Skjerven Håvard O, Megremis Spyridon, Papadopoulos Nikolaos G, Mowinckel Petter, Carlsen Kai-Håkon, Lødrup Carlsen Karin C
Institute of Clinical Medicine, University of Oslo Department of Pediatrics, Oslo University Hospital, Norway.
Department of Allergy, 2nd Pediatric Clinic, University of Athens, Greece Centre for Pediatrics and Child Health, Institute of Human Development, University of Manchester, United Kingdom.
J Infect Dis. 2016 Mar 15;213(6):915-21. doi: 10.1093/infdis/jiv513. Epub 2015 Oct 27.
Acute bronchiolitis frequently causes infant hospitalization. Studies on different viruses or viral genomic load and disease severity or treatment effect have had conflicting results. We aimed to investigate whether the presence or concentration of individual or multiple viruses were associated with disease severity in acute bronchiolitis and to evaluate whether detected viruses modified the response to inhaled racemic adrenaline.
Nasopharyngeal aspirates were collected from 363 infants with acute bronchiolitis in a randomized, controlled trial that compared inhaled racemic adrenaline versus saline. Virus genome was identified and quantified by polymerase chain reaction analyses. Severity was assessed on the basis of the length of stay and the use of supportive care.
Respiratory syncytial virus (83%) and human rhinovirus (34%) were most commonly detected. Seven other viruses were present in 8%-15% of the patients. Two or more viruses (maximum, 7) were detected in 61% of the infants. Virus type or coinfection was not associated with disease severity. A high genomic load of respiratory syncytial virus was associated with a longer length of stay and with an increased frequency of oxygen and ventilatory support use. Treatment effect of inhaled adrenaline was not modified by virus type, load or coinfection.
In infants hospitalized with acute bronchiolitis, disease severity was not associated with specific viruses or the total number of viruses detected. A high RSV genomic load was associated with more-severe disease.
NCT00817466 and EudraCT 2009-012667-34.
急性细支气管炎常导致婴儿住院。关于不同病毒或病毒基因组载量与疾病严重程度或治疗效果的研究结果相互矛盾。我们旨在调查急性细支气管炎中单一或多种病毒的存在或浓度是否与疾病严重程度相关，并评估检测到的病毒是否会改变对吸入消旋肾上腺素的反应。
在一项比较吸入消旋肾上腺素与生理盐水的随机对照试验中，收集了363例急性细支气管炎婴儿的鼻咽抽吸物。通过聚合酶链反应分析鉴定并定量病毒基因组。根据住院时间和支持治疗的使用情况评估疾病严重程度。
最常检测到呼吸道合胞病毒（83%）和人鼻病毒（34%）。其他七种病毒在8%-15%的患者中存在。61%的婴儿检测到两种或更多种病毒（最多7种）。病毒类型或合并感染与疾病严重程度无关。呼吸道合胞病毒的高基因组载量与更长的住院时间以及增加的吸氧和通气支持使用频率相关。吸入肾上腺素的治疗效果不受病毒类型、载量或合并感染的影响。
在因急性细支气管炎住院的婴儿中，疾病严重程度与特定病毒或检测到的病毒总数无关。呼吸道合胞病毒的高基因组载量与更严重的疾病相关。
NCT00817466和EudraCT 2009-012667-34。
