Viral etiologies of acute respiratory infections among hospitalized Vietnamese children in Ho Chi Minh City, 2004-2008.
Viral etiologies of acute respiratory infections among hospitalized Vietnamese children in Ho Chi Minh City, 2004-2008.
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DOI：
10.1371/journal.pone.0018176
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发表时间：
2011-03-24
期刊：
影响因子：
3.7
通讯作者：
de Jong MD
中科院分区：
文献类型：
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作者：
Do AH;van Doorn HR;Nghiem MN;Bryant JE;Hoang TH;Do QH;Van TL;Tran TT;Wills B;Nguyen VC;Vo MH;Vo CK;Nguyen MD;Farrar J;Tran TH;de Jong MD
对急性呼吸道感染（阿里斯）的主要病毒病因了解甚少，特别是在资源有限的热带国家的住院儿童中，阿里斯引起的发病率和死亡率最高。需要提高对病因的认识，以改善临床管理和预防。我们对越南南部最大的传染病转诊医院内2个月至13岁儿童的严重呼吸道疾病进行了为期三年的前瞻性描述性研究。使用多重RT-PCR试剂盒（Seeplex™ RV检测，Seegene）和额外的单重实时RT-PCR，对三种类型的呼吸道标本（鼻拭子、咽拭子和鼻咽抽吸物）进行15种病毒种属和亚型的分子检测。2004年11月至2008年1月，共有309名儿童入学。在72%（222/309）的病例中鉴定出病毒，包括呼吸道合胞病毒（24%）、流感病毒A和B（17%）、人博卡病毒（16%）、肠道病毒（9%）、人冠状病毒（8%）、人偏肺病毒（7%）、副流感病毒1-3（6%）、腺病毒（5%）和人鼻病毒A（4%）。在20%（62/309）的患者中检测到多种病毒的合并感染。当合并时，鼻拭子和咽拭子的诊断率与鼻咽抽吸物相似。与世界其他地区相似，RSV和流感是越南住院儿童中检测到的主要病毒病原体。鼻拭子和咽拭子的组合是一个广泛的病毒病原体的敏感分子检测的首选标本。需要进一步的研究，以更好地了解单一与多种病毒合并感染的临床意义，并解决细菌（共）感染在严重呼吸道疾病中的作用。
The dominant viral etiologies responsible for acute respiratory infections (ARIs) are poorly understood, particularly among hospitalized children in resource-limited tropical countries where morbidity and mortality caused by ARIs are highest. Improved etiological insight is needed to improve clinical management and prevention. We conducted a three-year prospective descriptive study of severe respiratory illness among children from 2 months to 13 years of age within the largest referral hospital for infectious diseases in southern Vietnam. Molecular detection for 15 viral species and subtypes was performed on three types of respiratory specimens (nose, throat swabs and nasopharyngeal aspirates) using a multiplex RT-PCR kit (Seeplex™ RV detection, Seegene) and additional monoplex real-time RT-PCRs. A total of 309 children were enrolled from November 2004 to January 2008. Viruses were identified in 72% (222/309) of cases, including respiratory syncytial virus (24%), influenza virus A and B (17%), human bocavirus (16%), enterovirus (9%), human coronavirus (8%), human metapneumovirus (7%), parainfluenza virus 1–3 (6%), adenovirus (5%), and human rhinovirus A (4%). Co-infections with multiple viruses were detected in 20% (62/309) of patients. When combined, diagnostic yields in nose and throat swabs were similar to nasopharyngeal aspirates. Similar to other parts in the world, RSV and influenza were the predominant viral pathogens detected in Vietnamese hospitalized children. Combined nasal and throat swabs are the specimens of choice for sensitive molecular detection of a broad panel of viral agents. Further research is required to better understand the clinical significance of single versus multiple viral coinfections and to address the role of bacterial (co-)infections involved in severe respiratory illness.