Meidani Mohsen, Mirmohammad Sadeghi Seyed Alireza
Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Adv Biomed Res. 2018 Jan 22;7:5. doi: 10.4103/abr.abr_433_15. eCollection 2018.
Respiratory infections are a frequent cause of fever in neutropenic patients, whereas respiratory viral infections are not frequently considered as a diagnosis, which causes high morbidity and mortality in these patients.
This prospective study was performed on 36 patients with neutropenia who admitted to hospital were eligible for inclusion with fever (single temperature of >38.3°C or a sustained temperature of >38°C for more than 1 h), upper and lower respiratory symptoms. Sampling was performed from the throat of the patient by the sterile swab. All materials were analyzed by quantitative real-time multiplex polymerase chain reaction covering the following viruses; influenza, parainfluenza virus (PIV), rhinovirus (RV), human metapneumovirus, and respiratory syncytial virus (RSV).
RV was the most frequently detected virus and then RSV was the most. PIV was not present in any of the tested samples. Furthermore, no substantial differences in the distribution of specific viral species were observed based on age, sex, neutropenia duration, hematological disorder, and respiratory tract symptoms and signs ( > 0.05).
Our prospective study supports the hypothesis that respiratory viruses play an important role in the development of neutropenic fever, and thus has the potential to individualize infection treatment and to reduce the extensive use of antibiotics in immunocompromised patients with neutropenia.
呼吸道感染是中性粒细胞减少患者发热的常见原因,而呼吸道病毒感染通常不被视为诊断结果,这导致这些患者的发病率和死亡率较高。
本前瞻性研究对36例因发热(单次体温>38.3°C或持续体温>38°C超过1小时)、有上下呼吸道症状而入院的中性粒细胞减少患者进行。通过无菌拭子从患者咽喉部取样。所有样本通过定量实时多重聚合酶链反应分析,检测以下病毒:流感病毒、副流感病毒(PIV)、鼻病毒(RV)、人偏肺病毒和呼吸道合胞病毒(RSV)。
RV是最常检测到的病毒,其次是RSV。在任何检测样本中均未发现PIV。此外,根据年龄、性别、中性粒细胞减少持续时间、血液系统疾病以及呼吸道症状和体征,未观察到特定病毒种类分布的显著差异(>0.05)。
我们的前瞻性研究支持以下假设,即呼吸道病毒在中性粒细胞减少性发热的发生中起重要作用,因此有可能实现感染治疗的个体化,并减少免疫功能低下的中性粒细胞减少患者对抗生素的广泛使用。