Wong-Chew Rosa María, García-León Miguel L, Noyola Daniel E, Perez Gonzalez Luis F, Gaitan Meza Jesús, Vilaseñor-Sierra Alberto, Martinez-Aguilar Gerardo, Rivera-Nuñez Victor Hugo, Newton-Sánchez Oscar A, Firo-Reyes Verónica, Del Río-Almendarez Carlos N, González-Rodríguez Alejandra Pamela, Ortiz-García Enrique R, Navarrete-Navarro Susana, Soria-Rodríguez Carmen, Carrasco-Castillo Adoniram, Sánchez-Medina Eneida, López-Martínez Irma, Hernández-Andrade Teresa, Alpuche-Aranda Celia M, Santos-Preciado José I
Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico city, Mexico.
Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico city, Mexico.
Int J Infect Dis. 2017 Sep;62:32-38. doi: 10.1016/j.ijid.2017.06.020. Epub 2017 Jun 30.
Acute respiratory infections are the leading cause of mortality in children worldwide, especially in developing countries. Pneumonia accounts for 16% of all deaths of children under 5 years of age and was the cause of death of 935000 children in 2015. Despite its frequency and severity, information regarding its etiology is limited. The aim of this study was to identify respiratory viruses associated with community-acquired pneumonia (CAP) in children younger than 5 years old.
One thousand four hundred and four children younger than 5 years of age with a clinical and/or radiological diagnosis of CAP in 11 hospitals in Mexico were included. Nasal washes were collected, placed in viral medium, and frozen at -70°C until processing. The first 832 samples were processed using the multiplex Bio-Plex/Luminex system and the remaining 572 samples using the Anyplex multiplex RT-PCR. Clinical data regarding diagnosis, clinical signs and symptoms, radiographic pattern, and risk factors were obtained and recorded.
Of the samples tested, 81.6% were positive for viruses. Respiratory syncytial virus (types A and B) was found in 23.7%, human enterovirus/rhinovirus in 16.6%, metapneumovirus in 5.7%, parainfluenza virus (types 1-4) in 5.5%, influenza virus (types A and B) in 3.6%, adenovirus in 2.2%, coronavirus (NL63, OC43, 229E, and HKU1) in 2.2%, and bocavirus in 0.4%. Co-infection with two or more viruses was present in 22.1%; 18.4% of the samples were negative. Using biomass for cooking, daycare attendance, absence of breastfeeding, and co-infections were found to be statistically significant risk factors for the presence of severe pneumonia.
Respiratory syncytial virus (types A and B), human enterovirus/rhinovirus, and metapneumovirus were the respiratory viruses identified most frequently in children younger than 5 years old with CAP. Co-infection was present in an important proportion of the children.
急性呼吸道感染是全球儿童死亡的主要原因，在发展中国家尤为如此。肺炎占5岁以下儿童死亡总数的16%，是2015年93.5万名儿童的死因。尽管其发病频率和严重程度较高，但其病因相关信息有限。本研究的目的是确定5岁以下儿童社区获得性肺炎（CAP）相关的呼吸道病毒。
纳入墨西哥11家医院中1404名5岁以下临床和/或放射学诊断为CAP的儿童。采集鼻洗液，置于病毒培养基中，在-70°C冷冻直至处理。前832份样本采用多重Bio-Plex/Luminex系统处理，其余572份样本采用Anyplex多重逆转录聚合酶链反应处理。获取并记录有关诊断、临床体征和症状、影像学表现及危险因素的临床数据。
在检测样本中，81.6%的病毒呈阳性。呼吸道合胞病毒（A和B型）占23.7%，人肠道病毒/鼻病毒占16.6%，偏肺病毒占5.7%，副流感病毒（1-4型）占5.5%，流感病毒（A和B型）占3.6%，腺病毒占2.2%，冠状病毒（NL63、OC43、229E和HKU1）占2.2%，博卡病毒占0.4%。22.1%的样本存在两种或更多病毒的合并感染；18.4%的样本为阴性。发现使用生物质做饭、日托、未进行母乳喂养以及合并感染是重度肺炎存在的统计学显著危险因素。
呼吸道合胞病毒（A和B型）、人肠道病毒/鼻病毒和偏肺病毒是5岁以下CAP儿童中最常发现的呼吸道病毒。重要比例的儿童存在合并感染。
