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台湾一家医学中心住院患者鼻病毒感染的分子流行病学和临床特征。

Molecular epidemiology and clinical features of rhinovirus infections among hospitalized patients in a medical center in Taiwan.

机构信息

Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.

Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

J Microbiol Immunol Infect. 2019 Apr;52(2):233-241. doi: 10.1016/j.jmii.2018.08.009. Epub 2018 Aug 30.

Abstract

BACKGROUND

Human rhinovirus (HRV) can cause severe illnesses in hospitalized patients. However, there are no studies regarding the prevalence of HRV infection, particularly the recently identified HRV-C, in hospitalized patients reported from Taiwan.

METHODS

Respiratory specimens collected from 487 hospitalized patients in designated wards between 2013 and 2014 in a medical center in northern Taiwan were retrospectively detected for HRV. Positive specimens were further determined for genotyping. Medical charts of the HRV-positive patients were reviewed retrospectively.

RESULTS

Totally, 76 patients (15.6%) were HRV positive, of which 60 were pediatric patients. HRV-A was identified in 41 (54%) patients, HRV-B in 6 patients (7.9%) and HRV-C in 29 patients (38%). A total of 47 different genotypes were identified. HRV infections were predominant during fall and winter seasons. 21.1% were affected by HRV alone and 78.9% were found to be co-infected with other microorganisms. The detection rate of HRV in children (18.6%) was significantly higher than in adults (9.6%). Compared with pediatric patients, adult patients were significantly associated with underlying disease, Pneumocystis jirovesii pneumonia co-infection, a diagnosis of pneumonia, fatal outcome, hospital acquisition of HRV, antibiotics administration and requiring intensive care, while pediatric patients were significantly associated with viral co-infection.

CONCLUSIONS

HRV was a common cause of respiratory tract infection in Taiwan, particularly in pediatric patients. Eighty percent of HRV-infected inpatients had other microorganisms co-infection. Adult patients were more likely to be associated with a severe respiratory disease entity.

摘要

背景

人类鼻病毒(HRV)可导致住院患者发生严重疾病。然而,目前尚无关于 HRV 感染流行情况的研究,尤其是在台湾地区,尚未报道有关住院患者 HRV-C 感染的情况。

方法

回顾性检测了 2013 年至 2014 年期间台湾北部一家医疗中心指定病房的 487 例住院患者的呼吸道标本中是否存在 HRV。对阳性标本进一步进行基因分型检测。回顾性分析 HRV 阳性患者的病历。

结果

共有 76 例患者(15.6%)HRV 阳性,其中 60 例为儿科患者。41 例(54%)患者为 HRV-A 型,6 例(7.9%)患者为 HRV-B 型,29 例(38%)患者为 HRV-C 型。共鉴定出 47 种不同的基因型。HRV 感染主要发生在秋季和冬季。21.1%的患者为单纯 HRV 感染,78.9%的患者合并其他微生物感染。儿童(18.6%)HRV 检出率明显高于成人(9.6%)。与儿科患者相比,成人患者与基础疾病、卡氏肺孢子虫肺炎合并感染、肺炎诊断、不良结局、医院获得性 HRV、抗生素治疗和需要重症监护治疗显著相关,而儿科患者则与病毒合并感染显著相关。

结论

HRV 是台湾地区呼吸道感染的常见病因,尤其是在儿科患者中。80%的 HRV 感染住院患者合并其他微生物感染。成人患者更易发生严重的呼吸道疾病。

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