Diaz Jahaziel, Morales-Romero Jaime, Pérez-Gil Gustavo, Bedolla-Barajas Martín, Delgado-Figueroa Netzahualpilli, García-Román Rebeca, López-López Omar, Bañuelos Evelyn, Rizada-Antel Cristal, Zenteno-Cuevas Roberto, Ramos-Ligonio Ángel, Sampieri Clara Luz, Orozco-Alatorre Luis Gustavo, Mora Silvia I, Montero Hilda
Instituto de Salud Pública, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n., Col. Industrial Ánimas, 91190, Xalapa, Veracruz, México.
Centro de Ciencias Biomédicas, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n., Col. Industrial Ánimas, 91190, Xalapa, Veracruz, México.
Ital J Pediatr. 2015 Apr 18;41:33. doi: 10.1186/s13052-015-0133-7.
Acute respiratory infections (ARIs) cause illness. Children under five years of age are highly vulnerable to these infections. Viral coinfection or multiple viral infection is a variable that can have a significant impact on the evolution of these diseases.
This cross-sectional study was carried out in Mexican children (under five years of age) who had an ARI and who were treated by an emergency service in a hospital in Guadalajara, Jalisco, Mexico. The viral etiology, as well as the presence of multiple viral infections, was determined. A structured questionnaire was used to obtain demographic and clinical information. Odds ratio (OR) was calculated, and univariate and multivariate analyses using logistic regression were performed.
In the study population, metapneumovirus (hMPV) was the most frequent virus (22%), followed by adenovirus (hAD) (16%), respiratory syncytial virus (RSV) (14%), rhinovirus (hRV) (12%), bocavirus (hBoV) (9%), influenza virus (IF) (7%), and parainfluenza (PIF) (4%). The frequency of viral coinfections was 31.62%, and multiple logistic regression analysis revealed that hMPV, RSV, PIF, and hBoV were independently associated with multiple viral infection. No difference was found in the clinical manifestation of children with simple and multiple infections. Simple hMPV infection was associated with patients who presented with severe ARI. Using a multivariate analysis, we found that overcrowding is associated with coinfection when the viral etiology was hRV (OR = 2.56, 95% confidence interval (CI) 1.07 to 6.13), IF (OR = 2.56, 95% CI 1.07 to 6.13), PIF (OR = 2.96, 95% CI 1.15 to 7.65), hAD (OR = 2.56, 95% CI 1.07 to 6.13), and hBoV (OR = 2.9, 95% CI 1.14 to 7.34).
Viral coinfections are frequent in children requiring treatment by an emergency service. However, the severity of ARI is similar to that of children with a simple infection. The hMPV is common and may confer a significant disease burden in the Mexican population. Finally, overcrowding is a housing characteristic that favors the development of coinfections.
急性呼吸道感染（ARIs）会引发疾病。五岁以下儿童极易感染这些疾病。病毒合并感染或多重病毒感染是一个可能对这些疾病的发展产生重大影响的变量。
这项横断面研究在墨西哥哈利斯科州瓜达拉哈拉市一家医院的急诊科接受治疗的患有ARIs的墨西哥五岁以下儿童中开展。确定了病毒病因以及多重病毒感染的情况。使用结构化问卷获取人口统计学和临床信息。计算优势比（OR），并使用逻辑回归进行单变量和多变量分析。
在研究人群中，人偏肺病毒（hMPV）是最常见的病毒（22%），其次是腺病毒（hAD）（16%）、呼吸道合胞病毒（RSV）（14%）、鼻病毒（hRV）（12%）、博卡病毒（hBoV）（9%）、流感病毒（IF）（7%）和副流感病毒（PIF）（4%）。病毒合并感染的发生率为31.62%，多因素逻辑回归分析显示，hMPV、RSV、PIF和hBoV与多重病毒感染独立相关。单纯感染和多重感染儿童的临床表现无差异。单纯hMPV感染与患有严重ARIs的患者相关。通过多变量分析，我们发现当病毒病因是hRV（OR = 2.56，95%置信区间（CI）1.07至6.13）、IF（OR = 2.56，95%CI 1.07至6.13）、PIF（OR = 2.96，95%CI 1.15至7.65）、hAD（OR = 2.56，95%CI 1.07至6.13）和hBoV（OR = 2.9，95%CI 1.14至7.34）时，过度拥挤与合并感染相关。
在需要急诊科治疗的儿童中，病毒合并感染很常见。然而，ARIs的严重程度与单纯感染儿童相似。hMPV很常见，可能给墨西哥人群带来重大疾病负担。最后，过度拥挤是有利于合并感染发生的居住特征。
