Clinical Features, Virus Identification, and Sinusitis as a Complication of Upper Respiratory Tract Illness in Children Ages 4-7 Years.
Clinical Features, Virus Identification, and Sinusitis as a Complication of Upper Respiratory Tract Illness in Children Ages 4-7 Years.
复制标题
DOI：
10.1016/j.jpeds.2015.12.034
复制
发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Wald ER
中科院分区：
文献类型：
--
作者：
DeMuri GP;Gern JE;Moyer SC;Lindstrom MJ;Lynch SV;Wald ER
目的了解儿童鼻窦炎并发上呼吸道疾病(URI)的发生率。我们前瞻性地确定了4至7岁儿童人群中URI的临床、病毒学和流行病学特征，并对其进行了1年的随访。这是一项在威斯康星州麦迪逊的2个初级保健儿科诊所进行的观察性队列研究。在4次无症状监测访问和有症状的尿毒症期间采集鼻样。采用聚合酶链式反应技术对9种呼吸道病毒进行检测。鼻窦炎的诊断是基于公布的标准。236名年龄在48-96个月之间的儿童参加了研究。共有327个URI被鉴定。每名儿童平均每年有1.3个URI(范围0-9)。81%的URI检出病毒，以鼻病毒(RV)最常见。到第10天，72%的URI临床上得到了解决。RV-A和RV-C在URI就诊时的检出频率更高；RV-B在无症状监测就诊和URI就诊中的检出频率相同。有症状的URI中有8.8%的人被诊断为鼻窦炎。在无症状儿童的样本中经常检测到病毒(33%)。在我们的研究中，鼻窦炎发生在8.8%的有症状的URI中。在儿童中检出最常见的URI病毒是轮状病毒；RV-A和RV-C的检测与疾病有关，而RV-B的检测不与疾病相关。病毒，特别是轮状病毒，在无症状的儿童中经常被检测到。大多数URI在发病后第10天已经改善或消失。儿童平均每年经历1.3个URI，低于预期。
To determine the rate of sinusitis complicating upper respiratory tract illnesses (URIs) in children. We prospectively identified the clinical, virologic, and epidemiologic characteristics of URIs in a population of 4- to 7-year-old children followed for 1 year. This was an observational cohort study in 2 primary care pediatric practices in Madison, Wisconsin. Nasal samples were obtained during 4 asymptomatic surveillance visits and during symptomatic URIs. A polymerase chain reaction-based assay for 9 respiratory viruses was performed on nasal samples. A diagnosis of sinusitis was based on published criteria. Two hundred thirty-six children ages 48-96 months were enrolled. A total of 327 URIs were characterized. The mean number of URIs per child was 1.3 (range 0-9) per year. Viruses were detected in 81% of URIs; rhinovirus (RV) was most common. Seventy-two percent of URIs were resolved clinically by the 10th day. RV-A and RV-C were detected more frequently at URI visits; RV-B was detected at the same rate for both asymptomatic surveillance visits and URI visits. Sinusitis was diagnosed in 8.8% of symptomatic URIs. Viruses were detected frequently (33%) in samples from asymptomatic children. Sinusitis occurred in 8.8% of symptomatic URIs in our study. The virus most frequently detected with URIs in children was RV; RV-A and RV-C detection but not RV-B detection were associated with illness. Viruses, especially RV, are detected frequently in asymptomatic children. Most URIs have improved or resolved by the 10th day after onset. Children experienced a mean of 1.3 URIs per year, which was lower than expected.