Respiratory viruses in children with cystic fibrosis: viral detection and clinical findings
Respiratory viruses in children with cystic fibrosis: viral detection and clinical findings
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DOI：
10.1111/j.1750-2659.2011.00292.x
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发表时间：
2012-05-01
影响因子：
4.4
通讯作者：
Englund, Janet A.
中科院分区：
文献类型：
--
作者：
Burns, Jane L.;Emerson, Julia;Englund, Janet A.
背景 现有的分子方法有助于从囊性纤维化 (CF) 儿童的不同呼吸道样本类型中进行病毒检测，但最佳采样策略尚未确定。此外，病毒检测与呼吸道症状之间的关联尚未得到很好的描述。 目的 研究目标是比较 CF 儿童同时上呼吸道和痰样本中病毒的分子检测，描述呼吸道病毒感染的相对频率并确定潜在的临床关联。 方法 我们对 44 名 6-18 岁 CF 儿童进行了为期 2 年的前瞻性监测研究。每季度和肺部病情加重期间收集上呼吸道和痰样本，并检测呼吸道合胞病毒 (RSV)、流感病毒、副流感病毒 1-4 型、人类偏肺病毒、冠状病毒、鼻病毒和腺病毒。通过体格检查和症状调查来识别呼吸道体征和症状。结果 在 359 次就诊中收集了上呼吸道样本；对 92 次就诊的 21 名参与者的配对上呼吸道和痰样本子集进行了基于 PCR 的病毒检测的一致性检查。鼻病毒是最常检测到的病毒（总体为 23.1%），两种样本类型的鼻病毒检测结果相同（各为 21.7%）。痰液中鼻病毒检测相对于上呼吸道采样的敏感性和特异性分别为 70% 和 91.7%。与鼻病毒检测相关的呼吸道症状包括咳嗽增加、鼻塞增加、痰液产生增加和喘息。结论通过上呼吸道或痰液样本观察到鼻病毒检测频率相对较高，临床结果表明存在显着相关的症状负担。
Background Viral detection from different respiratory sample types in children with cystic fibrosis (CF) is facilitated by available molecular methods, but optimum sampling strategies have not been identified. In addition, associations between viral detection and respiratory symptoms are not well described.Objectives Study goals were to compare molecular detection of viruses from concurrent upper airway and sputum samples in children with CF and to describe relative frequency of respiratory viral infections and identify potential clinical associations.Methods We conducted a 2-year prospective surveillance study in 44 children with CF aged 6-18 years. Upper airway and sputum samples were collected quarterly and during pulmonary exacerbations and tested for respiratory syncytial virus (RSV), influenza viruses, parainfluenza viruses types 1-4, human metapneumovirus, coronaviruses, rhinoviruses, and adenoviruses. Physical exams and symptom surveys were used to identify respiratory signs and symptoms.Results Upper airway samples were collected at 359 visits; concordance of PCR-based viral detection was examined in a subset of paired upper airway and sputum samples from 21 participants at 92 visits. Rhinovirus was the most commonly detected virus (23.1% overall), and rhinovirus detection was the same for both sample types (21.7% each). Sensitivity and specificity for the detection of rhinovirus in sputum relative to upper airway sampling were 70% and 91.7%, respectively. Respiratory symptoms associated with rhinovirus detection included increased cough, increased nasal congestion, increased sputum production, and wheezing.Conclusions A relatively high frequency of rhinovirus detection was observed by either upper airway or sputum samples, and clinical findings suggest a significant-associated symptom burden.