Laboratory of Microbiology and Immunology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
Research Unit for Genomic Characterization of Infectious Agents UR12SP34, University-Hospital of Farhat Hached of Sousse, Sousse, Tunisia.
PLoS One. 2017 Nov 17;12(11):e0188325. doi: 10.1371/journal.pone.0188325. eCollection 2017.
This study aimed to identify a broad spectrum of respiratory pathogens from hospitalized and not-preselected children with acute respiratory tract infections in the Farhat Hached University-hospital of Sousse, Tunisia. Between September 2013 and December 2014, samples from 372 children aged between 1 month and 5 years were collected, and tested using multiplex real-time RT-PCR by a commercial assay for 21 respiratory pathogens. In addition, samples were screened for the presence of Streptococcus pneumoniae 16S rDNA using real-time PCR. The viral distribution and its association with clinical symptoms were statistically analyzed. Viral pathogens were detected in 342 (91.93%) of the samples of which 28.76% were single positive and 63.17% had multiple infections. The most frequent detected viruses were rhinovirus (55.64%), respiratory syncytial virus A/B (33.06%), adenovirus (25.00%), coronavirus NL63, HKU1, OC43, and 229E (21.50%), and metapneumovirus A/B (16.12%). Children in the youngest age group (1-3 months) exhibited the highest frequencies of infection. Related to their frequency of detection, RSV A/B was the most associated pathogen with patient's demographic situation and clinical manifestations (p<0.05). Parainfluenza virus 1-4 and parechovirus were found to increase the risk of death (p<0.05). Adenovirus was statistically associated to the manifestation of gastroenteritis (p = 0.004). Rhinovirus infection increases the duration of oxygen support (p = 0.042). Coronavirus group was statistically associated with the manifestation of bronchiolitis (p = 0.009) and laryngitis (p = 0.017). Streptococcus pneumoniae DNA was detected in 143 (38.44%) of tested samples. However, only 53 samples had a concentration of C-reactive protein from equal to higher than 20 milligrams per liter, and 6 of them were single positive for Streptocuccus pneumoniae. This study confirms the high incidence of respiratory viruses in children hospitalized for acute respiratory tract infections in the Sousse area, Tunisia.
本研究旨在鉴定突尼斯苏塞法哈特哈切德大学医院住院和未经选择的急性呼吸道感染患儿的广谱呼吸道病原体。2013 年 9 月至 2014 年 12 月，采集了 372 名 1 个月至 5 岁儿童的样本，使用商业检测方法对 21 种呼吸道病原体进行了多重实时 RT-PCR 检测。此外，还使用实时 PCR 对肺炎链球菌 16S rDNA 的存在进行了筛选。对病毒的分布及其与临床症状的关系进行了统计学分析。在 342 份样本中检测到病毒病原体，其中 28.76%为单一阳性，63.17%为多重感染。最常检测到的病毒是鼻病毒（55.64%）、呼吸道合胞病毒 A/B（33.06%）、腺病毒（25.00%）、冠状病毒 NL63、HKU1、OC43 和 229E（21.50%）和肺炎支原体 A/B（16.12%）。年龄最小的儿童（1-3 个月）感染率最高。根据其检测频率，RSV A/B 是与患者人口统计学状况和临床表现最相关的病原体（p<0.05）。1-4 型副流感病毒和肠道病毒被发现增加死亡风险（p<0.05）。腺病毒与肠胃炎的表现有统计学关联（p = 0.004）。鼻病毒感染增加了吸氧时间（p = 0.042）。冠状病毒组与细支气管炎（p = 0.009）和喉炎（p = 0.017）的表现有统计学关联。在检测的 143 个样本中检测到肺炎链球菌 DNA。然而，只有 53 个样本的 C 反应蛋白浓度等于或高于 20 毫克/升，其中 6 个样本为肺炎链球菌单一阳性。本研究证实了突尼斯苏塞地区住院急性呼吸道感染患儿呼吸道病毒的高发病率。
