Li Liangyu, Zhang Haiyue, Xiong Pei, Liu Chan, Wan Lu, Liu Mengling, Mao Jieyu, Li Ruiyun, Shang Min, Liu Hailing, Luo Yuchuan, Yin Jing, Wu Xiaojun, Chen Jianjun
Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.
Virol Sin. 2025 Apr;40(2):166-175. doi: 10.1016/j.virs.2025.03.005. Epub 2025 Mar 20.
Identifying the cause of respiratory tract infections is important for reducing the burden of diagnosis and treatment. To assess viral etiologies of hospitalized patients with pulmonary infection, bronchoalveolar lavage fluid (BALF) specimens were collected from non-COVID-19 adult patients (n = 333, including patients with lower respiratory tract infection, tuberculosis, lung cancer, and pulmonary nodules) between November 2020 and November 2021. Multiple common respiratory pathogens were detected using multiplex reverse-transcription polymerase chain reaction. The result showed that at least one virus was identified in 35.44% (118/333) of the cases. Among these, influenza virus was the most commonly identified, followed by the parainfluenza virus, coronavirus, human rhinoviruses, and human respiratory syncytial viruses. The tuberculosis group demonstrated the highest viral detection rate, yet paradoxically exhibited the lowest co-infection rate. In contrast, the highest co-infection frequency was observed in the pulmonary nodules group. Patients with viral infections exhibited more severe clinical symptoms compared to those without detected viral infections. However, this observation was only noted in the lower respiratory tract infection group among the different disease groups. Notably, among patients infected with a specific virus, there were no significant differences in viral load between single and co-infections. Our study identified the major causative agents in hospitalized adult patients with pulmonary infection, offering insights for precise disease diagnosis and the prevention of unnecessary use of antimicrobial drugs.
确定呼吸道感染的病因对于减轻诊断和治疗负担至关重要。为了评估住院肺部感染患者的病毒病因,于2020年11月至2021年11月期间,从非新型冠状病毒肺炎成年患者(n = 333,包括下呼吸道感染、肺结核、肺癌和肺结节患者)中收集支气管肺泡灌洗液(BALF)标本。使用多重逆转录聚合酶链反应检测多种常见呼吸道病原体。结果显示,35.44%(118/333)的病例中至少鉴定出一种病毒。其中,流感病毒是最常鉴定出的病毒,其次是副流感病毒、冠状病毒、人鼻病毒和人呼吸道合胞病毒。肺结核组的病毒检测率最高,但矛盾的是其合并感染率最低。相比之下,肺结节组的合并感染频率最高。与未检测到病毒感染的患者相比,病毒感染患者表现出更严重的临床症状。然而,这一观察结果仅在不同疾病组中的下呼吸道感染组中出现。值得注意的是,在感染特定病毒的患者中,单一感染和合并感染的病毒载量没有显著差异。我们的研究确定了住院成年肺部感染患者的主要病原体,为精确的疾病诊断和预防不必要的抗菌药物使用提供了见解。