Visseaux Benoit, Burdet Charles, Voiriot Guillaume, Lescure François-Xavier, Chougar Taous, Brugière Olivier, Crestani Bruno, Casalino Enrique, Charpentier Charlotte, Descamps Diane, Timsit Jean-François, Yazdanpanah Yazdan, Houhou-Fidouh Nadhira
IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Laboratoire de Virologie, Hôpital Bichat, AP-HP, Paris, France.
IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Services des Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France.
PLoS One. 2017 Jul 14;12(7):e0180888. doi: 10.1371/journal.pone.0180888. eCollection 2017.
Multiplex PCR tests have improved our understanding of respiratory viruses' epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period.
All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units).
In total, 7196 samples (4958 patients) were included; 29.2% tested positive, with viral co-infections detected in 1.6% of samples. Overall, two viral groups accounted for 60.2% of all viruses identified: picornaviruses (rhinovirus or enterovirus, 34.3%) and influenza (26.6%). Influenza viruses constituted the group most frequently identified in winter (34.4%), in the upper respiratory tract (32%) and in patients over the age of 70 years (36.4%). Picornavirus was the second most frequently identified viral group in these populations and in all other groups, including lower respiratory tract infections (41.3%) or patients in intensive care units (37.6%).
This study, the largest to date in Europe, provides a broad picture of the distribution of viruses over seasons, age groups, types of clinical unit and respiratory tract regions in the hospital setting. It highlights the burden associated with the neglected picornavirus group. These data have important implications for the future development of vaccines and antiviral drugs.
多重聚合酶链反应(PCR)检测通过实现对多种呼吸道病毒的广泛检测,增进了我们对呼吸道病毒流行病学的了解。我们在此描述了这些病毒在医院环境中五年期间的感染负担情况。
回顾性纳入了2011年5月1日至2016年4月30日期间,应医生要求对成年患者(>20岁)进行多重PCR检测的所有呼吸道样本。按季节、患者年龄组、呼吸道区域(上呼吸道或下呼吸道)以及临床科室类型(重症监护病房、肺病科、肺移植科和其他医疗科室)报告病毒检测结果。
总共纳入了7196份样本(4958例患者);29.2%检测呈阳性,1.6%的样本检测到病毒合并感染。总体而言,两类病毒组占所有鉴定出病毒的60.2%:小核糖核酸病毒(鼻病毒或肠道病毒,34.3%)和流感病毒(26.6%)。流感病毒是冬季(34.4%)、上呼吸道(32%)以及70岁以上患者(36.4%)中最常鉴定出的病毒组。小核糖核酸病毒是这些人群以及所有其他组中第二常鉴定出的病毒组,包括下呼吸道感染患者(41.3%)或重症监护病房患者(37.6%)。
这项欧洲迄今为止规模最大的研究,全面呈现了医院环境中病毒在季节、年龄组、临床科室类型和呼吸道区域的分布情况。它凸显了被忽视的小核糖核酸病毒组所带来的负担。这些数据对疫苗和抗病毒药物的未来研发具有重要意义。