住院时间与毛细支气管炎的鼻病毒病因相关。

Hospital length-of-stay is associated with rhinovirus etiology of bronchiolitis.

作者信息

Jartti Tuomas, Aakula Matilda, Mansbach Jonathan M, Piedra Pedro A, Bergroth Eija, Koponen Petri, Kivistö Juho E, Sullivan Ashley F, Espinola Janice A, Remes Sami, Korppi Matti, Camargo Carlos A

机构信息

From the *Department of Pediatrics, Turku University Hospital, Turku, Finland; †Department of Medicine, Boston Children's Hospital, Boston, MA; ‡Departments of Molecular Virology and Microbiology, and Pediatrics, Baylor College of Medicine, Houston, TX; §Department of Pediatrics, Kuopio University Hospital, Kuopio; ¶Department of Pediatrics, Tampere University Hospital, Tampere, Finland; and ‖Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; **Allergy Unit, Tampere University Hospital, Tampere, Finland.

出版信息

Pediatr Infect Dis J. 2014 Aug;33(8):829-34. doi: 10.1097/INF.0000000000000313.

DOI:10.1097/INF.0000000000000313

PMID:25222302

Abstract

OBJECTIVE

To determine whether hospital length-of-stay (LOS) for bronchiolitis is influenced by the causative virus: respiratory syncytial virus (RSV) or rhinovirus.

METHODS

This prospective study was carried out in 3 university hospitals in Finland during 2 consecutive winter seasons. We enrolled consecutive children <2 years of age hospitalized with an attending physician's diagnosis of bronchiolitis. All enrolled children were included in the primary analysis. A parallel analysis was also conducted using a stricter definition for bronchiolitis (age <12 months and no history of wheeze). Polymerase chain reaction was used to test the nasopharyngeal aspirate samples for multiple respiratory pathogens.

RESULTS

The median age of the 408 children was 8 months, 73% had no history of wheeze and their median hospital LOS was 2 days. 144 (35%) children had RSV only and 92 (23%) children rhinovirus only infections. Children with rhinovirus only had shorter duration of prehospital symptoms, higher disease severity score at entry and more often a history of wheezing (all P ≤ 0.001). Controlling for 7 demographic and clinical characteristics, those with rhinovirus only had shorter hospital LOS when compared with children with RSV only (adjusted odds ratio: 0.45; 95% confidence interval: 0.22-0.92; P = 0.03). The rhinovirus only finding was similar in the subset of 206 children with stricter diagnosis (adjusted odds ratio: 0.30; 0.06-1.49; P = 0.14).

CONCLUSIONS

Hospital LOS is associated with rhinovirus etiology of bronchiolitis. Our data call attention to the importance of both RSV and rhinovirus testing in clinical research.

摘要

目的

确定毛细支气管炎的住院时间（LOS）是否受致病病毒（呼吸道合胞病毒（RSV）或鼻病毒）的影响。

方法

这项前瞻性研究在芬兰的3所大学医院连续两个冬季进行。我们纳入了经主治医生诊断为毛细支气管炎的连续住院的2岁以下儿童。所有纳入的儿童均纳入初步分析。还使用更严格的毛细支气管炎定义（年龄<12个月且无喘息史）进行了平行分析。采用聚合酶链反应检测鼻咽抽吸物样本中的多种呼吸道病原体。

结果

408名儿童的中位年龄为8个月，73%无喘息史，中位住院时间为2天。144名（35%）儿童仅感染RSV，92名（23%）儿童仅感染鼻病毒。仅感染鼻病毒的儿童院前症状持续时间较短，入院时疾病严重程度评分较高，且更常有喘息史（所有P≤0.001）。在控制了7个人口统计学和临床特征后，仅感染鼻病毒的儿童与仅感染RSV的儿童相比，住院时间更短（调整后的优势比：0.45；95%置信区间：0.22 - 0.92；P = 0.03）。在206名诊断更严格的儿童亚组中，仅感染鼻病毒的结果相似（调整后的优势比：0.30；0.06 - 1.49；P = 0.14）。