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儿科重症监护中人类鼻病毒/肠道病毒感染临床病程的评估

Assessment of the Clinical Course of Human Rhinovirus/Enterovirus Infections in Pediatric Intensive Care.

作者信息

Kocoglu Barlas Ulkem, Akcay Nihal, Menentoglu Mehmet Emin, Sevketoglu Esra, Duyu Muhterem, Telhan Leyla, Kangin Murat, Tugrul Hazal Ceren, Erdogan Seher, Durak Cansu, Guney Sahin Ebru, Umur Ozge, Sik Sare Guntulu, Citak Agop, Yaman Ayhan

机构信息

From the Pediatric Intensive Care Unit, Department of Pediatrics, Istanbul Medeniyet University, Goztepe Prof Dr Süleyman Yalcin City Hospital, Istanbul, Turkey.

Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

出版信息

Pediatr Infect Dis J. 2023 Dec 1;42(12):e454-e460. doi: 10.1097/INF.0000000000004127. Epub 2023 Oct 9.

Abstract

BACKGROUND

This study aims to evaluate the clinical course of human rhinovirus/enterovirus (HRV/EV) infections in the pediatric intensive care unit.

METHODS

The study was conducted as a multicenter, prospective observational study from September 2022 to December 2022. Cases with positive polymerase chain reaction testing for HRV/EV of nasopharyngeal swab samples within the first 24 hours of pediatric intensive care unit admission were recorded. There were 2 groups: 1-24 months and >24 months.

RESULTS

A total of 75 cases (39 male) were included in the study. The median age for all cases was 21 months. The highest polymerase chain reaction positivity rates were observed in October (37.33%). Among the cases, 32 (42.67%) presented with bronchopneumonia/pneumonia, 24 (32%) presented with acute bronchiolitis/bronchitis and 7 (9.33%) presented with sepsis/septic shock. The frequency of pediatric acute respiratory distress syndrome was found to be 6.67%. In the age group of 1-24 months, mean lymphocyte and liver enzyme levels were higher, while in the age group of >24 months, mean hemoglobin and mean kidney function test levels were higher ( P ≤ 0.05). Continuous oxygen therapy was provided to 65.3% of the cases, noninvasive ventilation to 33.3%, high-flow nasal cannula-oxygen therapy to 32% and invasive mechanical ventilation to 16%.

CONCLUSIONS

HRV/EV infections primarily affect the respiratory system and generally exhibit a clinical course with low mortality rates (1, 1.3%). In cases with underlying chronic diseases, more severe clinical conditions such as pediatric acute respiratory distress syndrome and septic shock may occur.

摘要

背景

本研究旨在评估儿科重症监护病房中人鼻病毒/肠道病毒(HRV/EV)感染的临床病程。

方法

本研究为2022年9月至2022年12月进行的多中心前瞻性观察性研究。记录儿科重症监护病房入院后24小时内鼻咽拭子样本HRV/EV聚合酶链反应检测呈阳性的病例。分为两组:1 - 24个月组和>24个月组。

结果

本研究共纳入75例病例(39例男性)。所有病例的中位年龄为21个月。10月份观察到最高的聚合酶链反应阳性率(37.33%)。其中,32例(42.67%)表现为支气管肺炎/肺炎,24例(32%)表现为急性细支气管炎/支气管炎,7例(9.33%)表现为脓毒症/感染性休克。发现小儿急性呼吸窘迫综合征的发生率为6.67%。在1 - 24个月年龄组中,平均淋巴细胞和肝酶水平较高,而在>24个月年龄组中,平均血红蛋白和平均肾功能测试水平较高(P≤0.05)。65.3%的病例接受持续氧疗,33.3%接受无创通气,32%接受高流量鼻导管给氧治疗,16%接受有创机械通气。

结论

HRV/EV感染主要影响呼吸系统,通常临床病程死亡率较低(1%,1.3%)。在患有基础慢性疾病的病例中,可能会出现更严重的临床状况,如小儿急性呼吸窘迫综合征和感染性休克。

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