婴幼儿病毒性急性呼吸道疾病增加呼吸道再入院风险。
Viral Acute Respiratory Illnesses in Young Infants Increase the Risk of Respiratory Readmission.
机构信息
From the Department of Pediatric Infectious Diseases.
Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
出版信息
Pediatr Infect Dis J. 2018 Dec;37(12):1217-1222. doi: 10.1097/INF.0000000000001998.
BACKGROUND
Respiratory viruses cause acute respiratory illness (ARI) in early childhood, but their effect on subsequent ARI admissions is not fully understood. This study aimed to determine the association between initial ARI admission because of viruses including human rhinovirus (HRV), respiratory syncytial virus (RSV), human adenovirus (HAdV) and human metapneumovirus (hMPV) and the risk of ARI readmission in children.
METHODS
Clinical information and nasopharyngeal swab samples were collected from children <2 years old at their initial ARI admission in Nha Trang, Vietnam, from January 2007 to April 2012. The incidence of ARI readmission during the follow-up period (initial admission to 5 years of age) was compared between children with and without 1 of 13 respiratory viruses (influenza virus A, influenza virus B, RSV, hMPV, parainfluenza virus-1, parainfluenza virus-2, parainfluenza virus-3 and parainfluenza virus-4, HRV, human coronavirus-229E, human coronavirus-OC43, HAdV and human bocavirus) at initial admission.
RESULTS
A total of 1941 children were enrolled in the study. Viruses were detected in 1254 (64.6%) children at enrollment; HRV, RSV, HAdV and hMPV were detected in 499 (25.7%), 439 (22.6%), 156 (8.0%) and 47 (2.4%) children, respectively. During the follow-up period (4572.7 person-years), 277 children were readmitted with ARI. Virus-related ARI initial admission was associated with an increased risk of ARI readmission for children who were initially admitted before 6 months of age (adjusted rate ratio, 1.6; 95% confidence interval: 1.1-2.5). HAdV (4.6; 1.8-11.9), hMPV (20.4; 6.2-66.9) and HRV (1.6; 1.0-2.4) were independently associated with the outcome. These associations were not observed for children whose initial admission occurred after 6 months of age.
CONCLUSIONS
HAdV-, hMPV- and HRV-related initial ARI admissions, when occurring during early infancy, increased the risk of subsequent ARI-related readmission.
背景
呼吸道病毒可导致婴幼儿急性呼吸道疾病（ARI），但其对随后的 ARI 再入院的影响尚不完全清楚。本研究旨在确定因病毒（包括人类鼻病毒（HRV）、呼吸道合胞病毒（RSV）、人腺病毒（HAdV）和人偏肺病毒（hMPV））导致的首次 ARI 入院与儿童 ARI 再入院风险之间的关系。
方法
2007 年 1 月至 2012 年 4 月，在越南芽庄，对<2 岁因 ARI 首次入院的儿童采集临床信息和鼻咽拭子样本。在随访期间（首次入院至 5 岁），比较了有和无 13 种呼吸道病毒（甲型流感病毒、乙型流感病毒、RSV、hMPV、副流感病毒-1、副流感病毒-2、副流感病毒-3、副流感病毒-4、HRV、人类冠状病毒-229E、人类冠状病毒-OC43、HAdV 和人类博卡病毒）之一的儿童的 ARI 再入院率。
结果
共纳入 1941 名儿童。在入组时，1254 名（64.6%）儿童检测到病毒；499 名（25.7%）、439 名（22.6%）、156 名（8.0%）和 47 名（2.4%）儿童分别检测到 HRV、RSV、HAdV 和 hMPV。在随访期间（4572.7 人年），277 名儿童因 ARI 再次入院。与病毒相关的 ARI 初次入院与<6 个月龄初次入院的儿童 ARI 再入院风险增加相关（校正发病率比，1.6；95%置信区间：1.1-2.5）。HAdV（4.6；1.8-11.9）、hMPV（20.4；6.2-66.9）和 HRV（1.6；1.0-2.4）与结局独立相关。对于>6 个月龄初次入院的儿童，未观察到这些关联。
结论
早发性婴儿期 HAdV、hMPV 和 HRV 相关的初次 ARI 入院会增加随后与 ARI 相关的再入院风险。
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