Undiagnosed respiratory viruses in children
Undiagnosed respiratory viruses in children
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DOI：
10.1542/peds.2006-3073
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发表时间：
2008-03-01
期刊：
影响因子：
8
通讯作者：
Sawyer, Mark H.
中科院分区：
文献类型：
--
作者：
Arnold, John C.;Singh, Kumud K.;Sawyer, Mark H.
OBJECTIVE.据估计，每年有1200万至3200万幼儿发生上呼吸道感染。此外，20%至53%的婴儿在出生后的第一年内会发生>= 1次下呼吸道感染。目前诊断呼吸道病毒的方法在范围和灵敏度上都有局限。聚合酶链反应是一种比抗原检测更敏感的方法，通常用于新发现的病毒。使用聚合酶链反应，我们试图诊断腺病毒，人类博卡病毒，人类偏肺病毒在我们的儿童医院。采集用于呼吸道病毒抗原检测的鼻拭子标本，并使用聚合酶链反应进行处理，以检测腺病毒、人博卡病毒和人偏肺病毒。回顾了住院和急诊记录中的临床和人口统计学数据。在21个月内收集了大约1500份标本;它们分别在5.9%、5.6%和5.2%的儿童中含有腺病毒、人博卡病毒和人偏肺病毒。使用聚合酶链反应和抗原检测，在多达62%的标本中发现了病毒因子。下呼吸道疾病最常见于感染人偏肺病毒的患者（63%），最不常见于感染腺病毒的患者（45%）。我们通过聚合酶链反应检测了59例抗原检测结果为阴性的患者中的腺病毒。在19%的人博卡病毒感染患者中，阵发性咳嗽导致临床怀疑百日咳杆菌感染。腺病毒、人博卡病毒和人偏肺病毒分别存在于提交用于呼吸道病毒快速检测的标本中，约占5%。下呼吸道在人博卡病毒和人偏肺病毒感染的患者中更常见。腺病毒抗原检测常不能确诊。其他发现包括与人类博卡病毒相关的百日咳样疾病的存在。
OBJECTIVE. An estimated 12 to 32 million upper respiratory infections occur in young children each year. In addition, 20% to 53% of infants will have >= 1 episode of lower respiratory infection in the first year of life. The current methods of diagnosing respiratory viruses are limited in scope and sensitivity. Polymerase chain reaction is a more sensitive method than antigen detection and is often used for newly discovered viruses. Using polymerase chain reaction, we sought to diagnose adenoviruses, human bocavirus, and human metapneumovirus at our children's hospital.METHODS. Nasal-swab specimens submitted for antigen detection of respiratory viruses were collected and processed by using polymerase chain reaction to detect adenoviruses, human bocavirus, and human metapneumovirus. Inpatient and emergency department records were reviewed for clinical and demographic data.RESULTS. Approximately 1500 specimens were collected over 21 months; they contained adenoviruses, human bocavirus, and human metapneumovirus in 5.9%, 5.6%, and 5.2% of children, respectively. Using polymerase chain reaction and antigen detection, a viral agent was identified in as many as 62% of the specimens. Lower respiratory tract disease was present most frequently in patients infected with human metapneumovirus (63%) and least frequently in those infected with adenoviruses (45%). We detected adenoviruses by polymerase chain reaction in 59 patients for whom the antigen-detection test results were negative. A paroxysmal cough led to clinical suspicion of Bordetella pertussis infection in 19% of patients infected with human bocavirus.CONCLUSIONS. Adenoviruses, human bocavirus, and human metapneumovirus were each present in similar to 5% of specimens submitted for respiratory virus rapid testing. The lower respiratory tract was more commonly affected in patients with human bocavirus and human metapneumovirus infections. Adenovirus was often undiagnosed by antigen detection. Other findings included the presence of a pertussis-like illness associated with human bocavirus.