Surveillance of respiratory virus infections in adult hospital admissions using rapid methods
Surveillance of respiratory virus infections in adult hospital admissions using rapid methods
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DOI：
10.1017/s0950268805005364
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发表时间：
2006-08-01
影响因子：
4.2
通讯作者：
Warren, R.
中科院分区：
文献类型：
--
作者：
Kaye, M.;Skidmore, S.;Warren, R.
流感和呼吸道合胞病毒（RSV）在冬季引起不同严重程度的呼吸道疾病流行。流感尤其被归咎于医院冬季床位压力，尽管人们认为RSV也可能发挥作用。人偏肺病毒（hMPV）是一种新的呼吸道病毒，据报道在儿童中很重要;只有有限数量的研究可用于成人人群。我们的目的是使用聚合酶链反应（PCR）技术初步确定病毒学确认的感染（即流感病毒、RSV和hMPV）的负担，此外，还评估该方法作为这些呼吸道病毒监测工具的可行性。要求在过去24小时内入院并在过去14天内出现急性呼吸道症状的成人患者参加研究。获得知情同意书并采集鼻和咽喉拭子。对甲型流感（H1 N1和H3 N2）、乙型流感（B）和RSV A和B进行多重PCR，同时对hMPV进行单独PCR。2001-2002年和2002-2003年分别对219名和216名患者进行了检测，两个季节的合并结果为：8名对甲型流感/H1N1呈阳性，14名对甲型流感/H3 N2呈阳性，2名对乙型流感呈阳性，14名对RSV A呈阳性，6名对RSV B呈阳性。大多数患者（261/435）> 65岁，大多数阳性（30/44）在该年龄组中发现。一些年龄> 65岁的流感阳性患者（12/15）报告接种了疫苗。总共检测了373份样本的hMPV，在除45-54岁年龄组外的所有年龄组中发现20份样本呈阳性。由于研究期间流感活动较低，因此无法评估感染对入院的影响。尽管如此，研究的病毒占呼吸道感染住院病例的15%。正如预期，大多数患者的年龄> 65岁。在研究的两年中，RSV和hMPV分别导致与流感一样多的呼吸道感染住院病例。即使有接种疫苗史的人也必须考虑流感感染。本研究中使用的分子方法表明，可以对这些呼吸道病毒进行监测，并可能有助于患者的管理。
Both influenza and respiratory syncytial virus (RSV) cause epidemics of respiratory illness of variable severity during the winter season. Influenza in particular has been blamed for hospital winter bed pressures, although it is thought that RSV may also play a role. Human metapneumovirus (hMPV) is a new respiratory virus reported to be important in children; only a limited number of studies are available for adult populations. We aimed to determine initially the burden of virologically confirmed infections, i.e. influenza, RSV and hMPV using polymerase chain reaction (PCR) technology and, in addition, to assess the feasibility of this approach as a surveillance tool for these respiratory viruses. Adult patients admitted to hospital in the previous 24 hours with onset of acute respiratory symptoms in the last 14 days were asked to participate. Informed written consent was obtained and nose and throat swabs taken. Multiplex PCR for influenza A (H1N1 and H3N2), influenza B and RSV A and B were carried out together with a separate PCR for hMPV. A total of 219 patients in 2001-2002 and 216 In 2002-2003 were tested and the combined results for both seasons were: 8 positive for influenza A/H1N1, 14 for influenza A/H3N2, 2 for influenza B, 14 for RSV A and 6 for RSV B. Most patients (261/435) were > 65 years and most positives (30/44) were found within this age group. A number of patients aged > 65 years who were positive for influenza (12/15) reported having had vaccine. In total, 373 samples were tested for hMPV and 20 were found positive across all age groups except the 45-54 years age group. As influenza activity was low during the study period the impact of infection on admissions could not be assessed. Nevertheless the viruses studied accounted for 15 % of hospital admissions for respiratory infection. Most patients were aged > 65 years, as expected. In the two years studied RSV and hMPV were each responsible for as many hospitalized cases of respiratory infection as influenza. Influenza infection must be considered even in those who give a history of vaccination. The molecular methods used in this study showed that surveillance of these respiratory viruses can be conducted and may help in the management of patients.