Whimbey E, Champlin R E, Couch R B, Englund J A, Goodrich J M, Raad I, Przepiorka D, Lewis V A, Mirza N, Yousuf H, Tarrand J J, Bodey G P
Section of Infectious Diseases, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Clin Infect Dis. 1996 May;22(5):778-82. doi: 10.1093/clinids/22.5.778.
From 1 November 1992 through 1 May 1993 and from 1 November 1993 through 1 May 1994, we conducted a prospective surveillance study at the University of Texas M.D. Anderson Cancer Center (Houston) to evaluate the role of community respiratory virus infections in hospitalized adult bone marrow transplant (BMT) recipients, Respiratory secretions were obtained from all adult BMT recipients with acute respiratory illnesses. During these two winters, a community respiratory virus was isolated from 37 (36%) of 102 patients and 30 (26%) of 115 patients, respectively. Approximately half (49%) of these infections were due to respiratory syncytial virus (RSV); the remainder were due to influenza virus (18%), picornaviruses (18%), parainfluenza virus (9%), or adenovirus (6%). Fifty-eight percent of these infections were complicated by pneumonia, with an associated mortality of 51%. The pneumonias that complicated RSV infection were almost exclusively viral in origin and were associated with a mortality of 100% if not treated promptly with antiviral agents. In contrast, many of the pneumonias that complicated the other viral infections, such as influenza, appeared to be either self-limited viral pneumonias or secondary bacterial or fungal pneumonias. Community respiratory viruses are frequent causes of acute respiratory illnesses in adult BMT recipients hospitalized during the winter and are associated with substantial morbidity and mortality.
1992年11月1日至1993年5月1日以及1993年11月1日至1994年5月1日期间，我们在德克萨斯大学MD安德森癌症中心（休斯顿）开展了一项前瞻性监测研究，以评估社区呼吸道病毒感染在住院成年骨髓移植（BMT）受者中的作用。从所有患有急性呼吸道疾病的成年BMT受者处获取呼吸道分泌物。在这两个冬季，分别从102例患者中的37例（36%）和115例患者中的30例（26%）分离出社区呼吸道病毒。这些感染中约一半（49%）由呼吸道合胞病毒（RSV）引起；其余由流感病毒（18%）、微小核糖核酸病毒（18%）、副流感病毒（9%）或腺病毒（6%）引起。这些感染中有58%并发肺炎，相关死亡率为死亡率为51%。并发RSV感染的肺炎几乎完全起源于病毒，如果不及时用抗病毒药物治疗，死亡率为100%。相比之下，许多并发其他病毒感染（如流感）的肺炎似乎是自限性病毒性肺炎或继发性细菌性或真菌性肺炎。社区呼吸道病毒是冬季住院成年BMT受者急性呼吸道疾病的常见病因，并与严重的发病率和死亡率相关。
