重庆地区婴幼儿重症肺炎呼吸道病毒病原分析

目的 了解重庆地区婴幼儿重症肺炎病毒病原的感染情况.方法 2006年12月至2008年3月,取ICU病房收集诊断为重症肺炎患儿的深部气道或机械通气气管导管内吸取物标本119例,采用RT-PCR或PCR方法 检测呼吸道合胞病毒(RSV)、人偏肺病毒(hMPV)、博卡病毒(HBoV)、腺病毒(ADV)、副流感病毒(PIV)1、2、3和流感病毒(IV)A、B等呼吸道病毒病原.结果 119例标本中病毒总检出例数为86例(72.3%),其中RSV检出率最高,为41.2%(49/119).有2种及以上病毒协同感染23例,占26.7%(23/86);RSV阳性中有19例存在协同感染,占38.8%(19/49).69例行细菌检测,其中53例为阳性,阳性率为76.8%.这69例标本中,病毒阳性率为76.8%;病毒细菌双阳性为41例,占59.4%.结论 (1)病毒感染仍是重庆地区婴幼儿重症肺炎的重要病因.(2)BSV是婴幼儿重症肺炎最常见病毒病原,其次为ADV和hMPV.(3)病毒的协同感染较在重症呼吸道患儿中可能较为普遍,但尚无证据说明病毒协同感染可加重病情.

Analysis of viral etiology of severe pneumonia in infants and young children in Chongqing area

Objective To investigate the prevalence of viral infections and putative association of viral infection with illness severity in young children with severe lower respiratory tract infection (LRTI) in Chongqing. Method Respiratory secretion specimens were collected from 119 hospitalized patients with severe pneumonia from December 2006 to March 2008. After being processed, the samples were detected for respiratory viruses including respiratory syncytial virus ( RSV ), adenovirus ( ADV ), human metapneumovirus (hMPV), human bocavirus (HBoV), parainfluenza virus 1, 2, 3 ( PIV 1, 2, 3 ), influenza virus A and B (IVA and IVB) either by PCR or RT-PCR. Clinical data were analyzed along with virological data by using appropriate statistical methods. Result Viral pathogens were identified in specimens of 86 (72.3% ) cases, among which RSV was detected in 49 (41.2%) patients. More than one virus was detected in 23 individual (26.7% ) samples, of which 19 were dual positive for RSV and another virus. Bacterial cultures were performed for 69 patients. Both bacterial and viral pathogens were identified in 53 (76.8% ) patients. Bacterial and viral coinfection was demonstrated in samples from 41 (59.4%) cases. Conclusion Viral pathogens are the main etiology of severe pneumonia in young children in Chongqing area during the study period. RSV was the most frequent viral pathogens, followed by ADV and hMPV. Coinfection with respiratory common viruses was relatively common, though co-infection with viruses did not appear to aggravate the patients' condition.