Pratheepamornkull Thitikarn, Ratanakorn Woranart, Samransamruajkit Rujipat, Poovorawan Yong
Southeast Asian J Trop Med Public Health. 2015 Jul;46(4):650-6.
Pneumonia is a leading cause of morbidity and mortality among infants and young children. The most common causes of pneumonia in children are respiratory viruses. In Thailand, the epidemiology of the viruses causing community-acquired pneumonia (CAP) among children is poorly defined. In this cross sectional study we used nasopharyngeal samples collected from hospitalized children diagnosed with severe CAP in accordance with WHO criteria between June 2013 and May 2014 to determine the causes of infection. The samples were analyzed for respiratory syncytial virus (RSV), parainfluenza viruses (PIV) types 1,2 and 3, adenovirus, rhinovirus, influenza viruses types A and B and coronavirus by polymerase chain reaction (PCR) and reverse transcriptase-polymerase chain reaction (RT-PCR). Of 102 cases of severe CAP, samples were obtained in 91 cases and 48 (52.7%) were positive for respiratory viruses. The most common viruses were RSV (n = 22; 45.8%), rhinovirus (n = 11; 22.9%) and adenovirus (n = 9; 18.7%). Patients were aged 1 month to 4 years 5 months, with a median age of 1 year 1 month. Thirty-seven (77.1%) were male. Asthma was the most common co-morbidity affecting 5 (10.4%) of the 48 cases with an identified virus. The peak prevalence occurred during October (n = 17). All patients required oxygen therapy and 17 (35.4%) required mechanical ventilation. The median length of hospitalization was 11 days. Preterm infants had a significantly higher rate of RSV infection than other respiratory viruses (8 of 21; 38% vs 3 of 27; 11.1%) (p = 0.02). Viruses were most commonly associated with severe CAP among children aged less than 1 year. The peak prevalence occurred during the rainy season. Our findings suggest that young and preterm infants with CAP should be monitored closely due to their high risk for developing serious complications.
肺炎是婴幼儿发病和死亡的主要原因。儿童肺炎最常见的病因是呼吸道病毒。在泰国，引起儿童社区获得性肺炎（CAP）的病毒流行病学情况尚不明确。在这项横断面研究中，我们使用了2013年6月至2014年5月期间从按照世界卫生组织标准诊断为重症CAP的住院儿童中采集的鼻咽样本，以确定感染原因。通过聚合酶链反应（PCR）和逆转录聚合酶链反应（RT-PCR）对样本进行呼吸道合胞病毒（RSV）、1、2和3型副流感病毒（PIV）、腺病毒、鼻病毒、甲型和乙型流感病毒以及冠状病毒检测。在102例重症CAP病例中，91例获取了样本，48例（52.7%）呼吸道病毒检测呈阳性。最常见的病毒是RSV（n = 22；45.8%）、鼻病毒（n = 11；22.9%）和腺病毒（n = 9；18.7%）。患者年龄为1个月至4岁5个月，中位年龄为1岁1个月。37例（77.1%）为男性。哮喘是最常见的合并症，在48例检测出病毒的病例中有5例（10.4%）受其影响。发病高峰出现在10月（n = 17）。所有患者均需要氧疗，17例（35.4%）需要机械通气。中位住院时间为11天。早产儿RSV感染率显著高于其他呼吸道病毒（21例中的8例；38%对27例中的3例；11.1%）（p = 0.02）。病毒在1岁以下儿童的重症CAP中最为常见。发病高峰出现在雨季。我们的研究结果表明，患有CAP的幼儿和早产儿应因其发生严重并发症的高风险而受到密切监测。
