Bulata-Pop Irina, Simionescu Bianca, Bulata Bogdan, Junie Lia Monica
Microbiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, ROU.
Pediatrics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, ROU.
Cureus. 2024 Sep 4;16(9):e68652. doi: 10.7759/cureus.68652. eCollection 2024 Sep.
Lower respiratory tract infections (LRTIs) are the most common cause for going to the doctor's at pediatric age. Respiratory infections are still of interest because they are widespread, significantly impact public health by potentially leading to pandemics, drive antimicrobial resistance through antibiotic misuse, more often spread globally due to traveling, and benefit from ongoing advancements in diagnostics and research for better management. This paper's main aim was to offer a systematic review of the literature published over the last 10 years on the etiology of LRTIs. The search strategy was based on reviewing original articles, systematic reviews, position papers, and guidelines published in MEDLINE, EMBASE, Cochrane Library, and PubMed. The review was previously registered with PROSPERO. The final review included 27 articles that met the eligibility criteria (studies identifying the etiology of inferior respiratory infections in children, according to the WHO definition, published in the last 10 years). Statistical analysis was performed using Microsoft Excel Version 2406 (Microsoft Corporation, Redmond, Washington, USA) and SPSS Statistics V.23 (IBM Corp., Armonk, New York, USA). The total number of patients was 2,193,978. Eight articles focused on children younger than five years, and two included children under the age of two. The results revealed that and respiratory syncytial virus (RSV) are significant respiratory pathogens with seasonal peaks and age-specific prevalence and that nasopharyngeal aspirates (NPAs) are more reliable than throat swabs for confirming infections due to their higher positive predictive value (PPV). The impact of COVID-19 interventions led to reduced infections from RSV, adenovirus, and influenza viruses, but an increase in rhinovirus post-reopening, with high co-infection rates. Co-infections are common, particularly with pathogens like human bocavirus (HBoV) and RSV, underscoring the need for comprehensive diagnostic approaches. The impact of non-pharmaceutical interventions during the COVID-19 pandemic significantly reduced the prevalence of many respiratory pathogens, except for rhinovirus, which increased post-reopening. Understanding these dynamics is crucial for managing respiratory infections, especially in pediatric populations.
下呼吸道感染（LRTIs）是儿童就医最常见的原因。呼吸道感染仍然备受关注，因为它们广泛传播，有可能引发大流行，从而对公共卫生产生重大影响；因抗生素滥用导致抗菌药物耐药性问题；由于旅行，它们更常传播到全球各地；并且受益于诊断和研究方面的不断进步，以便更好地进行管理。本文的主要目的是对过去10年发表的关于下呼吸道感染病因的文献进行系统综述。检索策略基于查阅发表在MEDLINE、EMBASE、Cochrane图书馆和PubMed上的原创文章、系统综述、立场文件和指南。该综述先前已在PROSPERO注册。最终综述纳入了27篇符合纳入标准的文章（根据世界卫生组织的定义，这些研究确定了过去10年发表的儿童下呼吸道感染的病因）。使用Microsoft Excel 2406版本（美国华盛顿州雷德蒙德市微软公司）和SPSS Statistics V.23（美国纽约州阿蒙克市IBM公司）进行统计分析。患者总数为2,193,978人。八篇文章关注五岁以下儿童，两篇纳入了两岁以下儿童。结果显示，[此处原文缺失部分内容]和呼吸道合胞病毒（RSV）是重要的呼吸道病原体，具有季节性高峰和特定年龄的患病率，并且鼻咽抽吸物（NPAs）由于其较高的阳性预测值（PPV），在确认感染方面比咽拭子更可靠。COVID-19干预措施的影响导致RSV、腺病毒和流感病毒感染减少，但重新开放后鼻病毒感染增加，且合并感染率较高。合并感染很常见，特别是与人博卡病毒（HBoV）和RSV等病原体合并感染，这凸显了采用综合诊断方法的必要性。COVID-疫情期间非药物干预措施的影响显著降低了许多呼吸道病原体的患病率，但鼻病毒除外，重新开放后鼻病毒患病率有所增加。了解这些动态对于管理呼吸道感染至关重要，尤其是在儿科人群中。
