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患有囊性纤维化的婴幼儿呼吸道合胞病毒感染相关的住院率

Respiratory Syncytial Virus Infection-associated Hospitalization Rates in Infants and Children With Cystic Fibrosis.

作者信息

Metz Jakob, Eber Ernst, Resch Bernhard

机构信息

From the*Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria; †Department for Paediatric and Adolescent Medicine, Harlaching Hospital, Munich, Germany; ‡Division of Pediatric Pulmonology and Allergology, and §Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.

出版信息

Pediatr Infect Dis J. 2017 Jun;36(6):545-548. doi: 10.1097/INF.0000000000001501.

Abstract

BACKGROUND

Infections with respiratory syncytial virus (RSV) are the leading cause for hospital admissions in infants and young children. The incidence of RSV-related hospitalizations in patients with cystic fibrosis (CF) is unclear. To date, no effective treatment for RSV infections is available. Thus, prophylaxis with the monoclonal antibody palivizumab is an important option.

METHODS

In a retrospective, single-center study at the Department of Pediatrics and Adolescent Medicine of the Medical University Graz, Austria, we analyzed all CF patients born between 1995 and 2012, who were admitted for respiratory problems between 1995 and 2014. We also defined a group of hypothetical RSV infections with the following criteria: admission caused by a respiratory infection during the first RSV season of life when no test for RSV was performed. Furthermore, we assessed the effectiveness of palivizumab as a prevention of RSV-related hospitalizations.

RESULTS

A total of 51 patients with CF were identified. The RSV-related hospitalization rate for the first RSV season was 0. Two patients (3.9%) were hospitalized 3 and 4 times, respectively, caused by RSV infections. The mean age at the time of admission was 12.4 ± 2.5 years. One case (1.9%) met our criteria for hypothetical RSV infections. There was no difference in RSV-related hospitalization rates between patients who received palivizumab and those who did not.

CONCLUSIONS

We found a low rate of RSV-related hospitalizations and could not demonstrate a benefit of palivizumab prophylaxis regarding a decrease of RSV-related hospital admissions. The role of RSV reinfections in CF patients beyond infancy appears to be underestimated.

摘要

背景

呼吸道合胞病毒(RSV)感染是婴幼儿住院的主要原因。囊性纤维化(CF)患者中与RSV相关的住院发生率尚不清楚。迄今为止,尚无有效的RSV感染治疗方法。因此,使用单克隆抗体帕利珠单抗进行预防是一个重要的选择。

方法

在奥地利格拉茨医科大学儿科和青少年医学部进行的一项回顾性单中心研究中,我们分析了1995年至2012年出生、在1995年至2014年因呼吸问题入院的所有CF患者。我们还根据以下标准定义了一组假设的RSV感染:在生命的第一个RSV季节因呼吸道感染入院,且未进行RSV检测。此外,我们评估了帕利珠单抗预防RSV相关住院的有效性。

结果

共确定了51例CF患者。第一个RSV季节的RSV相关住院率为0。两名患者(3.9%)分别因RSV感染住院3次和4次。入院时的平均年龄为12.4±2.5岁。1例(1.9%)符合我们假设的RSV感染标准。接受帕利珠单抗治疗的患者与未接受治疗的患者在RSV相关住院率方面没有差异。

结论

我们发现RSV相关住院率较低,且未证明帕利珠单抗预防在降低RSV相关住院率方面有获益。婴儿期后RSV再感染在CF患者中的作用似乎被低估了。

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