Acute lower respiratory infections due to respiratory syncytial virus and adenovirus among hospitalized children from Argentina
Acute lower respiratory infections due to respiratory syncytial virus and adenovirus among hospitalized children from Argentina
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DOI：
10.1016/s0928-0197(98)00017-8
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发表时间：
1998-05-01
期刊：
影响因子：
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通讯作者：
Aguilar, M
中科院分区：
文献类型：
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作者：
Videla, C;Carballal, G;Aguilar, M
背景：急性下呼吸道感染（ALRI）是导致幼儿发病和死亡的主要原因之一。目的：本研究的目的是确定ALRI儿童呼吸道合胞病毒（RSV）和腺病毒的频率、季节性及其与临床实体的相关性。研究设计：在连续2年（1991-1992），168名2岁以下的儿童住院，由于ALRI在布宜诺斯艾利斯，阿根廷，公立儿科医院进行了研究。用间接免疫荧光法（IIF）检测鼻咽吸出物（NPA）中的RSV和腺病毒。HEp-2细胞用于腺病毒分离。结果：36.3%的病例检出呼吸道合胞病毒（RSV），14.3%的病例检出腺病毒（腺病毒）（P < 0.0001）。通过IIF检测到的所有腺病毒也在培养物中分离。在61例RSV病例中，57%对应于细支气管炎，43%对应于肺炎。92%的RSV患儿小于1岁，70%小于5个月。RSV病例数最多的季节是冬季，7月出现明显高峰。71%的腺病毒病例与肺炎相关，只有24%与细支气管炎相关（P < 0.02），并且在5个月以上的儿童中占主导地位（P < 0.0001）。腺病毒几乎在一年中的所有月份都被检测到，在冬末春初有一个小高峰。与无病毒病因的儿童相比，RSV或腺病毒诊断的儿童在入院时的临床特征、过度喂养或营养不良方面无显著差异。总病死率为2.4%。在所有致死性病例中，在NPA中检测到腺病毒。因此，腺病毒感染患者的病死率达到16.7%。结论：我们的研究结果显示了与ALRI相关的RSV和腺病毒在2岁以下住院儿童中的重要性，以及这两种病毒在阿根廷布宜诺斯艾利斯的不同流行病学模式。(C)1998 Elsevier Science B. V.保留所有权利。
Background: Acute lower respiratory infection (ALRI) is one of the main causes of morbidity and mortality in small children. Objective: The aim of this study was to determine the frequency, seasonality and association with clinical entities of respiratory syncytial virus (RSV) and adenoviruses in children with ALRI. Study design: During 2 consecutive years (1991-1992), 168 children under 2 years of age hospitalized due to ALRI in a public pediatric hospital of Buenos Aires, Argentina, were studied. RSV and adenoviruses were investigated on nasopharyngeal aspirates (NPA) by indirect immunofluorescence (IIF). HEp-2 cells were used for adenovirus isolation. Results: RSV was detected in 36.3% and adenoviruses in 14.3% of the cases (P < 0.0001). All adenoviruses detected by IIF were also isolated in culture. Out of 61 RSV cases, 57% corresponded to bronchiolitis and 43% to pneumonia. Ninety-two per cent of children with RSV were less than 1 year old and 70% were less than 5 months. The highest number of RSV cases were observed during winter, with a clear peak in July. Seventy-one per cent of adenovirus cases were associated with pneumonia and only 24% with bronchiolitis (P < 0.02), and predominated in children older than 5 months of age (P < 0.0001). Adenoviruses were detected in almost all months of the year with a small peak at the end of winter and beginning of spring. No significant differences in clinical features at admission, boast feeding or malnutrition were observed among children with RSV or adenovirus diagnosis versus those with no viral etiology. The overall fatality rate was 2.4%. In all fatal cases adenovirus was detected in NPA. Thus: fatality rate among patients with adenoviruses reached 16.7%. Conclusions: Our findings show the importance of RSV and adenoviruses associated with ALRI in hospitalized children under 2 years of age and the different epidemiological patterns of the two viruses in Buenos Aires, Argentina. (C) 1998 Elsevier Science B.V. All rights reserved.