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越南胡志明市儿童 1 号医院 2 至 24 个月儿童因呼吸道合胞病毒和腺病毒引起的严重肺炎。

Severe Pneumonia Caused by Respiratory Syncytial Virus and Adenovirus in Children from 2 to 24 Months at Children's Hospital 1 in Ho Chi Minh City, Vietnam.

机构信息

School of Medicine, Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 710000, Vietnam.

Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City 700000, Vietnam.

出版信息

Viruses. 2024 Mar 7;16(3):410. doi: 10.3390/v16030410.

Abstract

In Vietnam, due to the lack of facilities to detect respiratory viruses from patients' specimens, there are only a few studies on the detection of viral pathogens causing pneumonia in children, especially respiratory syncytial virus (RSV) and adenovirus (Adv). Here, we performed a cross-sectional descriptive prospective study on 138 children patients from 2 to 24 months old diagnosed with severe pneumonia hospitalized at the Respiratory Department of Children's Hospital 1 from November 2021 to August 2022. The number of patients selected in this study was based on the formula n = ([Z(1 - α/2)]2 × P [1 - P])/d2, with α = 0.05, = 0.5, and d = 9%, and the sampling technique was convenient sampling until the sample size was met. A rapid test was used to detect RSV and Adv from the nasopharyngeal swabs and was conducted immediately after the patient's hospitalization. Laboratory tests were performed, medical history interviews were conducted, and nasotracheal aspirates were collected for multiplex real-time PCR (MPL-rPCR) to detect viral and bacterial pathogens. The results of the rapid test and the MPL-rPCR in the detection of both pathogens were the same at 31.9% (44/138) for RSV and 8.7% (7/138) for Adv, respectively. Using MPL-rPCR, the detection rate was 21% (29/138) for bacterial pathogens, 68.8% (95/138) for bacterial-viral co-infections, and 6.5% (9/138) for viral pathogens. The results showed few distinctive traits between RSV-associated and Adv-associated groups, and the Adv group children were more prone to bacterial infection than those in the RSV group. In addition, the Adv group experienced a longer duration of treatment and a higher frequency of re-hospitalizations compared to the RSV group. A total of 100% of Adv infections were co-infected with bacteria, while 81.82% of RSV co-infected with bacterial pathogens ( = 0.000009). This study might be one of the few conducted in Vietnam aimed at identifying viral pathogens causing severe pneumonia in children.

摘要

在越南,由于缺乏从患者标本中检测呼吸道病毒的设施,因此仅有少数研究检测导致儿童肺炎的病毒病原体,尤其是呼吸道合胞病毒(RSV)和腺病毒(Adv)。在这里,我们对 2021 年 11 月至 2022 年 8 月期间在儿童医院 1 号呼吸科住院的 138 名 2 至 24 个月大的重症肺炎患儿进行了一项横断面描述性前瞻性研究。本研究中选择的患者数量基于公式 n = ([Z(1 - α/2)]2 × P [1 - P])/d2,其中 α = 0.05, = 0.5,d = 9%,采样技术为方便采样,直到达到样本量。使用鼻咽拭子快速检测 RSV 和 Adv,并在患者住院后立即进行。进行实验室检查、病史访谈,并采集鼻气管抽吸物进行多重实时 PCR(MPL-rPCR)以检测病毒和细菌病原体。快速检测和 MPL-rPCR 在检测两种病原体方面的结果相同,RSV 为 31.9%(44/138),Adv 为 8.7%(7/138)。使用 MPL-rPCR,细菌病原体的检出率为 21%(29/138),细菌-病毒混合感染率为 68.8%(95/138),病毒病原体的检出率为 6.5%(9/138)。结果表明,RSV 相关组和 Adv 相关组之间没有明显的特征差异,Adv 组患儿比 RSV 组更容易发生细菌感染。此外,Adv 组的治疗时间和再住院频率均高于 RSV 组。Adv 组的所有感染均与细菌合并感染,而 RSV 组仅 81.82%与细菌合并感染( = 0.000009)。本研究可能是越南为数不多的旨在鉴定导致儿童重症肺炎的病毒病原体的研究之一。

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