del Valle Mendoza Juana, Cornejo-Tapia Angela, Weilg Pablo, Verne Eduardo, Nazario-Fuertes Ronald, Ugarte Claudia, del Valle Luis J, Pumarola Tomás
School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Perú; Nutrition Research Institute, Lima, Perú
J Med Virol. 2015 Jun;87(6):917-24. doi: 10.1002/jmv.24159. Epub 2015 Mar 17.
Acute respiratory infections are responsible for high morbi-mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses.
急性呼吸道感染是秘鲁儿童高发病率和高死亡率的原因。然而,病原体的识别情况很差。这项在2009年甲型H1N1流感大流行期间开展的研究,旨在确定秘鲁利马儿童急性呼吸道感染的主要病原体。对2009年1月至2010年12月期间从717名患有急性呼吸道感染的儿童中采集的鼻咽拭子进行了多重逆转录聚合酶链反应(RT-PCR)分析,检测13种呼吸道病毒:甲型、乙型和丙型流感病毒;1型、2型、3型和4型副流感病毒(PIV);以及甲型和乙型人呼吸道合胞病毒(RSV)等。样本还使用直接荧光抗体(DFA)检测了六种呼吸道病毒。RT-PCR和DFA分别在240例(33.5%)和85例(11.9%)病例中检测到呼吸道病毒。最常见的病原体是甲型RSV(15.3%),其次是甲型流感病毒(4.6%)、1型PIV(3.6%)和2型PIV(1.8%)。通过DFA鉴定的病毒为RSV(5.9%)和甲型流感病毒(1.8%)。因此,呼吸道合胞病毒(RSV)被发现是急性呼吸道感染最常见的病因。作者建议进行主动监测以识别病原体并改善临床管理,尤其是在大流行病毒可能传播的情况下。