成都地区儿童上呼吸道病毒和细菌感染状况及流行病学特征

目的了解成都地区儿童急性上呼吸道病毒和细菌感染状况,并分析其流行病学特征。方法将2018年4月至2020年4月医院收治住院治疗的1324例急性上呼吸道感染患儿纳入研究。对咽拭子标本进行病原体培养、分离与鉴定。结果1324份标本中,检出阳性1012份,阳性率为76.44%,其中单纯病毒感染检出率为50.40%,单纯细菌感染检出率为16.21%,混合感染检出率为33.40%。1324份标本中,细菌和病毒总检出率为76.44%,其中单纯病毒感染检出率为47.13%,单纯细菌感染检出率为16.21%,混合感染检出率为33.40%;细菌类型以流感嗜血杆菌为主,病毒类型以呼吸道合胞病毒A为主;不同年龄儿童上呼吸道病毒感染阳性率差异有统计学意义(P<0.05);不同季节儿童上呼吸道细菌和病毒感染阳性率差异有统计学意义(P<0.05);不同地区儿童上呼吸道病毒感染阳性率差异有统计学意义(P<0.05)。结论成都地区儿童上呼吸道感染以病毒感染为主,流感嗜血杆菌和呼吸道合胞病毒A为儿童上呼吸道感染的主要病原体,0~1岁为上呼吸道细菌感染高发年龄,1~4岁为上呼吸道病毒感染高发年龄,冬季和城区儿童上呼吸道感染阳性率较高。     

儿童急性呼吸道感染578例病毒检测分析

目的 了解三门峡地区儿童急性呼吸道感染(ARI)的病毒病原学构成,指导临床诊断与治疗。方法 采集578例ARI住院患儿的鼻咽拭子,采用直接免疫荧光法检测7种病毒即呼吸道合胞病毒(RSV)、腺病毒(ADV)、副流感病毒Ⅰ、Ⅱ、Ⅲ(PIVⅠ～Ⅲ)、流感病毒A、B型(IVA、IVB)。结果 儿童ARI的病毒总检出率为61.59%,混合感染占45.22%。病毒总检出率冬季最高(77.35%)、夏季最低(25.00%)。下呼吸道感染的病毒总检出率高于上呼吸道感染。RSV、PIVⅢ、IVA的检出率位居前三位,分别为30.62%、28.89%、21.97%。RSV及PIVⅢ在秋冬季、下呼吸道感染、3岁以下患儿中检出率较高;IVA在冬季、上呼吸道感染患儿中检出率较高。结论 RSV 、PIVⅢ、IVA是三门峡地区儿童急性呼吸道感染的主要病毒病原。RSV 、PIVⅢ是秋冬季节婴幼儿下呼吸道感染的主要病原;IVA是冬季各年龄患儿上呼吸道感染的主要病原。通过检测儿童ARI的病毒病原,对尽早明确病毒病原,避免滥用抗生素具有重要意义。     

The viral etiology of acute respiratory infections in children in Uganda.

The role of viruses in respiratory diseases of young children in Uganda was studied. A viral etiology was established in 36% of the infections investigated. The most important pathogens were found to be respiratory syncytial virus and parainfluenza viruses, which were responsible for 26% of infections investigated. They caused both upper and lower respiratory tract diseases. There was little or no seasonal variation in the etiology of these infections. Adenoviruses were found to be less important and were etiologically related to only 4% of respiratory disease cases. Influenza viruses and enteroviruses were also found to be associated with respiratory infections. However, they were less frequent and their role was insignificant. The role of multiple virus infections was also insignificant.     

Severe acute respiratory syndrome coronavirus 2 and respiratory syncytial virus coinfection in children

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has infected many people around the world. Children are considered an important target group for SARS-CoV-2, as well as other viral infections such as respiratory syncytial virus infection. Both SARS-CoV-2 and respiratory syncytial virus can affect the respiratory tract. Coinfection of SARS-CoV-2 and respiratory syncytial virus can pose significant challenges in terms of diagnosis and treatment in children. This review compares the symptoms, diagnostic methods, and treatment of COVID-19 and respiratory syncytial virus infection in children.     

北京市2001-2003年3141例儿科急性呼吸道感染中副流感病毒的研究

目的探讨应用传代狗肾细胞（MDCK细胞）进行副流感病毒（PIV）的分离,了解近年来北京地区儿科急性呼吸道感染中PIV的感染状况.方法收集2001年1月至2003年12月急性呼吸道感染患儿的临床标本3141例,应用微量细胞培养法比较MDCK细胞与传代猴肾细胞（Vero细胞）用于分离PIV的敏感性;所有标本接种于MDCK细胞,结合血凝试验及间接免疫荧光法进行PIV检测.结果 Vero细胞PIV分离阳性的标本在MDCK细胞中也得到阳性结果;3141例标本中PIV阳性94例（3.0%）.1191例上呼吸道感染患儿标本中PIV135例（2.9%）,PIV311例（0.9%）;1634例下呼吸道感染患儿标本中PIV115例（0.9%）,PIV3 24例（1.5%）;207例支气管哮喘患儿标本中PIV阳性3例（1.4%）;38例发热患儿中PIV阳性1例;71例其他标本中PIV阳性5例.结论利用MDCK细胞可进行PIV的分离;北京地区儿科急性呼吸道感染中PIV感染是原因之一.     

Enterovirus 68 in children with acute respiratory tract infections, Osaka, Japan

Enterovirus 68 strains were detected in 14 specimens from children with respiratory tract infections and 1 specimen from a child with febrile convulsions during 2010 in Osaka, Japan. These strains had deletions in the 5' untranslated region and were genetically different from reported strains. This virus is associated with respiratory tract infections in Japan.     

Human metapneumovirus infections in hospitalized children

We evaluated the percentage of hospitalizations for acute respiratory tract infections in children < or =3 years of age attributable to human metapneumovirus (HMPV) and other respiratory viruses in a prospective study during winter and spring 2002. We used real-time polymerase chain assays and other conventional diagnostic methods to detect HMPV, human respiratory syncytial virus (HRSV), and influenza viruses in nasopharyngeal aspirates of children. HMPV was detected in 12 (6%) of the 208 children hospitalized for acute respiratory tract infections, HRSV in 118 (57%), and influenza A in 49 (24%). Bronchiolitis was diagnosed in 8 (68%) and pneumonitis in 2 (17%) of HMPV-infected children; of those with HRSV infection, bronchiolitiss was diagnosed in 99 (84%) and pneumonitis in 30 (25%). None of the HMPV-infected children was admitted to an intensive-care unit, whereas 15% of those with HRSV or influenza A infections were admitted. HMPV is an important cause of illness in young children with a similar, although less severe, clinical presentation to that of HRSV.     

武汉地区冬春季儿童急性呼吸道感染病原学研究

目的 了解武汉地区冬春季儿童急性呼吸道感染不同病原体的检出率、构成等相关流行病学特征.方法 对6348例于2010年10月-2011年3月到医院就诊,诊断为呼吸道感染的儿童,用间接免疫荧光法检测9种呼吸道病原体IgM抗体.结果 病原体总阳性检出率为34.40％,9种病原体检出率由高到低依次为:肺炎支原体占21.88％、腺病毒占10.41％、乙型流感病毒占10.03％、呼吸道合胞病毒占7.36％、副流感病毒占5.01％、肺炎军团菌血清1型占1.02％、甲型流感病毒占0.72％、Q热立克次体占0.09％、肺炎衣原体0.02％;肺炎支原体在整个冬春季其间检出率均较高,腺病毒在10月份检出率较低,但在随后月份中其检出率均比较高,乙型流感病毒在2011年1月呈暴发态势,阳性病例数和检出率上升5倍,呼吸道合胞病毒阳性检出率在2010年12月份达到最高.结论 引起武汉地区冬春季急性呼吸道感染患儿的主要病原体为肺炎支原体、腺病毒、乙型流感病毒、呼吸道合胞病毒、副流感病毒,且乙型流感病毒在2011年1月有暴发流行的趋势.     

人类偏肺病毒的研究进展

人类偏肺病毒是人类呼吸道感染病毒,多发于婴幼儿、老年人和免疫抑制的患者.大约有5%～10%的急性呼吸道感染住院患儿是由人类偏肺病毒所致,现就其病毒学、流行特点及临床特征等方面综述如下.     

Infections à Bocavirus humain

Human Bocavirus (HboV) was recently cloned by a systematic screening of nasopharyngeal samples from children hospitalized for respiratory tract infections. This virus, genus Bocavirus, family Parvoviridae, was identified by screening for its DNA in 5% of nasopharyngeal aspirates, as reported in several studies. It may be responsible for upper and lower respiratory tract infections of young children under five years with a peak rate in winter. Because of a high rate of viral co-infections, its pathogenic role in these infections should be documented. Further studies are required to determine the role of this possibly systemic virus in other affections.     

A seven-year study of WHO virus laboratory reports on respiratory viruses

In 1963 the World Health Organization established a system for the collection and distribution of information on viruses. By 1973 laboratories in 45 countries were participating in this scheme. The present study is an analysis of the reports on adenovirus, influenza viruses A, B, and C, parainfluenza virus, respiratory syncytial (RS) virus, rhinovirus, and Mycoplasma pneumoniae during 1967-73. In the northern hemisphere, from which over 95% of the reports were received, a clear pattern of the seasonal incidence of different respiratory tract infections emerged. Over 70% of the total number of reported adenovirus infections, over 80% of the parainfluenza virus infections, and over 90% of the RS virus infections were in children. M. pneumoniae infections were most frequently reported in adults. Influenza A virus infection was predominant in the adult population, with a high proportion in those aged 60 years and over. Influenza B infections were reported equally in adults and children, but over one third were in children of school age. The proportion of lower respiratory infections to total respiratory infections varied from one virus to another, and ranged from less than half for adenovirus to over four fifths for mycoplasma infections. Nonlocalizing fever was usually the second principal clinical condition reported in association with respiratory viruses.     

儿童反复上呼吸道感染与血浆抗菌肽LL-37及维生素D水平的相关性研究

目的 分析人血浆抗菌肽LL-37、25羟维生素D₃与儿童反复上呼吸道感染的相关性,以期为儿童反复上呼吸道感染的防治提供依据。方法 2018年2－8月选取在河北大学附属医院就诊的24例反复上呼吸道感染患儿为实验组,对照组为24例同期健康儿童。两组对象均空腹采血,检测血浆LL-37、25羟维生素D₃含量,同时记录反复呼吸道感染患儿既往1年内发生上呼吸道感染的次数。结果 实验组患儿血浆25羟维生素D₃含量(18.37±5.50) ng/ml与血浆抗菌肽LL-37水平(3.45±0.98) ng/ml明显低于健康对照组(29.24±9.04) ng/ml、(8.93±2.23) ng/ml(P＜0.05)。实验组患儿血浆25羟维生素D₃含量、LL-37水平均与上呼吸道感染次数呈负相关(r=-0.645、-0.560,P＜0.05);血浆25羟维生素D₃含量与血浆LL-37水平呈正相关(r=0.908,P＜0.05)。结论 维生素D缺乏与反复上呼吸道感染发生有关,反复上呼吸道感染患儿血浆LL-37水平下降,且25羟维生素D₃缺乏可能是反复上呼吸道感染患儿血浆LL-37水平下降的重要原因。     

Human metapneumovirus--new identified virus infecting human respiratory tract

Some information regarding some characteristics of new identified virus, causing human respiratory diseases (named human metapneumovirus--hMPV) has been written. Moreover, areas of existing, frequency of infections, the possibility of diagnosis have been included. This virus has been isolated and identified by Dutch researcher, van den Hoogen, for the first time in 2001. It is suggested that hMPV belongs to Paramyxoviridae family, Pneumovirinae subfamily, Metapneumovirus genus, but it has not been confirmed by the Committee of the Taxonomy of Viruses, yet. This virus has been reported and demonstrated to be present mostly in children, but also in elderly people over 65, in Europe, North America, Australia and Asia, suggesting a worldwide distribution. Serological studies showed that all children in Netherlands had been exposed to hMPV by the age of 5; it means that infections with hMPV are common in the childhood. The presence of antibodies in retrospective serum and the presence of virus in numerous retrospective specimens taken from individuals with respiratory infections in which an etiologic agent was not initially detected indicates that this virus had been circulating in human beings for at least 50 years. Clinical diseases associated with hMPV appears to be similar to those ones associated with human respiratory syncytial virus (hRSV), ranging from mild upper respiratory tract infection to bronchiolitis and bronchopneumonia. Preliminary studies indicate that hMPV should be added to the list of pathogens associated with severe respiratory tract infections in immunocompromised patients and in chronic respiratory diseases patients (eg. asthma).     

西安地区儿童副流感病毒感染状况分析

【目的】 分析西安地区儿童副流感病毒(parainfluenza virus,PIV)感染情况及与中性粒细胞减少的关系。 【方法】 采用酶联免疫吸附(ELISA)法检测血清中副流感病毒特异性IgM抗体(PIV-IgM),血细胞分析仪检测外周血白细胞。 【结果】 1~6岁年龄组PIV感染阳性率较其他年龄组明显升高,1~3岁年龄组中性粒细胞减少症发生率较高,PIV感染与中性粒细胞减少的发生关系密切。 【结论】 西安地区儿童呼吸道PIV感染阳性率较高,常规进行病原血清特异性抗体检测有助于临床医生合理用药。     

儿童八项呼吸道感染病原体IgM抗体检测分析

目的了解宁海地区0岁~14岁儿童八项呼吸道病原体IgM检测结果及流行情况,为儿童呼吸道疾病提供科学诊治依据。方法收集本院儿科2017年5月-2018年4月的0岁~14岁1 782例儿童血清,采用间接免疫荧光法检测流感病毒A(INFA)、流感病毒B(INFB)、呼吸道合胞病毒(RSV)等八项呼吸道病原体IgM抗体,分析不同性别、年龄和季节患儿感染情况。结果总阳性标本检出率为57.52%,前三位分别为INFB(41.75%)、MP(37.03%)、INFA(20.37%);不同年龄组IgM阳性率差异有统计学意义(χ^2=216.892,P<0.05),学龄组阳性率最高(78.31%);不同季节阳性检出率差异无统计学意义(χ^2=5.213,P>0.05);女童阳性率高于男童(χ^2=64.875,P<0.05)。结论 INFB、MP和INFA是宁海地区儿童最主要的呼吸道感染病原体,不同年龄段和性别存在显著差异,应针对性采用有效的措施预防感染。     

Risk factors for acute respiratory tract infections in young Greenlandic children

Acute respiratory infections cause considerable morbidity among Inuit children, but there is very little information on the risk factors for these infections in this population. To identify such factors, the authors performed a prospective community-based study of acute respiratory infections in an open cohort of 288 children aged 0-2 years in the town of Sisimiut, Greenland. Between July 1996 and August 1998, children were monitored weekly, and episodes of upper and lower respiratory tract infections were registered. Risk factor analyses were carried out using a multivariate Poisson regression model adjusted for age. Risk factors for upper respiratory tract infections included attending a child-care center (relative risk = 1.7 compared with home care) and sharing a bedroom with adults (relative risk = 2.5 for one adult and 3.1 for two adults). Risk factors for lower respiratory tract infections included being a boy (relative risk = 1.5), attending a child-care center (relative risk = 3.3), exposure to passive smoking (relative risk = 2.1), and sharing a bedroom with children aged 0-5 years (relative risk = 2.0 for two other children). Breastfeeding tended to be protective for lower respiratory tract infections. The population-attributable risk of lower respiratory tract infections associated with passive smoking and child-care centers was 47% and 48%, respectively. The incidence of acute respiratory infections among Inuit children may be reduced substantially through public health measures.     

反复呼吸道感染学龄前儿童气质和行为特点研究

【目的】 探讨反复呼吸道感染学龄前儿童气质和行为特点,为能正确教育、抚养该类儿童提供理论依据。 【方法】 在5所幼儿园选择4~5岁反复呼吸道感染学龄前儿童145例为观察组,同龄健康儿童244例作为对照组,采用“NYLS 3~7岁儿童气质问卷”和“Achenbach儿童行为量表父母问卷”进行儿童气质和行为测评。 【结果】 观察组气质类型分布以及气质维度在活动水平、规律性、趋避性、适应性、反应强度、注意力分散度上和对照组差异有统计学意义(P均<0.05);适应性是反复呼吸道感染的相关因子;观察组男童的行为问题检出率和躯体诉述、抑郁、幼稚不成熟、分裂样、攻击5个因子与对照组男童比较差异均有统计学意义(P均<0.05);观察组女童的行为问题检出率和行为8个因子与对照组比较差异均有统计学意义(P均<0.05)。 【结论】 反复呼吸道感染儿童的气质特点与正常儿童不同,适应性是发生反复呼吸道感染的相关因子,反复呼吸道感染儿童易发生行为问题。     

Clinical and epidemiological aspects of respiratory syncytial virus lower respiratory tract infections

This paper has analyzed respiratory syncytial virus lower respiratory tract infections in 201 hospitalized children. In children with wheezing, erythrocyte sedimentation rate (ESR) was significantly higher in those with pneumonia than with syndroma pertussis, while the white blood cell (WBC) count was significantly lower in patients with bronchitis than in those with bronchiolitis and syndroma pertussis. Bronchodilatators were applied in 75.6% and corticosteroids in 20% of patients. Ten patients were ventilated. Fatal disease outcome was observed in one infant. Twelve consecutive-year study of respiratory syncytial virus (RSV) infections showed that 27.3% of these diseases were bronchiolitis and pneumonia.     

商州地区5岁以下小儿下呼吸道感染1 200例病原学检测分析

目的 分析商州地区1 200例5岁以下小儿下呼吸道感染患儿的病原学检测结果,为临床诊治提供参考依据。 方法 对商州地区1 200例5岁以下下呼吸道感染患儿呼吸道分泌物进行病原学鉴定和药敏试验,并对检测结果进行统计学分析。 结果 <3个月的下呼吸道感染的患儿病原检测阳性率最高,高达75.9%(309/407),病原检测的阳性率随患儿年龄增大逐渐降低。3岁以下患儿以感染呼吸道合胞病毒最常见。患儿细菌感染以肺炎克雷伯菌最常见,肺炎链球菌和大肠埃希菌次之。肺炎球菌对于头孢类药物以及非常规使用的抗生素诸如利福平、氯霉素、万古霉素等敏感性好。肺炎克雷伯菌以及大肠埃希菌对于亚胺培南均有很高的敏感性。 结论 病毒学检测、细菌学检测以及细菌药敏试验对于下呼吸道感染的诊断及治疗均有着重要的意义。     

2017—2019年孝感市儿童呼吸道病毒感染流行病学特征

目的 对湖北省孝感市0~13岁呼吸道感染患儿进行病毒病原学检测,分析呼吸道病毒感染病原学特点,为0~13岁儿童呼吸道感染的预防、诊断和治疗提供科学依据。 方法 通过采集2017年1月1日—2019年12月31日,在湖北省孝感市中心医院就诊的呼吸道感染患儿的咽拭子标本,采用实时荧光定量 PCR,进行七项呼吸道病毒检测。 结果 共采集12 486例标本,其中3 309例标本为阳性,总阳性率为26.5%。其中呼吸道合胞病毒 (respiratory syncytial virus, RSV) 阳性率最高,为1 574 例 (12.6%)。阳性率随着年龄的增加而下降,各年龄组间病毒阳性率差异有统计学意义(χ²=318.972,P<0.001)。0~1岁组病毒阳性率最高(32.1%)。0~1岁组和~3岁组,RSV检出率最高分别为18.7%和9.4%。~6岁组和~13岁组,腺病毒(adenovirus, ADV)检出率最高分别为8.1%和4.6%。各季节间,病毒阳性率差异有统计学意义(χ²=822.421,P<0.001)。春季,副流感病毒Ⅲ (parainfluenza virus Ⅲ, PIV Ⅲ)检出率最高;夏季,ADV检出率最高;秋、冬季,RSV检出率最高。 结论 对于0~1岁的婴幼儿,冬、春季,应重点预防RSV感染,而夏季应重点预防PIVⅢ感染。而对于>1岁的儿童,在春、夏两季应注意ADV的感染,冬季应注意预防FluA、FluB的感染。