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呼吸道混合病毒感染;连续冬季的流行病学研究。

Mixed viral infections of the respiratory tract; an epidemiological study during consecutive winter seasons.

机构信息

4th Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece.

Department of Cytopathology, University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece.

出版信息

J Med Virol. 2018 Apr;90(4):663-670. doi: 10.1002/jmv.25006. Epub 2018 Jan 17.

Abstract

The current study aimed to describe the molecular epidemiology of mixed respiratory viral infections during consecutive winter seasons in a tertiary care hospital. Patients with symptoms of respiratory tract infection were evaluated during the 2009-2011 and 2013-15 winter seasons. A clinical microarray technique was used for viral detection. Clinical and epidemiological data were correlated with mixed viral detection and the need for hospitalization. In 332 out of 604 (54.4%) evaluated patients (17.6% children) a respiratory virus was identified. Mixed viral infections were diagnosed in 68/332 (20.5%) patients with virus detection (66.2% mixed Influenza-RSV infections). Mixed viral infections were more commonly detected in children (OR 3.7; 95%CI 1.9-5.6, P < 0.01) and patients with comorbidities. In logistic regression analyses, mixed viral infections were associated with younger age (mean age 30.4 years vs. 41.8 years, P ≤ 0.001) and increased rates of fever (OR: 2.7; 95%CI 1.04-7.2, P < 0.05) but no adverse outcomes or increased rates of hospitalization. High rates of mixed viral infections were noted during all winter seasons (especially Influenza and RSV) and were more common in younger patients. The clinical significance of mixed respiratory viral infection needs further elucidation.

摘要

本研究旨在描述三级保健医院连续冬季呼吸道混合病毒感染的分子流行病学。在 2009-2011 年和 2013-2015 年冬季,对有呼吸道感染症状的患者进行评估。采用临床微阵列技术进行病毒检测。将临床和流行病学数据与混合病毒检测和住院需求相关联。在 604 例评估患者中的 332 例(17.6%为儿童)中发现了呼吸道病毒。在 332 例有病毒检测结果的患者中诊断出 68 例(20.5%)混合病毒感染(66.2%为混合流感-RSV 感染)。混合病毒感染在儿童(比值比 3.7;95%置信区间 1.9-5.6,P < 0.01)和合并症患者中更常见。在逻辑回归分析中,混合病毒感染与年龄较小(平均年龄 30.4 岁比 41.8 岁,P ≤ 0.001)和发热率升高(比值比:2.7;95%置信区间 1.04-7.2,P < 0.05)相关,但无不良结局或住院率升高。在所有冬季都发现了高混合病毒感染率(尤其是流感和 RSV),且在年轻患者中更为常见。混合呼吸道病毒感染的临床意义需要进一步阐明。

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