Microbiology Laboratory, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Infez Med. 2021 Mar 1;29(1):94-101.
Viruses are frequent causal agents of acute respiratory infections and the most common are influenza virus, respiratory syncytial virus (RSV), human parainfluenza virus (HPIV), human metapneumovirus (HMPV), rhinovirus (RV), adenovirus (AdV) and the four endemic human coronaviruses (HCoV) -229E, -NL63, -OC43, -HKU1. Multiplex real-time PCR platforms are becoming increasingly common in laboratories mostly in relation to the increased diagnostic sensitivity and reduced turnaround time. The aim of our study was to determine the prevalence of respiratory viruses in a population of patients within the S.S. Antonio e Biagio e Cesare Arrigo General Hospital catchment area of Alessandria, Italy, from January 2016 to June 2020. Therefore, we retrospectively analyzed the results of multiplex real-time PCR performed on nasopharyngeal swabs collected from consecutive patients with symptoms of respiratory infection. A total of 572 patients were included in the study subdivided as follows: pediatric 197/572 (34.4%), adults 200/572 (35%) and elderly 175/572 (30.6%). Among all samples, 235/572 (41.1%) were positive for a respiratory virus, of whom 189/235 (80.4%) were monomicrobial. The prevalence was: 15.5% (89/572) of rhinovirus/enterovirus (RV/EV); 9.4% (54/572) of RSV; 8.9% (51/572) of influenza virus; 5.4% (31/572) of AdV; 3.1% (18/572) of HCoV; 2.8% (16/572) of HPIV; and 2.3% (13/572) of HMPV. RV/EV were the pathogens most frequently involved in coinfections (34.7%, 16/46), followed by AdV (19.6%, 9/46) and influenza virus (19.6%, 9/46). Samples collected from the pediatric group were more frequently positive. The prevalence of positive pediatric samples compared to adults and elderly, respectively was: 28.4% (56/197) for RV/EV vs 10.5% (21/200) vs 6.9% (12/175), p<0.0001; 18.8% (37/197) for RSV vs 2% (4/200) vs 7.4% (13/175), p<0.0001; 13.7% (27/197) for AdV vs 1% (2/200) vs 1.1% (2/175), p<0.0001; and 6.6% (13/197) for HPIV vs 0.5% (1/200) vs 1.1% (2/175), (p<0.0001). With regard to seasonality, a significantly higher prevalence of influenza virus (p<0.0001) and RSV (p=0.029) was found during winter, with peaks in January-February. AdV peaked during winter 2018-2019 (p=0.004), while HCoV were detected with a significantly higher prevalence during winter 2019-2020 (p=0.037). With regard to HPIV, a significant peak from summer to fall 2018 was observed (p=0.016). Most viral respiratory infections have seasonal patterns and the prevalence of respiratory viruses varies according to the method, geographic area and population considered. Knowledge of local epidemiology is therefore crucial for implementation of prevention and treatment strategies.
病毒是急性呼吸道感染的常见病原体，最常见的有流感病毒、呼吸道合胞病毒（RSV）、人类副流感病毒（HPIV）、人类偏肺病毒（HMPV）、鼻病毒（RV）、腺病毒（AdV）和四种地方性人类冠状病毒（HCoV）-229E、-NL63、-OC43、-HKU1。多重实时 PCR 平台在实验室中越来越常见，主要是因为其具有更高的诊断灵敏度和更短的周转时间。我们的研究目的是确定意大利亚历山德里亚 S.S. Antonio e Biagio e Cesare Arrigo 综合医院的患者人群中呼吸道病毒的流行情况，时间范围是从 2016 年 1 月到 2020 年 6 月。因此，我们回顾性分析了对连续出现呼吸道感染症状的患者进行的鼻咽拭子进行的多重实时 PCR 检测结果。共有 572 例患者纳入研究，分为以下几类：儿科 197/572（34.4%）、成人 200/572（35%）和老年 175/572（30.6%）。所有样本中，235/572（41.1%）为呼吸道病毒阳性，其中 189/235（80.4%）为单一微生物感染。其流行情况为：鼻病毒/肠道病毒（RV/EV）15.5%（89/572）；RSV 9.4%（54/572）；流感病毒 8.9%（51/572）；AdV 5.4%（31/572）；HCoV 3.1%（18/572）；HPIV 2.8%（16/572）；HMPV 2.3%（13/572）。RV/EV 是最常涉及混合感染的病原体（34.7%，16/46），其次是 AdV（19.6%，9/46）和流感病毒（19.6%，9/46）。儿科组采集的样本阳性率更高。与成人和老年患者相比，儿科阳性样本的流行率分别为：RV/EV 28.4%（56/197）比 10.5%（21/200）比 6.9%（12/175），p<0.0001；RSV 18.8%（37/197）比 2%（4/200）比 7.4%（13/175），p<0.0001；AdV 13.7%（27/197）比 1%（2/200）比 1.1%（2/175），p<0.0001；HPIV 6.6%（13/197）比 0.5%（1/200）比 1.1%（2/175），p<0.0001。就季节性而言，流感病毒（p<0.0001）和 RSV（p=0.029）在冬季的流行率显著更高，在 1 月至 2 月达到高峰。AdV 在 2018-2019 年冬季达到高峰（p=0.004），而 HCoV 在 2019-2020 年冬季的检测阳性率显著更高（p=0.037）。关于 HPIV，在 2018 年夏季到秋季观察到了一个显著的高峰（p=0.016）。大多数病毒性呼吸道感染具有季节性模式，呼吸道病毒的流行率根据所使用的方法、地理位置和人群而有所不同。因此，了解当地的流行病学情况对于实施预防和治疗策略至关重要。
