Clinical And Virologic Impacts of Respiratory Viral Co-infections in Children With Influenza
Clinical And Virologic Impacts of Respiratory Viral Co-infections in Children With Influenza
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流感儿童呼吸道病毒合并感染的临床和病毒学影响
DOI：
10.1097/inf.0000000000003940
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发表时间：
2023
影响因子：
3.6
通讯作者：
Hosoya Mitsuaki
中科院分区：
文献类型：
--
作者：
Sato Masatoki;Takashita Emi;Katayose Masahiko;Nemoto Kenji;Sakai Nobuko;Fujisaki Seiichiro;Hashimoto Koichi;Hosoya Mitsuaki
背景：多重聚合酶链反应（PCR）方法的进步使多种呼吸道病毒的同时检测成为可能。我们的目的是评估流感和其他呼吸道病毒合并感染对儿童的临床和病毒学影响。方法：我们分别招募了38名和35名诊断为流感并接受巴洛韦和奥司他韦治疗的儿童。我们采用定量逆转录- pcr方法检测和测量在初始抗病毒剂量之前和之后第3天和第5天收集的3份鼻咽拭子样本的非流感病毒水平。我们使用问卷评估患者的临床信息。结果：73例患儿抗病毒治疗前检出除流感病毒外的一种或多种呼吸道病毒26例（35.6%）。合并感染和未合并感染儿童流感病毒载量和流感发病当日的临床特征相似。在治疗后未出现巴洛韦和奥司他韦减感变异体的26例和32例儿童中，分别有8例（30.8%）和7例（21.9%）儿童双感染人鼻病毒。这些儿童在第0天的人鼻病毒RNA水平小于流感病毒RNA的- 3 log 10，并且人鼻病毒合并感染对临床或病毒学病程没有影响。结论：当在同一患者中检测到多种呼吸道病毒时，有必要评估临床症状以及检测到的病毒水平，以确定哪种病毒导致疾病的发展。
Background:Advances in multiplex polymerase chain reaction (PCR) methods have enabled the simultaneous detection of multiple respiratory viruses. We aimed to estimate the clinical and virologic impacts of influenza and other respiratory virus co-infection in children.Methods:We enrolled 38 and 35 children diagnosed with influenza and treated with baloxavir marboxil (baloxavir) and oseltamivir, respectively. We performed quantitative reverse transcription-PCR to detect and measure the levels of noninfluenza viruses from 3 nasopharyngeal swab samples collected before and on days 3 and 5 after the initial antiviral dose. We assessed patients’ clinical information using questionnaires.Results:One or more respiratory viruses other than influenza virus were detected in 26 (35.6%) of 73 children before antiviral treatment. The influenza virus load and clinical characteristics on the day of influenza onset were similar between children with and without virus co-infections. Of the 26 and 32 children without the emergence of the reduced baloxavir and oseltamivir susceptible variants after treatment, 8 (30.8%) and 7 (21.9%) children were dually co-infected with human rhinovirus only, respectively. The level of human rhinovirus RNA on day 0 in these children was less than− 3 log 10 that of influenza virus RNA, and the human rhinovirus co-infection had no impact on the disease course either clinically or virologically.Conclusions:When multiple respiratory viruses are detected in the same patient, it is necessary to assess clinical symptoms as well as the levels of detected viruses to determine which virus contributes to the development of illness.