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越南国家儿童医院治疗的下呼吸道感染的临床和病原学特征

Clinical and Pathogenic Characteristics of Lower Respiratory Tract Infection Treated at the Vietnam National Children's Hospital.

作者信息

Pham Hien T, Nguyen Phuc T T, Tran Sinh T, Phung Thuy T B

机构信息

International Outpatient Department of Vietnam National Children's Hospital (VNCH), Hanoi 100000, Vietnam.

Research Biomolecular for Infectious Disease Department of Vietnam National Children's Hospital (VNCH), Hanoi 100000, Vietnam.

出版信息

Can J Infect Dis Med Microbiol. 2020 Mar 11;2020:7931950. doi: 10.1155/2020/7931950. eCollection 2020.

Abstract

Lower respiratory tract infections are commonly caused by viruses and cause significant morbidity and mortality among children. Early identification of the pathological agent causing these infections is essential to avoid unnecessary antibiotic use and improve patient management. Multiplex PCR techniques were recently developed to detect multiple viral pathogens using a single PCR reaction. In this study, we identify viral pathogens in children with respiratory infections. We collected 194 nasopharyngeal aspirates from infants (2-24 months old) with lower respiratory tract infections treated at the Vietnam National Children's Hospital between November 2014 and June 2015 and assessed the presence of 16 virus types and subtypes by multiplex PCR using the xTAG Respiratory Viral Panel (RVP) assay. Overall, 73.7% of the samples were positive for at least one virus, and 24.2% corresponded to infections with multiple viruses. The most common viruses were respiratory syncytial virus and enterovirus/rhinovirus. These viruses were more frequent among younger patients (2-5 months old) and caused symptoms similar to those of bronchiolitis and pneumonia. The most common clinical manifestation caused by respiratory tract infection was bronchiolitis. Elevated neutrophils levels were associated with adenovirus infection. Our results showed that the xTAG Respiratory Viral Panel (RVP) can effectively detect multiple viruses causing respiratory infections in children and that the nasopharyngeal aspirates are a good sample choice to detect respiratory viruses in children. Applying this approach in the clinical setting would improve patient management and allow early diagnosis, thus avoiding the unnecessary use of antibiotics.

摘要

下呼吸道感染通常由病毒引起,在儿童中导致显著的发病率和死亡率。尽早识别引起这些感染的病原体对于避免不必要的抗生素使用和改善患者管理至关重要。多重PCR技术是最近开发的,用于通过单次PCR反应检测多种病毒病原体。在本研究中,我们识别了呼吸道感染儿童中的病毒病原体。我们收集了2014年11月至2015年6月期间在越南国家儿童医院接受治疗的194例患有下呼吸道感染的婴儿(2至24个月大)的鼻咽抽吸物,并使用xTAG呼吸道病毒检测板(RVP)检测法通过多重PCR评估了16种病毒类型和亚型的存在情况。总体而言,73.7%的样本至少对一种病毒呈阳性,24.2%对应于多种病毒感染。最常见的病毒是呼吸道合胞病毒和肠道病毒/鼻病毒。这些病毒在较年轻的患者(2至5个月大)中更为常见,并引起与细支气管炎和肺炎相似的症状。呼吸道感染最常见的临床表现是细支气管炎。中性粒细胞水平升高与腺病毒感染有关。我们的结果表明,xTAG呼吸道病毒检测板(RVP)可以有效检测引起儿童呼吸道感染的多种病毒,并且鼻咽抽吸物是检测儿童呼吸道病毒的良好样本选择。在临床环境中应用这种方法将改善患者管理并实现早期诊断,从而避免不必要的抗生素使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42a4/7086417/03576cc4794c/CJIDMM2020-7931950.001.jpg

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