呼吸道合胞病毒基因型如何影响毛细支气管炎住院婴儿的临床病程。

How Respiratory Syncytial Virus Genotypes Influence the Clinical Course in Infants Hospitalized for Bronchiolitis.

机构信息

Department of Pediatrics, Sapienza University, Rome, Italy.

Virology Laboratory, Department of Molecular Medicine, Sapienza University, Rome, Italy.

出版信息

J Infect Dis. 2019 Jan 29;219(4):526-534. doi: 10.1093/infdis/jiy496.

DOI:10.1093/infdis/jiy496

PMID:30204889

Abstract

BACKGROUND

We aimed to study respiratory syncytial virus (RSV) genotype distribution, clinical presentation, and disease severity in infants with bronchiolitis from RSV subtypes and new RSV genotypes.

METHODS

We prospectively enrolled previously healthy term infants less than 1 year old hospitalized for bronchiolitis in an Italian university hospital over 12 epidemic seasons. In 312 nasopharyngeal washings positive for RSV, we sequenced the viral genotype and analyzed this according to patient data. Strain-specific RSV loads were quantified for 273 specimens.

RESULTS

From 2005-2006 to 2011-2012, the RSV-A genotype NA1 predominated, and was replaced in 2012 by the novel ON1. All infants infected with RSV subtype B were genotype BA. Stratifying data according to genotypes NA1, ON1, and BA showed that NA1-infected infants were the youngest and had the most severe clinical course. Conversely, BA-infected infants had less severe symptoms and more frequently had eosinophilia and a family history of asthma. Infants with the ON1 genotype had a milder clinical course than those with NA1 and more risk factors for asthma, despite having the highest viral loads.

CONCLUSION

The disease course in infants hospitalized for acute RSV bronchiolitis may depend on the RSV genotype.

摘要

背景

我们旨在研究 RSV 亚型和新 RSV 基因型引起毛细支气管炎的婴幼儿的 RSV 基因型分布、临床特征和疾病严重程度。

方法

我们前瞻性地招募了意大利一家大学医院 12 个流行季节期间因毛细支气管炎住院的既往健康的足月婴幼儿。在 312 例鼻咽拭子 RSV 阳性的标本中，我们对病毒基因型进行了测序，并根据患者数据进行了分析。对 273 份标本进行了特定毒株 RSV 载量的定量检测。

结果

从 2005-2006 年到 2011-2012 年，RSV-A 基因型 NA1 占主导地位，2012 年被新型 ON1 取代。所有感染 RSV-B 亚型的婴儿均为 BA 基因型。根据 NA1、ON1 和 BA 基因型分层数据显示，感染 NA1 的婴儿年龄最小，临床病程最严重。相反，BA 感染的婴儿症状较轻，更常出现嗜酸性粒细胞增多和哮喘家族史。与感染 NA1 的婴儿相比，感染 ON1 的婴儿临床病程较轻，但哮喘的危险因素更多，尽管病毒载量最高。