Human metapneumovirus infection in young children hospitalized with acute respiratory tract disease - Virologic and clinical features
Human metapneumovirus infection in young children hospitalized with acute respiratory tract disease - Virologic and clinical features
复制标题
DOI：
10.1097/inf.0b013e318162a164
复制
发表时间：
2008-05-01
影响因子：
3.6
通讯作者：
Fiorentini, Simona
中科院分区：
文献类型：
--
作者：
Caracciolo, Sonia;Minini, Chiara;Fiorentini, Simona
背景资料：人偏肺病毒（Human metapneumovirus，hMPV）是一种与急性呼吸道感染（acute respiratory tract infections，阿里斯）相关的新型病毒，在2个连续的冬春季季节中，hMPV感染的病毒学和临床特征得到评价。通过逆转录-聚合酶链反应检测标本中的hMPV。对hMPV F基因扩增产物进行测序，并构建系统发育树。hMPV感染的高发病率2005-2006年冬春季节的感染率为25.3%，系统发育分析表明，在两个季节中，A2 a型占60.4%，22.9%为A2 b，4.2%为B1，12.5%为B2。在所有供试标本中均未检出hMPV A1毒株。临床诊断为细支气管炎57.1%，肺炎25%，上呼吸道疾病17.8%。1岁以下儿童毛细支气管炎发生率（80%）高于1岁以上儿童（30.8%）（P < 0.05）。在hMPV感染较多的病例中，hMPV的传播与呼吸道合胞病毒（RSV）的传播重叠，hMPV/RSV混合感染为常见事件（19/39; 48.7%）。hMPV/RSV合并感染的儿童肺炎发生率高于hMPV感染的患者（57.9%对20%），但在疾病的严重程度（衡量住院时间和氧气需求）没有差异observed.Conclusions：这些结果提供了进一步的证据，hMPV作为一种病原体与ARI在幼儿的重要性。怀疑肺炎病例中涉及hMPV/RSV合并感染。
Background: Human metapneumovirus (hMPV) is an emerging virus associated with acute respiratory tract infections (ARIs) in young children.Objectives: To evaluate virologic and clinical features of hMPV infection during 2 consecutive winter-spring seasons.Methods: Nasal washes were obtained from children younger than 5 years of age hospitalized for ARI. Specimens were tested for hMPV by reverse transcription-polymerase chain reaction. The hMPV F gene amplification products were sequenced, and phylogenetic trees were constructed.Results: A high incidence of hMPV infection (25.3%) was observed during the 2005-2006 winter-spring season, whereas a much lower rate of infection (4.7%) during the following season was found. Phylogenetic analysis revealed that, during the 2 seasons, 60.4% of the hMPV detected were A2a, 22.9% were A2b, 4.2% were B1, and 12.5% were B2. hMPV A1 strains were not detected in any tested specimen. Clinical diagnosis was bronchiolitis in 57.1%; pneumonia in 25%; and a upper respiratory tract illness in 17.8%. Bronchiolitis was more frequent in children less than 1 year of age (80%) than in children more than 1 year of age (30.8%) (P < 0.05). When hMPV was found frequently, the hMPV spread overlapped with that of respiratory syncytial virus (RSV) and hMPV/RSV coinfections were common events (19 of 39; 48.7%). hMPV/RSV-coinfected children developed pneumonia more frequently than hMPV-infected patients (57.9% versus 20%) but no differences in disease severity (gauged by duration of hospitalization and requirement of oxygen) were observed.Conclusions: These results provide further evidence of the importance of hMPV as a pathogen associated with ARI in young children. Involvement of hMPV/RSV coinfection in cases of pneumonia is suspected.