Does Respiratory Virus Coinfection Increases the Clinical Severity of Acute Respiratory Infection Among Children Infected With Respiratory Syncytial Virus?
Does Respiratory Virus Coinfection Increases the Clinical Severity of Acute Respiratory Infection Among Children Infected With Respiratory Syncytial Virus?
复制标题
DOI：
10.1097/inf.0b013e31828ba08c
复制
发表时间：
2013-05-01
影响因子：
3.6
通讯作者：
Ariyoshi, Koya
中科院分区：
文献类型：
--
作者：
Harada, Yoshitaka;Kinoshita, Fumiko;Ariyoshi, Koya
背景：呼吸道合胞病毒（RSV）是 5 岁以下儿童急性下呼吸道感染的主要原因。非 RSV 呼吸道病毒合并感染对 RSV 疾病严重程度的影响尚不清楚。 方法：这项以医院为基础的前瞻性研究在日本长崎进行，研究对象为所有 5 岁以下患有急性呼吸道感染 (ARI) 的儿童，这些儿童在 2009 年 4 月至 2010 年 3 月期间接受了快速 RSV 诊断测试。使用多重聚合酶链反应从鼻咽拭子样本中鉴定出 13 种呼吸道病毒；聚合酶链反应阳性样本被视为确诊的呼吸道病毒感染。根据胸片和住院记录的结果，将病例分为3类（肺炎、中重度非肺炎性急性呼吸道感染和轻度急性呼吸道感染）。 结果：入组的384例病例中，371例符合分析条件，其中85例（23%）属于肺炎病例； 137 例 (37%) 为中度至重度非肺炎性 ARI 病例，162 例 (40%) 为轻度 ARI 病例。 172例（61.6%）检出RSV，31例（18.0%）有其他呼吸道病毒双重或三重感染。与轻度 ARI 病例相比，RSV 感染在肺炎病例（比值比 [OR]：2.3；95% 置信区间 [CI]：1.31-3.9）和中重度非肺炎 ARI 病例（OR：2.95；95% CI：1.82-4.78）中更常见。 RSV/非 RSV 呼吸道病毒合并感染（调整后 OR：4.91；95% CI：1.9-12.7）与中重度非肺炎 ARI 病例的关联性强于 RSV 单一感染（调整后 OR：2.77；95% CI：1.64-4.7）。结论：非 RSV 呼吸道病毒合并感染在儿童中并不罕见。感染RSV的儿童可能会增加RSV疾病的严重程度。
Background: Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection in children less than 5 years of age. The impact of non-RSV respiratory virus coinfection on the severity of RSV disease is unknown.Methods: This hospital-based prospective study was conducted in Nagasaki, Japan, on all children less than 5 years of age with acute respiratory infection (ARI) who had undergone a rapid RSV diagnostic test between April 2009 and March 2010. Thirteen respiratory viruses were identified from nasopharyngeal swab samples using a multiplex polymerase chain reaction; polymerase chain reaction-positive samples were considered as confirmed respiratory virus infections. The cases were classified into 3 categories (pneumonia, moderate-to-severe nonpneumonic ARI and mild ARI) according to the findings of the chest radiograph and the hospitalization records.Results: Among 384 cases enrolled, 371 were eligible for analysis, of whom 85 (23%) were classified as pneumonia cases; 137 (37%) as moderate-to-severe nonpneumonic ARI cases and 162 (40%) as mild ARI cases. RSV was detected in 172 cases (61.6%), and 31 cases (18.0%) had double or triple infections with other respiratory viruses. RSV infection was more frequently observed in pneumonia cases (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.31-3.9) and moderate-to-severe nonpneumonic ARI cases (OR: 2.95; 95% CI: 1.82-4.78) than in mild ARI cases. The association with moderate-to-severe nonpneumonic ARI cases was stronger with RSV/non-RSV respiratory virus coinfection (adjusted OR: 4.91; 95% CI: 1.9-12.7) than with RSV single infection (adjusted OR: 2.77; 95% CI: 1.64-4.7).Conclusions: Non-RSV respiratory virus coinfection is not uncommon in RSV-infected children and may increase the severity of RSV disease.