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在初级保健中对急性呼吸道感染进行特征描述以更好地管理病毒感染。

Characterizing acute respiratory infections in primary care for better management of viral infections.

作者信息

Petat Hortense, Schuers Matthieu, Le Bas François, Humbert Xavier, Rabiaza Andry, Corbet Sandrine, Vabret Astrid, Gouilh Meriadeg Ar, Marguet Christophe

机构信息

Univ Rouen Normandie, Dynamicure INSERM UMR 1311, CHU Rouen, Department of paediatrics and adolescent medicine, F-76000, Rouen, France.

UFR Santé Rouen, Department of general practice, 76000, Rouen, France.

出版信息

NPJ Prim Care Respir Med. 2025 Jun 5;35(1):28. doi: 10.1038/s41533-025-00434-w.

Abstract

Acute respiratory infections (ARI) are the most common infections in the general population and represent an important socio-economic burden. Characterizing ARIs in primary care in patients of all ages in terms of clinical presentation, and virological results. We conducted a prospective multicenter study in primary care: 36 French general practitioners (GPs) included patients from all ages presenting with symptoms of ARI, and performed a nasopharyngeal swab, which was analyzed by Multiplex RT-PCR. 685 patients of all ages were included in the cohort. We found associations between clinical diagnosis and respiratory viruses: influenza was associated with the diagnosis of flu-like syndrome (p < 0.001), HRV with rhinitis (p < 0.05), and RSV with bronchiolitis (p < 0.001) and bronchitis (p < 0.05). Respiratory distress was associated with RSV (p = 0.002), and a cough at the inclusion was significantly not associated with the influenza virus (p = 0.009). Antibiotic prescriptions were not associated with any specific virus. By day 7, persistent cough was significantly associated with active and passive smoking (respectively p = 0.01 and p < 0.001), influenza and RSV-positive samples (p < 0.05) and an age of less than 2 years (p < 0.01). With this prospective cohort performed in primary care including patients of all ages, we characterized viral respiratory infections, to better understand correlations between clinical data and virological results.

摘要

急性呼吸道感染(ARI)是普通人群中最常见的感染,也是一项重要的社会经济负担。本研究旨在根据临床表现和病毒学结果,对各年龄段初级保健患者的ARI进行特征描述。我们在初级保健机构开展了一项前瞻性多中心研究:36名法国全科医生(GP)纳入了所有出现ARI症状的各年龄段患者,并进行了鼻咽拭子采样,通过多重逆转录聚合酶链反应(Multiplex RT-PCR)进行分析。该队列共纳入685名各年龄段患者。我们发现临床诊断与呼吸道病毒之间存在关联:流感与类流感综合征的诊断相关(p < 0.001),人鼻病毒(HRV)与鼻炎相关(p < 0.05),呼吸道合胞病毒(RSV)与细支气管炎相关(p < 0.001)以及与支气管炎相关(p < 0.05)。呼吸窘迫与RSV相关(p = 0.002),纳入时的咳嗽与流感病毒无显著关联(p = 0.009)。抗生素处方与任何特定病毒均无关联。到第7天时,持续性咳嗽与主动和被动吸烟显著相关(分别为p = 0.01和p < 0.001)、流感和RSV阳性样本(p < 0.05)以及年龄小于2岁相关(p < 0.01)。通过在初级保健机构对所有年龄段患者进行的这项前瞻性队列研究,我们对病毒性呼吸道感染进行了特征描述,以更好地理解临床数据与病毒学结果之间的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a35/12141667/deb955170559/41533_2025_434_Fig1_HTML.jpg

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