with respiratory symptoms admitted to a tertiary care center in southeast Michigan during the 2006-2007 respiratory viral season. A convenience sample of 256 nasopharyngeal specimens was subjected to nucleic acid extraction and amplification to identify those specimens positive for hMPV. A medical record review was undertaken to retrieve demographic and clinical data of patients with hMPV, comparing them to RSV-positive patients and patients evaluated for respiratory symptoms who were negative for hMPV and RSV. We found that hMPV was the second most commonly identified virus after RSV. hMPV-positive patients were older than RSV-positive patients. Among hMPV-positive patients, pneumonia was diagnosed in 37.5% and bronchiolitis in 31.2%, peribronchial cuffing was present on chest radiographs of 37.5%, antibiotic treatment was used in 81.2%, and admission to the ICU was seen in 37.5%. Finally, hMPV-positive patients were more likely to have fever than RSV-positive patients or patients negative for hMPV and RSV. We concluded that hMPV is a major pathogen associated with hospitalization of children and with the same severity of illness as RSV but in a slightly older population. Because of the apparent prevalence and severity of illness, routine screening should be implemented.
人偏肺病毒（hMPV）是一种最近发现的可导致儿童呼吸道疾病并可能需要住院治疗的病毒。我们开展这项研究是为了进一步了解与hMPV相关的疾病，比较hMPV和呼吸道合胞病毒（RSV）的临床特征，并确定hMPV常规筛查的实用性。我们回顾性地确定了2006 - 2007年呼吸道病毒流行季期间，密歇根州东南部一家三级医疗中心收治的有呼吸道症状儿童中所描述的与hMPV相关的疾病。对256份鼻咽标本的便利样本进行核酸提取和扩增，以鉴定那些hMPV阳性的标本。进行病历审查以获取hMPV患者的人口统计学和临床数据，并将他们与RSV阳性患者以及接受呼吸道症状评估但hMPV和RSV均为阴性的患者进行比较。我们发现hMPV是仅次于RSV的第二常见病毒。hMPV阳性患者比RSV阳性患者年龄更大。在hMPV阳性患者中，37.5%被诊断为肺炎，31.2%为细支气管炎，37.5%的胸部X线片显示有支气管周围套袖征，81.2%使用了抗生素治疗，37.5%入住了重症监护病房。最后，hMPV阳性患者比RSV阳性患者或hMPV和RSV均为阴性的患者更易出现发热。我们得出结论，hMPV是与儿童住院相关的主要病原体，其疾病严重程度与RSV相同，但发病年龄稍大。鉴于其明显的患病率和疾病严重程度，应实施常规筛查。
