福州地区急性呼吸道感染患儿呼吸道合胞病毒检测及亚型分析

目的:分析福州地区2006-2007年冬春季我院收治急性呼吸道感染患儿呼吸道合胞病毒(RSV)及其亚型流行情况。方法:采用RT-PCR方法检测176例急性呼吸道感染患儿的鼻咽拭子中RSV并进行亚型鉴定分析。结果:(1)在176例标本中,RSV阳性28例(15.9%)。其中急性下呼吸道感染阳性率为38%,显著高于急性上呼吸道感染的4%(!2=33.15,P<0.05)。(2)28例RSV阳性标本中,A亚型23例(82%),B亚型4例(14%),不明分型者1例(4%);上、下呼吸道感染组患儿间RSV亚型分布差异无显著性(P>0.05),都以A型为主。(3)RSV阳性患儿的年龄主要以3岁以下为主。结论:RSV是婴幼儿急性下呼吸道感染的重要病原体;福州地区2006-2007年冬春季RSV两种亚型同时流行,以A亚型为主。     

鼻咽拭子与口咽拭子呼吸道病毒抗原检出率比较

目的 比较鼻咽拭子与口咽拭子常见呼吸道病毒抗原阳性检出率,为临床选择样本类型提供参考.方法 选取199例上呼吸道感染患儿,同时采集其口咽拭子和鼻咽拭子样本,按随机原则确定不同患儿采集2个部位样本的先后顺序.2份样本同时送检,采用胶体金免疫分析法检测流行性感冒病毒(Flu)A、FluB、呼吸道合胞病毒(RSV)和腺病毒(...     

RT—PCR检测呼吸道合胞病毒的研究

呼吸道合胞病毒是婴幼儿支气管炎和肺炎最常见的病原之一。应用逆转录－聚合酶链式反应对检测ＲＳＶ的方法进行了研究。采用的引物特异性扩增ＲＳＶ Ｆ糖蛋白Ｆ１亚基的一个片段，计算机检索与其它常见呼吸道病毒无同源性。敏感性测定显示该方法ＲＳＶ最低量为１０ＴＣＩＤ５０Ｓ。这些结果表明ＲＴ－ＰＣＲ可作为快速诊断ＲＳ的有效方法，在临床上推广应用。     

江苏省常州地区急性呼吸道感染患儿呼吸道合胞病毒流行病学特点

目的探讨常州地区急性呼吸道感染（ARTI）患儿呼吸道合胞病毒（RSV）的流行病学特点。方法选取2011年1月—2012年12月在本院就诊的ARTI患儿3483例。采集患儿鼻咽分泌物,直接免疫荧光法检测RSV病毒抗原。结果所有患儿中共检出RSV阳性标本627例,总阳性率为18.00%（627/3843）,其中2011年阳性率为22.96%（306/1333）,2012年阳性率为14.93%（321/2150）,2011年RSV感染率明显高于2012年,差异有统计学意义（χ2=35.904,P=0.000）。男孩RSV感染率明显高于女孩。随年龄的增加,RSV感染率逐渐下降,新生儿感染率最高。RSV流行高峰期在每年的冬春季节,且毛细支气管炎患儿为好发人群。结论 RSV是常州地区ARTI患儿的重要病原体,3岁以内儿童多见,好发于冬春季,在毛细支气管炎患儿中检出率最高。     

实时逆转录聚合酶链反应快速鉴别呼吸道合胞病毒亚型

呼吸道合胞病毒（RSV）是婴幼儿时期急性下呼吸道感染最主要的病原体。近年发展起来的实时聚合酶链反应技术具有灵敏度高、特异性好、方法简便等特点，广泛应用于病原体的检测。为此，我们设计并建立了用SYBR Green I实时逆转录PCR结合融解曲线分析快速鉴别呼吸道合胞病毒A、B亚型的方法。     

急性呼吸道感染患儿三类RNA病毒的检测及意义

急性呼吸道感染是儿童常见病、多发病，病毒是主要病原体之一。为获得人类偏肺病毒（hMPV）、鼻病毒（hRV）、冠状病毒（COV）等，三类RNA病毒在重庆地区急性呼吸道感染住院患儿中的流行病学资料，我们建立了hMPV、hRV、COV等RNAPCR检测技术，并对本地区258例急性呼吸道感染住院患儿鼻咽分泌物中提取的病毒RNA同时进行检测，部分样品逆转录-聚合酶链反应（RT-PCR）产物进行核酸序列分析。     

呼吸道病毒定植与哮喘病严重度的关系

目的 比较致死样哮喘（NFA）缓解期患者与健康人中常见的呼吸道病毒的分布差异。方法 研究对象包括NFA缓解期患者12例．轻症哮喘患者2I例及无哮喘病史的健康人52名。诱导痰用于RNA及DNA的提取．PCR及RT-PCR方法用于7种常见的呼吸道病毒，微小病毒（HRV），流感病毒A、B，副流感病毒1、3，呼吸道合胞病毒及腺病毒的检测。结果 NFA缓解期患者的病毒检出率为42％（5／12）．而轻症患者为24％（5／2I），健康人为10％（5／52）。NFA患者的病毒检出率显著高于健康人。微小病毒、流感病毒A、B可存在于NFA缓解期患者的下呼吸道内。而健康人呼吸道内以微小病毒为主。哮喘患者气道内存在2种以上病毒定植的情况。结论 呼吸道病毒可定植于哮喘患者及健康人的气道内而不诱发呼吸道症状，呼吸道病毒定植可能与哮喘的严重度有关。     

多重RT-PCR与毛细电泳联用技术在儿童下呼吸道感染病原体检测中的应用

目的 采用多重逆转录聚合酶链反应(RT-PCR)与毛细电泳联用技术对13种儿童呼吸道常见病原体痰液标本进行检测,研讨其在儿童下呼吸道感染病原体检测中的价值.方法 采集2019年12月至2020年1月该院38例因下呼吸道感染住院患儿的痰液标本,应用多重RT-PCR技术检测13种呼吸道病原体,同时采用直接免疫荧光法检测7种...     

Incidence of bacterial coinfection with respiratory syncytial virus bronchopulmonary infection in pediatric inpatients

Bacterial coinfection occurs in pediatric bronchopulmonary infections caused by respiratory syncytial virus (RSV), but the incidence is uncertain. Our subjects are 188 pediatric inpatients having RSV bronchopulmonary infection in two hospitals in Chiba Prefecture between 2005 and 2007. On admission, antigen detection kits using nasopharyngeal aspirate were performed to detect RSV infection and washed sputum bacterial culture was performed to detect bacterial infection. Of the 188 pediatric inpatients with RSV bronchopulmonary infection, 95 (50.5%) patients were aged less than 1 year, 57 (30.3%) were aged 1–2 years, and 36 (19.1%) were aged 2 years or more. Thirty-six (19.1%) patients were associated with bronchial asthma attacks. Pathogenic bacteria were predominantly isolated from 43.6% of the patients. The three most frequently isolated bacteria were Haemophilus influenzae (43.9%), Streptococcus pneumoniae (36.6%), and Moraxella catarrhalis (29.3%). We found that 38.9% of H. influenzae strains were β-lactamase-nonproducing ampicillin-resistant strains. All S. pneumoniae strains were penicillin G (PcG) sensitive. However, 21.9% of S. pneumoniae strains showed PcG minimum inhibitory concentration values of 2 μg/ml. RSV bronchopulmonary infections in hospitalized children are often associated with antimicrobial-resistant bacterial infection in their lower airways. These results indicate that we should be aware of bacterial coinfections in the management of pediatric inpatients with RSV bronchopulmonary infection.     

Inhaled nitric oxide for a severe respiratory syncytial virus infection in an infant with bronchopulmonary dysplasia

Objective To report the first case of ARDS in children treated with nitric oxide (NO) inhalation.Methods A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concentration of 20–80 ppm for 7 days. NO and NO₂ were continuously monitored (Polyton Draeger). Respiratory mechanics were evaluated by using the method of passive inflation by the ventilator.Results NO inhalation improved oxygenation (tcSaO₂) and reduced respiratory system resistance without affecting arterial pressure. NO₂ level remained below 5 ppm, and methaemoglobin level below 1%. The child survived without neurologic sequela.Conclusions Two mechanisms to explain oxygenation improvement can be suggested:selective improvement in perfusion of ventilated regions and bronchodilation.     

呼吸道合胞病毒RNA及IgM在小儿呼吸道感染诊断中的应用价值

目的探讨呼吸道合胞病毒RNA(RSV-RNA)及呼吸道合胞病毒IgM(RSV-IgM)在小儿呼吸道感染诊断中的应用价值。方法选取2015年9月至2017年4月确诊呼吸道合胞病毒感染患儿56例,收集其咽部分泌物标本,对RSV-RNA进行检测;另抽取患儿空腹静脉血,对RSV-IgM进行检测,对两者的阳性检出率及与年龄、发病时间的相关性进行统计学分析。结果 RSV-RNA、RSV-IgM阳性检出率分别为89.29%、32.14%,RSV-RNA的阳性检出率显著高于RSV-IgM,差异有统计学意义(P0.05)。≤6个月,6个月至1岁患儿的RSV-RNA阳性检出率均高于RSV-IgM(P0.05);发病时间≤7d的患儿RSVRNA的阳性检出率高于RSV-IgM(P0.05)。结论在小儿RSV感染检测中,检测RNA比IgM具有更高的准确性,尤其是对年龄≤1岁、发病时间较短(≤7d)的患儿,早期诊断具有重要指导作用。     

A community health concern: respiratory syncytial virus and children

Respiratory syncytial virus (RSV) is a significant health issue. Nearly all children contract RSV by 3 years of age. This virus causes mild cold-like symptoms in older children and adults. However, in infants and toddlers, it causes serious lower respiratory tract infections. Recovery from RSV can be lengthy, and caring for an unwell child can become a burden for a family. Prevention plans for those children that are at highest risk have been helpful in reducing the incidence of RSV. The American Academy of Pediatrics outlines the use of Palivizumab as part of its RSV prevention guidelines.     

Evidence for a causal relationship between respiratory syncytial virus infection and asthma

Respiratory syncytial virus (RSV) infects all children early in life, is the most common cause of infant lower respiratory tract infections, and causes disease exacerbations in children with asthma. Episodes of lower respiratory tract infection in early life are associated with asthma development. Whether RSV infection early in life directly causes asthma or simply identifies infants who are genetically predisposed to develop subsequent wheezing is debatable. Recent studies suggest that these two explanations are not mutually exclusive, and are likely both important in asthma development. An open-label study of RSV immunoprophylaxis administered to preterm infants reduced recurrent wheezing by 50%. Clinical trials of infant RSV prevention, delay or severity reduction on the outcome of childhood asthma would confirm the causal relationship between RSV infection and asthma, and offer a primary prevention strategy.     

呼吸道合胞病毒A与B亚型多重荧光PCR检测方法的建立及应用

目的建立一种新的呼吸道合胞病毒(RSV)分型检测方法,用于快速检测和监测。方法针对RSV G基因设计引物、探针,并引入人β-actin基因(ACTB)作为内参质控,建立RSV-A、RSV-B多重荧光PCR检测方法。使用多种常用呼吸道病原体及体外转录RNA产物考核其特异性和灵敏度。并对2015年1月至12月广州两家医院的儿童急性呼吸道感染患者进行检测。结果所建立的多重检测方法未见非特异性反应。RSV-A、RSV-B和ACTB分别可检测低至4、8和12 copies/μL的RNA模板,且分别在10~1×10~(10)copies/μL、100~1×10~(10)copies/μL和100~1×10~(10)copies/μL时具备良好的线性关系,线性相关系数r2均大于0.99。儿童急性呼吸道感染患者监测中,RSV-A为期间优势亚型。结论本研究所建立的RSV-A、RSV-B多重荧光PCR检测方法,具有较好的特异性、灵敏度、可操作性,可用于相关研究。     

Concurrent bacterial infection and prolonged mechanical ventilation in infants with respiratory syncytial virus lower respiratory tract disease

Objective To identify demographic, clinical, and laboratory variables predictive for a concurrent bacterial pulmonary infection in ventilated infants with respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) and investigate antimicrobial drug use.Design and setting Retrospective, observational study in a 14-bed pediatric intensive care unit.Patients 82 infants younger than 1 year of age with a virologically confirmed RSV LRTD during 1996 – 2001, of whom 65 were mechanically ventilated.Results Microbiological data were available from 38 ventilated infants, 10 of whom had a positive blood culture (n=1) or endotracheal aspirate (n=9) obtained upon admission to the pediatric intensive care unit (PICU). Infants with a positive culture had a lower mean gestational age but were otherwise demographically comparable to those with negative culture results. Infants with a positive culture were ventilated 4 days longer. Indicators for a concurrent bacterial infection were comparable between ventilated and nonventilated infants. Antimicrobial drugs were used in 95.1% of infants (100% of ventilated infants) with a mean duration of 7.8±0.3 days. The moment of initiation and duration of antimicrobial drug treatment varied considerably.Conclusions We observed in ventilated infants a low occurrence of concurrent bacterial pulmonary infection, but infants with positive cultures needed prolonged ventilatory support. Improvement in the diagnosis of a pulmonary bacterial infection is warranted to reduce the overuse of antimicrobial drugs among ventilated infants with RSV LRTD and to restrict these drugs to the proper patients.