Strempas Petros, Weberruss Heidi, Bollinger Thomas, Rupprecht Thomas
Medizincampus Oberfranken (MCO), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Children's Hospital, Klinikum Bayreuth, 95445 Bayreuth, Germany.
Children (Basel). 2025 Mar 29;12(4):438. doi: 10.3390/children12040438.
Respiratory tract infections (RTIs) represent a frequent cause of inpatient admission in children's hospitals, especially in the fall and winter seasons, resulting in major healthcare problems due to a lack of beds. The age and seasonal distribution of each pathogen seem to be multifactorial features that influence the course of infection. Other severity predictors appear to be the length of hospital stay, the presence or absence of oxygen demand, and the value of inflammatory markers.
All inpatients from our children's hospital between 2021 and 2023 who had a nasopharyngeal swab and presented with RTI symptoms were recruited for this retrospective cohort study. The parameters of interest were age, swab result, month of detection, CRP values, duration of hospitalization, presence of oxygen demand, and comorbidities. The data were analyzed using chi-square tests, paired -tests and regression analysis to determine the associations of differences between the groups.
Detection of more than one respiratory pathogen in the same swab, apart from combinations with SARA-CoV-2, influenza, or RS-virus, was not associated with longer hospital stay, higher mean maximal CRP values, or oxygen demand compared to mono-infection with the same pathogens. In contrast, the detection of a pathogen versus no detection could be related to higher rates of oxygen demand and higher CRP values.
Since co-infection with more than one virus, excluding those with epidemic potential, was not associated with a more severe course of RTIs, strict patient isolation seems to be dispensable for several viruses, as well as isolation of infected or colonized patients.
呼吸道感染(RTIs)是儿童医院住院患儿的常见病因,尤其是在秋冬季节,由于床位短缺导致了重大的医疗问题。每种病原体的年龄和季节分布似乎是影响感染病程的多因素特征。其他严重程度预测指标似乎还有住院时间、是否需要吸氧以及炎症标志物的值。
本回顾性队列研究招募了2021年至2023年期间在我院儿科住院且进行了鼻咽拭子检查并出现RTIs症状的所有患儿。感兴趣的参数包括年龄、拭子结果、检测月份、CRP值、住院时间、是否需要吸氧以及合并症。使用卡方检验、配对检验和回归分析对数据进行分析,以确定各组之间差异的关联性。
与单一病原体感染相比,在同一拭子中检测到一种以上呼吸道病原体(除了与SARS-CoV-2、流感或呼吸道合胞病毒的组合),与更长的住院时间、更高的平均最大CRP值或吸氧需求无关。相比之下,检测到病原体与未检测到病原体可能与更高的吸氧率和更高的CRP值有关。
由于感染一种以上病毒(不包括具有流行潜力的病毒)与更严重的RTIs病程无关,对于几种病毒而言,严格的患者隔离似乎是不必要的,感染或定植患者的隔离也是如此。