From the Department of Pediatrics, Graduate School of Biomedical Sciences, Nagasaki University.
Department of Pediatrics, Nagasaki Harbor Medical Center.
Pediatr Infect Dis J. 2020 Aug;39(8):687-693. doi: 10.1097/INF.0000000000002668.
Acute lower respiratory tract infections (ALRIs) are the most common disease for hospitalized children in Japan. The aim of this study was to identify viruses in children hospitalized for ALRIs and to demonstrate epidemiologic and clinical characteristics in Japan.
During a 2-year period from February 2013 to January 2015, we collected nasopharyngeal swab specimens from almost all hospitalized children with ALRIs in Nagasaki, a regional city of Japan, and its environs. Viruses were detected by multiplex polymerase chain reaction from these samples.
We detected one or more viruses from 259 (69%) of 374 patients, 227 of whom were infected with a single virus, 30 with 2, and 2 with 3 viruses. Detected viruses in this study were rhinovirus (46.4%), respiratory syncytial virus (29.7%), human metapneumovirus (6.8%), parainfluenza virus (5.5%), enterovirus D68 (3.4%), influenza virus (2.7%), adenovirus (2.4%), bocavirus (2.0%) and Coxsackie virus (1.0%). We detected a seasonal shift in respiratory syncytial virus outbreaks from the 2013-2014 to the 2014-2015 seasons. There was no significant difference in clinical course and severity among those viruses. Patients with a history of asthma or underlying diseases were older and more frequently required oxygen therapy than previously healthy patients.
Viral etiology in hospitalized children with ALRIs in Nagasaki, Japan, was similar to that in many other countries. Enterovirus D68, which was recently recognized as a causative agent of severe ALRIs, was also identified in this study area. Severity of ALRIs may depend on underlying disease rather than type of etiologic virus.
急性下呼吸道感染（ALRIs）是日本住院儿童最常见的疾病。本研究旨在确定因 ALRIs 住院的儿童中的病毒，并展示日本的流行病学和临床特征。
在 2013 年 2 月至 2015 年 1 月的 2 年期间，我们从日本长崎及其周边地区几乎所有因 ALRIs 住院的儿童中收集了鼻咽拭子样本。通过多重聚合酶链反应从这些样本中检测病毒。
我们从 374 名患者中的 259 名（69%）检测到一种或多种病毒，其中 227 名患者感染了单一病毒，30 名患者感染了 2 种病毒，2 名患者感染了 3 种病毒。本研究中检测到的病毒包括鼻病毒（46.4%）、呼吸道合胞病毒（29.7%）、人偏肺病毒（6.8%）、副流感病毒（5.5%）、肠道病毒 D68（3.4%）、流感病毒（2.7%）、腺病毒（2.4%）、博卡病毒（2.0%）和柯萨奇病毒（1.0%）。我们发现呼吸道合胞病毒爆发从 2013-2014 年到 2014-2015 年有季节性变化。这些病毒之间的临床过程和严重程度没有显著差异。有哮喘或基础疾病病史的患者比以前健康的患者年龄更大，更频繁地需要吸氧治疗。
日本长崎住院儿童 ALRIs 的病毒病因与许多其他国家相似。本研究区域也发现了肠道病毒 D68，它最近被认为是严重 ALRIs 的病原体。ALRIs 的严重程度可能取决于基础疾病而不是病因病毒的类型。
