OCCURRENCE OF GROUP-A AND GROUP-B OF RESPIRATORY SYNCYTIAL VIRUS OVER 15 YEARS - ASSOCIATED EPIDEMIOLOGIC AND CLINICAL CHARACTERISTICS IN HOSPITALIZED AND AMBULATORY CHILDREN
OCCURRENCE OF GROUP-A AND GROUP-B OF RESPIRATORY SYNCYTIAL VIRUS OVER 15 YEARS - ASSOCIATED EPIDEMIOLOGIC AND CLINICAL CHARACTERISTICS IN HOSPITALIZED AND AMBULATORY CHILDREN
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DOI：
10.1093/infdis/162.6.1283
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发表时间：
1990-12-01
影响因子：
6.4
通讯作者：
ANDERSON, LJ
中科院分区：
文献类型：
--
作者：
HALL, CB;WALSH, EE;ANDERSON, LJ
对1209例住院和门诊儿童15年以上呼吸道合胞病毒（RSV）分离株进行了株组和亚组检查，以确定相关的流行病学和临床特征。暴发流行存在3种模式：（1）A群菌株占绝对优势（9年，A群菌株占83%~ 100%）;（2）A群和B群菌株比例相对相等（4年）;（3）B群菌株占绝对优势（78%~ 85%）。第一种模式为A株高度优势，以连续1年或2年为周期，中间有一年B株≥ 100%。4%的分离株。亚组A1和A2占主导地位，而B2，3，4几乎相等。A组感染的儿童需要重症监护的频率显著更高（15.4 vs. 8.3%，P = 0.008），表明A组菌株的临床严重程度更高。此外，强优势A株年份与需要重症监护的RSV入院比例较高相关（16.6%对5.5%，P <0.01）。A2和B4亚群菌株在住院患者中更常见，A1亚群菌株在门诊患者中更常见，重症监护入院率最高的2年是A2亚群占主导地位的2年。
Over 15 years respiratory syncytial virus (RSV) isolates from 1209 hospitalized and ambulatory children were examined for strain group and in a subset for subgroup to determine the associated epidemiologic an clinical characteristics. Three patterns of yearly outbreaks existed: (1) strong predominance of group A strain (9 years with 83%-100% A strains), (2) relatively equal proportions of group A and B strains (4 years), and (3) strong predominance of group B strains (78%-85%) in 2 years, separated by a decade. The first pattern of highly dominant A strain occurred in cycles of 1 or 2 consecutive years with a single intervening year in which B strains were .gtoreq. 4% of the isolates. Subgroups A1 and A2 predominated, while B2, 3, an 4 occurred almost equally. A greater clinical severity for Group A strains was suggested by children with group A infections requiring intensive care significantly more often (15.4 vs. 8.3%, P = .008). Further, strongly dominant A strain years were associated with higher proportions of RSV admissions requiring intensive care (16.6% vs. 5.5%, P < .01). Strains of subgroups A2 and B4 were more frequently found in hospitalized patients and A1 in outpatients, and the 2 years with the highest rates of intensive care admissions were those in which subgroup A2 dominated.