Human parechoviruses as an important viral cause of sepsislike illness and meningitis in young children
Human parechoviruses as an important viral cause of sepsislike illness and meningitis in young children
复制标题
DOI：
10.1086/589752
复制
发表时间：
2008-08-01
影响因子：
11.8
通讯作者：
Pajkrt, Dasja
中科院分区：
文献类型：
--
作者：
Wolthers, Katja C.;Benschop, Kimberley S. M.;Pajkrt, Dasja
背景肠道病毒（EV）属于小核糖核酸病毒科，是新生儿败血症和病毒性脑膜炎的众所周知的原因。人类双埃柯病毒（HPeV）1型和2型，以前称为埃可病毒22和23，与幼儿的轻度胃肠道或呼吸道症状有关。目前已知六种HPeV基因型，其中HPeV 3与新生儿败血症和脑膜炎相关。选择2004-2006年期间通过EV特异性聚合酶链反应（PCR）检测的< 5岁儿童的脑脊液样本（n = 761）。其中716名儿童的样本可通过HPeV特异性实时PCR进行回顾性检测。比较EV和HPeV的感染率。回顾性分析儿童HPeV感染的临床资料。33例（4.6%）患儿脑脊液标本中检出HPeV。脑脊液中HPeV的年患病率变化显著：2004年为8.2%，2005年为0.4%，2006年为5.7%。EV检出率为14%（761份样本中的108份），年患病率无变化。脑脊液中HPeV阳性的患儿临床表现为脓毒症样疾病和脑膜炎，导致住院和抗生素治疗。EV特异性PCR不能检测HPeV。HPeV特异性PCR的增加使5岁以下儿童中新生儿败血症或中枢神经系统症状的病毒原因的检测增加了31%。HPeV可以被认为是幼儿病毒性败血症和脑膜炎的第二个原因，通过PCR快速识别HPeV可能有助于缩短抗生素使用和住院时间。
Background. Enteroviruses (EVs) belong to the family Picornaviridae and are a well-known cause of neonatal sepsis and viral meningitis. Human parechoviruses (HPeVs) type 1 and 2, previously named echovirus 22 and 23, have been associated with mild gastrointestinal or respiratory symptoms in young children. Six HPeV genotypes are currently known, of which HPeV3 is associated with neonatal sepsis and meningitis.Methods. Cerebrospinal fluid samples from children aged < 5 years previously tested by EV-specific polymerase chain reaction (PCR) during 2004-2006 were selected (n = 761). Samples from 716 of those children were available for retrospective testing by HPeV-specific real-time PCR. The prevalence of EV and HPeV in these samples was compared. Data on clinical presentation of children infected with HPeV were retrospectively documented.Results. HPeV was found in cerebrospinal fluid samples from 33 (4.6%) of the children. Yearly prevalence of HPeV in cerebrospinal fluid varied remarkably: 8.2% in 2004, 0.4% in 2005, and 5.7% in 2006. EV was detected in 14% (108 of 761 samples), with no variation in yearly prevalence. Children with HPeV in cerebrospinal fluid presented with clinical symptoms of sepsislike illness and meningitis, which led to hospitalization and antibiotic treatment.Conclusion. EV-specific PCRs do not detect HPeVs. The addition of an HPeV-specific PCR has led to a 31% increase in detection of a viral cause of neonatal sepsis or central nervous system symptoms in children aged < 5 years. HPeV can be considered to be the second cause of viral sepsis and meningitis in young children, and rapid identification of HPeV by PCR could contribute to shorter duration of both antibiotic use and hospital stay.