Cui Dawei, Feng Luzhao, Chen Yu, Lai Shengjie, Zhang Zike, Yu Fei, Zheng Shufa, Li Zhongjie, Yu Hongjie
Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, China.
Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, 310003, China.
PLoS One. 2016 Nov 1;11(11):e0165437. doi: 10.1371/journal.pone.0165437. eCollection 2016.
Respiratory syncytial virus (RSV) is a leading cause of morbidity and mortality worldwide in children aged <5 years and older adults with acute lower respiratory infections (ALRIs). However, few studies regarding the epidemiology of hospitalizations for RSV infection have been performed previously in China. Here, we aimed to describe the clinical and epidemiologic characteristics of hospitalized patients with laboratory-confirmed RSV infection in eastern China. Active surveillance for hospitalized ALRI patients using a broad case definition based on symptoms was performed from 2009-2013 in 12 sentinel hospitals in eastern China. Clinical and epidemiologic data pertaining to hospitalized patients of all ages with laboratory-confirmed RSV infection by PCR assay were collected and analyzed in this study. From 2009 to 2013, 1046 hospitalized patients with laboratory-confirmed RSV infection were enrolled in this study, and 14.7% of patients had subtype A, 24.2% of patients had subtype B, 23.8% of patients with subtype not performed, and 37.3% of patients had RSV coinfections with other viruses. RSV and influenza coinfections (33.3%) were the most common coinfections noted in this study. Moreover, young children aged <5 years (89.1%, 932/1046), particularly young infants aged <1 year (43.3%, 453/1046), represented the highest proportion of patients with RSV infections. In contrast, older adults aged ≥60 years (1.1%, 12/1046) represented the lowest proportion of patients with RSV infections among enrolled patients. The peak RSV infection period occurred mainly during autumn and winter, and 57% and 66% of patients exhibited symptoms such as fever (body temperature ≥38°C) and cough separately. Additionally, only a small number of patients were treated with broad-spectrum antiviral drugs, and most of patients were treated with antimicrobial drugs that were not appropriate for RSV infection. RSV is a leading viral pathogen and a common cause of viral infection in young children aged <5 years with ALRIs in eastern China. Effective vaccines and antiviral agents targeting RSV are needed to mitigate its large public health impact.
呼吸道合胞病毒（RSV）是全球5岁以下儿童和患有急性下呼吸道感染（ALRI）的老年人发病和死亡的主要原因。然而，此前中国很少有关于RSV感染住院流行病学的研究。在此，我们旨在描述中国东部地区实验室确诊的RSV感染住院患者的临床和流行病学特征。2009年至2013年期间，在中国东部的12家哨点医院对住院的ALRI患者进行了基于症状的广泛病例定义的主动监测。本研究收集并分析了所有年龄通过PCR检测确诊为RSV感染的住院患者的临床和流行病学数据。2009年至2013年期间，本研究纳入了1046例实验室确诊的RSV感染住院患者，其中14.7%的患者为A亚型，24.2%的患者为B亚型，23.8%的患者未进行亚型检测，37.3%的患者RSV与其他病毒合并感染。RSV与流感病毒合并感染（33.3%）是本研究中最常见的合并感染。此外，5岁以下儿童（89.1%，932/1046），尤其是1岁以下幼儿（43.3%，453/1046），在RSV感染患者中占比最高。相比之下，60岁及以上老年人（1.1%，12/1046）在纳入患者中RSV感染患者占比最低。RSV感染高峰期主要发生在秋季和冬季，分别有57%和66%的患者出现发热（体温≥38°C）和咳嗽等症状。此外，只有少数患者接受了广谱抗病毒药物治疗，大多数患者接受了不适合RSV感染的抗菌药物治疗。RSV是中国东部5岁以下患有ALRI的幼儿中主要的病毒病原体和常见的病毒感染原因。需要有效的针对RSV的疫苗和抗病毒药物来减轻其对公共卫生的巨大影响。
