Parechovirus A Infections in Healthy Australian Children During the First 2 Years of Life: A Community-based Longitudinal Birth Cohort Study
Parechovirus A Infections in Healthy Australian Children During the First 2 Years of Life: A Community-based Longitudinal Birth Cohort Study
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DOI：
10.1093/cid/ciz761
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发表时间：
2020-07-01
影响因子：
11.8
通讯作者：
Bialasiewicz, Seweryn
中科院分区：
文献类型：
--
作者：
Wang, Claire Y. T.;Ware, Robert S.;Bialasiewicz, Seweryn
背景。医院研究发现副肠孤病毒 (PeV)（主要是 PeV-A3）是幼儿严重感染的重要原因。然而，基于社区的研究很少发表，真正的 PeV 感染负担尚不清楚。我们在一项基于社区的纵向出生队列研究中调查了健康儿童的 PeV 流行病学。方法。参加儿童传染病观察研究 (ORChID) 研究的澳大利亚儿童 (n = 158) 从出生到两岁生日都被跟踪。每周收集粪便和鼻拭子以及每日症状日记。通过逆转录聚合酶链式反应对拭子进行 PeV 检测，并通过亚基因组测序确定基因型。对发病率、感染特征、临床关联和病毒联合检测进行了调查。结果。分别在 11 124 份粪便和鼻拭子中的 1423 份（12.8%）和 8100 份粪便和鼻拭子中检测到 17 份（0.2%）PeV。已确定的 306 起感染事件中，主要基因型为 PeV-A1（47.9%）、PeV-A6（20.1%）和 PeV-A3（18.3%）。发病率为每 100 个儿童年 144 次（95% 置信区间，128-160）。首次感染出现的中位年龄为 8 个月（四分位距，6.0-11.7）个月。观察到每年季节性峰值从 PeV-A1 到 PeV-A3 的变化。感染与年龄 >= 6 个月、夏季、同龄时非纯母乳喂养呈正相关
Background. Hospital-based studies identify parechovirus (PeV), primarily PeV-A3, as an important cause of severe infections in young children. However, few community-based studies have been published and the true PeV infection burden is unknown. We investigated PeV epidemiology in healthy children participating in a community-based, longitudinal birth cohort study.Methods. Australian children (n = 158) enrolled in the Observational Research in Childhood Infectious Diseases (ORChID) study were followed from birth until their second birthday. Weekly stool and nasal swabs and daily symptom diaries were collected. Swabs were tested for PeV by reverse-transcription polymerase chain reaction and genotypes determined by subgenomic sequencing. Incidence rate, infection characteristics, clinical associations, and virus codetections were investigated.Results. PeV was detected in 1423 of 11 124 (12.8%) and 17 of 8100 (0.2%) stool and nasal swabs, respectively. Major genotypes among the 306 infection episodes identified were PeV-A1 (47.9%), PeV-A6 (20.1%), and PeV-A3 (18.3%). The incidence rate was 144 episodes (95% confidence interval, 128-160) per 100 child-years. First infections appeared at a median age of 8 (interquartile range, 6.0-11.7) months. Annual seasonal peaks changing from PeV-A1 to PeV-A3 were observed. Infection was positively associated with age >= 6 months, summer season, nonexclusive breastfeeding at age