Department of Pediatrics, Children's Hospital, Cairo University, Egypt.
Department of Clinical and Chemical Pathology Cairo University, Egypt.
Turk J Pediatr. 2022;64(3):549-557. doi: 10.24953/turkjped.2020.1926.
Cystic fibrosis (CF) is a degenerative disease distinguished by progressive epithelial secretory gland dysfunction associated with recurrent respiratory tract infections. Despite that bacteria have previously been studied as the main cause of CF airway damage, a strong effect of respiratory viral infections is also now recognized. We aimed to detect the relationship between viral infection and exacerbation in children with cystic fibrosis.
This is a cross sectional observational study recruiting 60 patients diagnosed as CF following in Cystic Fibrosis Clinic, Children`s Hospital, Cairo University, throughout a period of 7 months. Their age ranged from 6 months to 13 years. Patients had nasal swabs and sputum samples obtained when they developed respiratory exacerbations. Multiplex PCR (polymerase chain reaction) technique was used to detect respiratory viruses from nasal swabs.
We detected viruses in 48 patients during exacerbation (80%), the most common virus was rhinovirus in 43.4% of patients, followed by bocavirus in 20%, adenovirus in 13.3%, enterovirus in 10% and human metapneumovirus in 6.7%. Co-infection with double viruses was detected in 10 patients. Bacterial infection was present in 56.7% of patients; the most common organism was Pseudomonas in 20% of patients, followed by Staphylococcus aureus, methicillin resistant Staphylococcus aureus, Klebsiella and Haemophilus influenzae. CRP was positive in 53.3% of patients. There was a significant relationship between sputum positive bacterial culture and each of influenza A virus, enterovirus and human metapneumovirus.
This study demonstrated that exacerbation in cystic fibrosis may be exaggerated by viral infections such as influenza A and enterovirus necessitating hospitalization which shows the important protective role of vaccination. Also, a strong relationship was detected between some viruses such as enterovirus, human metapneumovirus and influenza and between bacterial infection.
囊性纤维化（CF）是一种进行性上皮分泌腺功能障碍的退行性疾病，与复发性呼吸道感染有关。尽管细菌以前被研究为 CF 气道损伤的主要原因，但现在也认识到呼吸道病毒感染的强烈影响。我们旨在检测病毒感染与囊性纤维化儿童恶化之间的关系。
这是一项横断面观察性研究，在开罗大学儿童医院囊性纤维化诊所招募了 60 名被诊断为 CF 的患者，研究时间为 7 个月。他们的年龄在 6 个月至 13 岁之间。当患者出现呼吸恶化时，从他们的鼻腔拭子和痰样本中获得。使用多重 PCR（聚合酶链反应）技术从鼻腔拭子中检测呼吸道病毒。
我们在恶化期间检测到 48 名患者（80%）中的病毒，最常见的病毒是鼻病毒，占 43.4%，其次是博卡病毒占 20%，腺病毒占 13.3%，肠道病毒占 10%，人类偏肺病毒占 6.7%。10 名患者检测到双重病毒感染。56.7%的患者存在细菌感染；最常见的病原体是假单胞菌，占 20%，其次是金黄色葡萄球菌、耐甲氧西林金黄色葡萄球菌、肺炎克雷伯菌和流感嗜血杆菌。53.3%的患者 CRP 阳性。痰培养阳性的细菌与甲型流感病毒、肠道病毒和人类偏肺病毒之间存在显著关系。
本研究表明，流感 A 病毒和肠道病毒等病毒感染可能使囊性纤维化恶化，需要住院治疗，这表明疫苗接种具有重要的保护作用。此外，还检测到某些病毒（如肠道病毒、人类偏肺病毒和流感病毒）与细菌感染之间存在很强的关系。
