Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.
Leibniz-Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, Jena, Germany.
Transpl Infect Dis. 2020 Dec;22(6):e13415. doi: 10.1111/tid.13415. Epub 2020 Jul 23.
Community-acquired respiratory viruses (CARV) cause upper and lower respiratory tract infections (URTI/LRTI) and may be life-threatening for recipients of an allogeneic stem cell transplantation (allo-SCT).
In a prospective study encompassing 4 winter-seasons, we collected throat gargles (TG) at random time points from allo-SCT recipients (patients) and controls and followed them up for at least 3 weeks including repetitive sampling and documentation of symptoms. A Multiplex-PCR system to identify 20 CARV and Mycoplasma pneumoniae was used to detect CARV.
One hundred ninety-four patients with 426 TG and 273 controls with 549 TG were included. There were more patients with a positive test result (25% vs 11% in the controls), and the patients had a higher number of positive TG (70 = 16%) compared to controls (32 = 6%) (P < .001). Altogether, 115 viruses were detected. Multiple viruses in one TG (11/48, 34%) and prolonged shedding were only observed in patients (13/48, 27%). Patients had more RSV (18/83, 26%) and adenovirus (15/83, 21%) than controls (both viruses 2/32, 6%). Independent risk factors for the detection of CARV included age >40 years (OR 3.38, 95% CI 1.8-6.4, P < .001) and presence of URTI-symptoms (OR 3.22, 95% CI 1.9-5.5, P < .001). No controls developed a LRTI or died whereas 4/48 (8%) patients developed a LRTI (coronavirus in 2, RSV in 1 and influenza A H1N1 in 1 patient). One patient died of CARV (influenza A H1N1).
Allo-SCT-recipients have more CARV-infections, exhibit a different epidemiology, have more cases of co-infection or prolonged shedding and have a higher rate of LRTI and mortality.
社区获得性呼吸道病毒（CARV）可引起上呼吸道和下呼吸道感染（URTI/LRTI），并且可能对异基因干细胞移植（allo-SCT）受者造成生命威胁。
在一项包含 4 个冬季的前瞻性研究中，我们从 allo-SCT 受者（患者）和对照者随机时间点采集咽拭子（TG），并对其进行至少 3 周的随访，包括重复采样和症状记录。使用 20 种 CARV 和肺炎支原体的多重 PCR 系统来鉴定 CARV。
共纳入 194 例患者（426 份 TG）和 273 例对照者（549 份 TG）。患者中阳性检测结果的比例更高（25% vs. 对照者的 11%），并且患者的阳性 TG 数量更多（70%[16%] vs. 对照者的 32%[6%]）（P<.001）。总共检测到 115 种病毒。在一个 TG 中同时检测到多种病毒（11/48，34%）和持续排出仅在患者中观察到（13/48，27%）。患者中检测到更多的 RSV（18/83，26%）和腺病毒（15/83，21%），而对照者中只有 2/32（6%）检测到这两种病毒。CARV 检测的独立危险因素包括年龄>40 岁（OR 3.38，95%CI 1.8-6.4，P<.001）和 URTI 症状（OR 3.22，95%CI 1.9-5.5，P<.001）。无对照者发生 LRTI 或死亡，而 4/48（8%）的患者发生 LRTI（2 例为冠状病毒，1 例为 RSV，1 例为甲型流感 H1N1）。1 例患者死于 CARV（甲型流感 H1N1）。
allo-SCT 受者有更多的 CARV 感染，表现出不同的流行病学特征，有更多的合并感染或持续排出，并且 LRTI 和死亡率更高。
