Meena Jagdish Prasad, Brijwal Megha, Seth Rachna, Gupta Aditya Kumar, Jethani Jyoti, Kapil Arti, Jat Kana Ram, Choudhary Aashish, Kabra S K, Dwivedi S N, Dar Lalit
Department of Pediatrics, All India Institute of Medical Sciences , New Delhi , India.
Department of Microbiology, All India Institute of Medical Sciences , New Delhi , India.
Pediatr Hematol Oncol. 2019 Sep;36(6):330-343. doi: 10.1080/08880018.2019.1631920. Epub 2019 Sep 12.
: The role of respiratory viruses (RV) in children with cancer having febrile neutropenic episodes has not been well studied. The objectives of our study were to investigate the prevalence and clinical outcomes of Respiratory viral infection (RVI). Children with cancer and febrile neutropenia (FN) having acute respiratory infections (ARI) were considered as cases and febrile neutropenic cancer patients without ARI were considered as controls. A throat swab sample was obtained for the detection of 21-respiratory pathogens. A total of 81 episodes of FN in cases and 37 episodes of FN in controls were included. Prevalence of RVI (at least 1 RV) was seen in 76.5% of cases and 48.6% of controls ( = 0.005). The mixed-respiratory viruses (co-infections of ≥2 viruses) were seen only in cases (26%) ( = 0.00). Rhinovirus (36.8%) and respiratory syncytial virus (13.6%) were the most frequently detected viruses. Median duration of fever before presentation was more in cases with RVI compared to without RVI [2 (1-5) days vs 1 (1-5) day ( = 0.012)]. The median total duration of febrile period was 4 (IQR, 3-6) days in cases with RVI and 3 (IQR, 1-4) days in cases without RVI ( = 0.005). The median duration of antibiotic days were longer in cases with RVI as compared to patients without RVI [9 (IQR, 7-17) days vs 7 (IQR, 6-10) days ( = 0.046)] respectively. : There was high prevalence of RVI in children with cancer and FN; more in association with ARI. The RVI were associated with prolonged febrile period and days of antibiotics therapy.
呼吸道病毒(RV)在患有发热性中性粒细胞减少症的癌症患儿中的作用尚未得到充分研究。我们研究的目的是调查呼吸道病毒感染(RVI)的患病率和临床结局。患有癌症且发热性中性粒细胞减少症(FN)并伴有急性呼吸道感染(ARI)的儿童被视为病例组,而患有发热性中性粒细胞减少症且无ARI的癌症患儿被视为对照组。采集咽拭子样本以检测21种呼吸道病原体。病例组共纳入81例FN发作,对照组纳入37例FN发作。病例组中RVI(至少感染1种RV)的患病率为76.5%,对照组为48.6%(P = 0.005)。混合呼吸道病毒(≥2种病毒合并感染)仅在病例组中出现(26%)(P = 0.00)。鼻病毒(36.8%)和呼吸道合胞病毒(13.6%)是最常检测到的病毒。与无RVI的病例相比,出现发热前的中位持续时间在有RVI的病例中更长[2(1 - 5)天 vs 1(1 - 5)天(P = 0.012)]。有RVI的病例发热期的中位总持续时间为4(四分位间距,3 - 6)天,无RVI的病例为3(四分位间距,1 - 4)天(P = 0.005)。与无RVI的患者相比,有RVI的病例使用抗生素的中位天数更长[9(四分位间距,7 - 17)天 vs 7(四分位间距,6 - 10)天(P = 0.046)]。癌症合并FN的儿童中RVI患病率很高;与ARI相关的更多。RVI与发热期延长和抗生素治疗天数相关。