Zimmerman Richard K, Rinaldo Charles R, Nowalk Mary Patricia, Balasubramani G K, Moehling Krissy K, Bullotta Arlene, Eng Heather F, Raviotta Jonathan M, Sax Theresa M, Wisniewski Stephen
Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
BMC Infect Dis. 2015 Feb 22;15:87. doi: 10.1186/s12879-015-0806-2.
While it is known that acute respiratory illness (ARI) is caused by an array of viruses, less is known about co-detections and the resultant comparative symptoms and illness burden. This study examined the co-detections, the distribution of viruses, symptoms, and illness burden associated with ARI between December 2012 and March 2013.
Outpatients with ARI were assayed for presence of 18 viruses using multiplex reverse transcriptase polymerase chain reaction (MRT-PCR) to simultaneously detect multiple viruses.
Among 935 patients, 60% tested positive for a single virus, 9% tested positive for ≥1 virus and 287 (31%) tested negative. Among children (<18 years), the respective distributions were 63%, 14%, and 23%; whereas for younger adults (18-49 years), the distributions were 58%, 8%, and 34% and for older adults (≥50 years) the distributions were 61%, 5%, and 32% (P < 0.001). Co-detections were more common in children than older adults (P = 0.01), and less frequent in households without children (P = 0.003). Most frequently co-detected viruses were coronavirus, respiratory syncytial virus, and influenza A virus. Compared with single viral infections, those with co-detections less frequently reported sore throat (P = 0.01), missed fewer days of school (1.1 vs. 2 days; P = 0.04), or work (2 vs. 3 days; P = 0.03); other measures of illness severity did not vary.
Among outpatients with ARI, 69% of visits were associated with a viral etiology. Co-detections of specific clusters of viruses were observed in 9% of ARI cases particularly in children, were less frequent in households without children, and were less symptomatic (e.g., lower fever) than single infections.
虽然已知急性呼吸道疾病（ARI）由一系列病毒引起，但对于病毒合并检测以及由此产生的比较症状和疾病负担了解较少。本研究调查了2012年12月至2013年3月期间与ARI相关的病毒合并检测、病毒分布、症状及疾病负担。
采用多重逆转录聚合酶链反应（MRT-PCR）对ARI门诊患者检测18种病毒的存在情况，以同时检测多种病毒。
935例患者中，60%单一病毒检测呈阳性，9%≥1种病毒检测呈阳性，287例（31%）检测呈阴性。儿童（<18岁）中，相应分布分别为63%、14%和23%；较年轻成人（18 - 49岁）中，分布分别为58%、8%和34%；较年长者（≥50岁）中，分布分别为61%、5%和32%（P < 0.001）。病毒合并检测在儿童中比年长者更常见（P = 0.01），在无子女家庭中频率更低（P = 0.003）。最常合并检测到的病毒是冠状病毒、呼吸道合胞病毒和甲型流感病毒。与单一病毒感染相比，合并感染者较少报告喉咙痛（P = 0.01），缺课天数较少（1.1天对2天；P = 0.04），或误工天数较少（2天对3天；P = 0.03）；其他疾病严重程度指标无差异。
ARI门诊患者中，69%的就诊与病毒病因相关。9%的ARI病例中观察到特定病毒簇的合并检测，尤其在儿童中，在无子女家庭中频率更低，且比单一感染症状较轻（如发热较低）。
