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Impact of respiratory virus infections on persons with chronic underlying conditions 总被引:22,自引:0,他引:22
CONTEXT: While hospitalization rates have declined overall, hospitalizations for acute lower respiratory tract infections have increased steadily since 1980. Development of new approaches for prevention of acute respiratory tract conditions requires studies of the etiologies of infections and quantification of the risk of hospitalization for vulnerable patients. OBJECTIVE: To determine the frequency of specific virus infections associated with acute respiratory tract conditions leading to hospitalization of chronically ill patients. DESIGN: Analysis of viral etiology of patients hospitalized with acute respiratory tract conditions between July 1991 and June 1995. SETTING: Four large clinics and related hospitals serving diverse populations representative of Harris County, Texas. PATIENTS: A total of 1029 patients who were hospitalized for pneumonia, tracheobronchitis, bronchiolitis, croup, exacerbations of asthma or chronic obstructive pulmonary disease, and/or congestive heart failure. MAIN OUTCOME MEASURE: Virus infection, defined by culture, antigen detection, and significant rise in serum antibodies, by underlying condition; hospitalization rates by low- vs middle-income status. RESULTS: Ninety-three percent of patients older than 5 years had a chronic underlying condition; a chronic pulmonary condition was most common. Patients with chronic pulmonary disease from low-income populations were hospitalized at a rate of 398.6 per 10000, almost 8 times higher than the rate for patients from middle-income groups (52.2 per 10000; P<.001). Of the 403 patients (44.4% of adults and 32.3% of children) who submitted convalescent serum specimens for antibody testing, respiratory tract virus infections were detected in 181 (44.9%). Influenza, parainfluenza, and respiratory syncytial virus (RSV) infections accounted for 75% of all virus infections. CONCLUSIONS: Our study suggests that respiratory virus infections commonly trigger serious acute respiratory conditions that result in hospitalization of patients with chronic underlying conditions, highlighting the need for development of effective vaccines for these viruses, especially for parainfluenza and RSV. 相似文献
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Human bocavirus in children suffering from acute lower respiratory tract infection in Beijing Children’s Hospital 总被引:1,自引:0,他引:1
ZHANG Li-li TANG Liu-ying XIE Zheng-de TAN Xiao-juan LI Chong-shan CUI Ai-li JI Yi-xin XU Song-tao MAO Nai-ying XU Wen-bo SHEN Kun-ling 《中华医学杂志(英文版)》2008,121(17):1607-1610
Background Human bocavirus (HBoV) is a parvovirus recently found to possibly cause respiratory tract disease in children and adults. This study investigated HBoV infection and its clinical characteristics in children younger than five years of age suffering from acute lower respiratory tract infection in Beijing Children's Hospital. Methods Nasopharyngeal aspirates were collected from children suffering from acute lower respiratory tract infection during the winters of 2004 to 2006 (from November through the following February). HBoV was detected by polymerase chain reaction amplification and virus isolation and the amplification products were sequenced for identification. Results HBoV infection was detected in 16 of 333 study subjects. Coinfections with respiratory syncytial virus were detected in 3 of 16 HBoV positive patients with acute lower respiratory tract infection. The median age for HBoV positive children was 8 months (mean age, 17 months; range, 3 to 57 months). Among the HBoV positive children, 14 were younger than 3 years old, 9 were younger than 1 year old and 7 were younger than 6 months. These 16 positive HBoV children exhibited coughing and abnormal chest radiography findings and more than 60% of these children had wheezing and fever. Ten children were clinically diagnosed with pneumonia, 2 bronchiolitis, 2 acute bronchitis and 2 asthma. One child died. Conclusions HBoV was detected in about 5% of children with acute lower respiratory infection seen in Beijing Children's HosPital. Further investigations regarding clinical and epidemiologic characteristics of HBoV infection are needed. 相似文献
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聊城地区呼吸道合胞病毒致小儿下呼吸道感染的临床研究 总被引:1,自引:0,他引:1
目的了解呼吸道合胞病毒(RSV)在小儿急性下呼吸道感染中的发生率和临床特征。方法对我院2007年10月-2008年10月临床诊断为急性下呼吸道感染的住院患儿556例行痰直接免疫荧光法检测呼吸道合胞病毒抗原。结果556例患儿中,阳性193例,阳性率34.71%,其中男132例(23.74%),女61例(10.97%),男女发病比例为2.16:1。全年均可检出RSV,发病率最高的是11、12、1、2月份(43.06%),最低的是5~8月份(16.36%)。RSV感染多见于3岁以下,尤以6个月以下忠儿感染率最高(44.50%)。结论呼吸道合胞病毒是引起小儿急性下呼吸道感染的主要病原,特别是婴幼儿感染率最高。 相似文献
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Changing patterns of asthma hospitalization among children: 1979 to 1987 总被引:21,自引:1,他引:20
The National Hospital Discharge Survey was used to evaluate the trends in asthma hospitalizations among children under International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM): 1979 to 1987. During this period, asthma hospitalizations among children aged 0 to 17 years increased 4.5% per annum (95% confidence interval [Cl], 2% to 7.1%). The increase was largest among 0 to 4 year olds, 5.0% per annum (95% Cl, 3.4% to 6.7%), vs 2.9% per annum (95% Cl, -0.3% to 6.2%) observed among 5 to 17 year olds. Among children aged 0 to 4 years, blacks had approximately 1.8 times the increase of whites. During this time, total hospitalizations decreased -4.6% (95% Cl, -6.6% to -2.5%), while admissions for lower respiratory tract disease had a statistically insignificant decrease: -1.3%. Acute and chronic/unspecified bronchitis hospitalizations decreased -6.1% (95% Cl, -9.4% to -2.7%), but this decrease did not begin until 1983. Thus, a shift in coding from bronchitis to asthma does not seem to fully explain the increase. 相似文献
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Mortality associated with influenza and respiratory syncytial virus in the United States 总被引:45,自引:8,他引:37
CONTEXT: Influenza and respiratory syncytial virus (RSV) cause substantial morbidity and mortality. Statistical methods used to estimate deaths in the United States attributable to influenza have not accounted for RSV circulation. OBJECTIVE: To develop a statistical model using national mortality and viral surveillance data to estimate annual influenza- and RSV-associated deaths in the United States, by age group, virus, and influenza type and subtype. DESIGN, SETTING, AND POPULATION: Age-specific Poisson regression models using national viral surveillance data for the 1976-1977 through 1998-1999 seasons were used to estimate influenza-associated deaths. Influenza- and RSV-associated deaths were simultaneously estimated for the 1990-1991 through 1998-1999 seasons. MAIN OUTCOME MEASURES: Attributable deaths for 3 categories: underlying pneumonia and influenza, underlying respiratory and circulatory, and all causes. RESULTS: Annual estimates of influenza-associated deaths increased significantly between the 1976-1977 and 1998-1999 seasons for all 3 death categories (P<.001 for each category). For the 1990-1991 through 1998-1999 seasons, the greatest mean numbers of deaths were associated with influenza A(H3N2) viruses, followed by RSV, influenza B, and influenza A(H1N1). Influenza viruses and RSV, respectively, were associated with annual means (SD) of 8097 (3084) and 2707 (196) underlying pneumonia and influenza deaths, 36 155 (11 055) and 11 321 (668) underlying respiratory and circulatory deaths, and 51 203 (15 081) and 17 358 (1086) all-cause deaths. For underlying respiratory and circulatory deaths, 90% of influenza- and 78% of RSV-associated deaths occurred among persons aged 65 years or older. Influenza was associated with more deaths than RSV in all age groups except for children younger than 1 year. On average, influenza was associated with 3 times as many deaths as RSV. CONCLUSIONS: Mortality associated with both influenza and RSV circulation disproportionately affects elderly persons. Influenza deaths have increased substantially in the last 2 decades, in part because of aging of the population, underscoring the need for better prevention measures, including more effective vaccines and vaccination programs for elderly persons. 相似文献
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探讨某院近5 年呼吸道感染患儿肺炎支原体感染的流行病学特征。方法选取2011年1月-2015 年12 月该院呼吸科患儿378 例,比较不同年龄、性别、季节、居住地及疾病类型患儿的肺炎支原体感染情况。结果年龄≤1 岁、1~3 岁、3~5 岁、>5 岁患儿感染率分别为10.96%、19.15%、30.61%和40.71%。男性和女性患儿感染率分别为21.59%和35.10%。春、夏、秋、冬季感染率分别为18.63%、16.48%、33.68%和40.00%。城市和农村患儿感染率分别为31.12%和22.53%。大叶性肺炎、间质性肺炎、哮喘、支气管肺炎、支气管炎、上呼吸道感染、毛细支气管炎患儿感染率分别为66.67%、50.00%、46.51%、26.67%、25.00%、20.59%和10.17%。结论呼吸道感染患儿的肺炎支原体感染风险较高,年龄较大、女性及大叶性肺炎患儿更易感染,且秋、冬季是肺炎支原体感染的高发季节。 相似文献
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Over 200 strains of respiratory viruses cause a variety of human infections ranging from common cold to life-threatening pneumonia. Respiratory viruses implicated in this study are respiratory syncytial viruses (RSV), adenovirus, influenza viruses and parainfluenza viruses. The objective of this study is to determine the epidemiology of respiratory viruses in paediatric patients with lower respiratory tract infection. The methods used were direct antigen detection method, shell vial culture method and conventional tube culture method. The samples included in this study are paediatric patients seen in Universiti Kebangsaan Malaysia Hospital, Kuala Lumpur with suspected acute viral respiratory infection, presenting with acute laryngotracheobronchitis (croup), bronchiolitis and pneumonia. Nasopharyngeal aspirates were collected and processed almost immediately. A total of 222 specimens were received during February 1999 to January 2000 showing a dual peak pattern in the months of April and December. The mean age of the patients was 13 months. Pneumonia (77.9%) was the most common clinical diagnosis in children with lower respiratory tract infection. This was followed by bronchiolitis (19.4%) and croup (27%). Viral aetiologies were confirmed in 23.4% of the patients. The most common respiratory virus isolated or detected was RSV, followed by parainfluenza viruses, influenza viruses and adenovirus. 相似文献
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张媛媛 《中国现代医学杂志》2017,27(23):95-99
目的探讨急性呼吸道感染(ARI)患儿呼吸道病原体的感染情况及季节流行特点,为临床实施行之有效地预防和诊治提供依据。方法应用间接免疫荧光法(IFA)检测该院2015 年1 月-2015 年12 月3 461 例0~12 岁ARI患儿血清中呼吸道合胞病毒(RSV)、腺病毒(ADV)、甲型流感病毒(FluA)、乙型流感病毒(FluB)、副流感病毒(PIV)、肺炎支原体(MP)、肺炎衣原体(CP)、嗜肺军团菌(LP)IgM抗体。结果3 461 份血清中呼吸道感染病原体IgM 抗体阳性检出率为69.17%,最常检测到的病原体是FluB(51.1%)、FluA(36.38%)、MP(25.14%)和RSV(9.04%)。FluA、FluB和MP 感染无明显季节性,检出率整年均较高;RSV 呈现流行高峰在冬、春季;ADV和CP 为春、夏季多发;PIV和LP发病率终年较低。随年龄增长RSV发病率下降,而其他病原体则相反。病原体混合感染检出1 627 例,占47.01%;混合感染最常见病原体为FluA+FluB和FluA+FluB+MP。结论淮安地区2015 年8 种呼吸道病原体阳性率达69.17%,以FluB检出率最高;呼吸道病原体感染的流行季节各有不同;伴随年龄的增长RSV 阳性率降低,而其他病原体阳性率则逐步增长;以FluA 和FluB 的混合感染为最多见;早期检测呼吸道病原体,将有助于儿科医生诊治和控制呼吸道感染。 相似文献
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目的: 调查盐城地区急性呼吸道感染(ARI)住院患儿的病毒病原学情况,为本地区儿童ARI防治提供依据。方法: 收集2011年6月至2012年7月ARI患儿的鼻咽分泌物标本1 582份,采用直接免疫荧光法检测呼吸道合胞病毒(RSV)、流感病毒A(IVA)、流感病毒B(IVB)、副流感病毒1-3(PIV 1-3)以及腺病毒7种病毒。结果: 1 582例标本中有426例检出病毒(26.9%),其中RSV检出率最高,为289例(18.3%),其次是腺病毒,为46例(2.9%);病毒的总检出率在年龄及季节分布上有统计学差异,以6个月~1岁年龄组检出率最高,冬春季发病率较高。结论: RSV及腺病毒是盐城地区ARI住院患儿病毒感染的主要病原体,其检出率与年龄及季节分布有明显相关性。 相似文献
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目的 探讨小儿呼吸道人偏肺病毒(human metapneumovirus,hMPV)的感染阳性率、流行病学及其临床特征.方法 2002年12月至2003年12月在本科固定时间收集新入院的急性呼吸道感染患儿的鼻咽分泌物,一式两份.1份采用免疫荧光快速诊断方法用于分析包括呼吸道合胞病毒(respiratory syncytial virus,RSV)、腺病毒(adenovirus)、流感病毒(influenza virus) A、B副流感病毒(parainfluenza virus)1、2、3 这7种常见呼吸道病毒;另1份采用RT-PCR的方法检测上述患儿鼻咽分泌物中hMPV的L基因和M基因,鼻病毒与冠状病毒的基因.结果 检出 hMPV阳性标本25例,阳性率为9.7%,主要分布在秋冬季;25例hMPV阳性标本中单纯hMPV感染10例,占40%,15例(60%)系hMPV与其他病毒合并感染,其中包括8例hMPV与RSV合并感染,hMPV与鼻病毒、冠状病毒合并感染各2例,3例标本同时检出hMPV、RSV、鼻病毒为阳性;分析hMPV阳性呼吸道感染患儿的临床特征:男:女=16:9,12例(48%)临床诊断为毛细支气管炎,9例(36%)临床诊断为肺炎,4例(16%)为哮喘急性发作患儿,除hMPV和其他病毒合并感染更容易出现发热外,单纯hMPV感染与hMPV与其他病毒混合感染在发病年龄、性别、病程及临床表现上无明显差异.结论 hMPV是小儿急性呼吸道感染的重要病原,可与呼吸道其他常见病毒混合感染,仅从临床表现上很难将hMPV感染与其他呼吸道病毒感染区别. 相似文献
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Trends in hospitalization associated with traumatic brain injury. 总被引:26,自引:1,他引:25
CONTEXT: Traumatic brain injury (TBI) is associated with more than 50000 deaths in the United States each year, and recent observations suggest a substantial decline in TBI-related hospitalizations and deaths. OBJECTIVE: To analyze long-term trends in TBI-related hospitalization in the United States. DESIGN, SETTING, AND PARTICIPANTS: Analysis of existing data from 1980 through 1995 from the National Hospital Discharge Survey, an annual survey representing the US general population. The number of participating hospitals ranged from 400 to 494. MAIN OUTCOME MEASURES: Annual rates of TBI-related hospitalization, stratified by age, sex, severity of injury, and outcome. RESULTS: The annual number of TBI cases identified from the sample during the study period ranged from 1611 to 3129. Overall rates of hospitalization for TBI declined an estimated 51%, from 199 to 98 per 100000 per year. When analyzed by severity of injury, mild TBIs declined most during this period, from 130 to 51 hospitalizations per 100000 per year (61% decline; P<.001 compared with intermediate and severe TBI). The decline was greatest among those aged 5-14 years (-66%) and least among those aged 65 years or older (-9%). The ratio of male to female rates showed little variation during the study period (ratio, 1.8; 95% confidence interval [CI], 1.6-2.0), as did the in-hospital mortality rate (mean, 5.3 per 100000; 95% CI, 3.6-7.1). CONCLUSIONS: Changes in hospital practices may be a major factor in the declining rates of TBI-related hospital admissions. These practices increasingly appear to exclude persons with less severe TBI from hospital admission and shift their care to outpatient settings. 相似文献
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目的:了解小剂量阿奇霉素治疗毛细支气管炎疗效。方法:将66例3月~2岁诊断为呼吸道合胞病毒毛细支气管炎患儿分为治疗1组(阿奇霉素治疗组)和治疗2组(常规治疗组),采用抽血测定其血清半胱氨酰白三烯(CysLTs)水平,并比较两组治疗前后CysLTs变化和喘息持续时间,30例正常儿童为对照组。结果:毛细支气管炎患儿血清CysLTs水平明显高于健康对照组,经小剂量阿奇霉素治疗的患儿与常规治疗组患儿比较治疗后喘息持续时间短,血清CysLTs降低。结论:呼吸道合胞病毒毛细支气管炎患儿血清CysLTs水平明显升高,使用小剂量阿奇霉素治疗毛细支气管炎,能降低炎症反应,缩短病程。 相似文献
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目的:分析彭州地区295例住院患儿呼吸道病毒检测情况。方法采用直接免疫荧光法对295例住院患儿的鼻拭子进行腺病毒(adenovirus,ADV)、呼吸道合胞病毒(respiratory syncytial virus,RSV)、甲型流感病毒(influenza A,IA)、乙型流感病毒(influenza B,IB)和副流感病毒1、2、3型(parainfluenza 1、2、3,PIV1、PIV2、PIV3)7种病毒的检测,分析各种病毒检测情况。结果295例患儿病毒总阳性率34.58%(102/295),阳性率最高为 RSV(20.68%)。<1岁、1~3岁、3~7岁和≥7岁组病毒感染阳性率分别为47.25%、30.92%、27.27%和15.79%。急性上呼吸道感染及急性支气管炎患儿中以 IB 感染为主,阳性率分别为11.11%和16.00%,毛细支气管炎及肺炎患儿中以 RSV 感染为主,阳性率分别为40.00%和30.00%。结论彭州地区最常见的住院患儿感染病毒为 RSV,且7种病毒在不同年龄、不同呼吸道感染疾病中具有不同分布特点。 相似文献
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目的探讨鼻咽部定植菌对呼吸道合胞病毒(RSV)毛细支气管炎的影响。方法选取因急性毛细支气管炎而住院的儿童211例为研究对象,采用无菌负压抽取痰液法检测鼻咽部病原菌及肺炎支原体特异性抗体。以外科手术患儿为对照组,比较两组患儿定植菌分布情况。同时对定植菌阳性的RSV患儿与阴性者的临床和实验室指标做比较。结果对照组鼻咽部定植菌阳性率高达74.1%(292/394),明显高于RSV毛细支气管炎患儿的55.0%(116/211)(P〈0.01)。定植菌阳性的RSV毛细支气管炎患儿的重症毛细支气管炎的比例高于定植菌阴性RSV患儿(13.8%比4.2%,P=0.018),更易出现呼气困难(19.8%比9.5%,P=0.037),且住院时间也略长(8.2d比7.5d,P=0.036),CRP升高的比例要明显高于后者(17.2%比4.2%,P=0.003)。结论鼻咽部定植菌可作为临床重症RSV毛细支气管炎的预测指标。 相似文献
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目的 了解苏州地区5岁以下严重急性呼吸道感染(severe acute respiratory infection,SARI)住院患儿的病毒病原学构成、季节分布和临床特征,为苏州地区SARI病例的临床诊断治疗及防控提供线索和依据。方法 对2011年3月至2012年2月期间在苏州大学附属儿童医院内科急诊病房及呼吸科病房住院治疗的5岁以下SARI病例采集鼻咽部分泌物进行实验室检测,同时收集患儿的既往病史及临床特征等相关信息。结果 共纳入SARI病例746例,其中474例采集了鼻咽部分泌物。病毒阳性检出率为46.0%,其中流感病毒A型2.1%、B型11.0%、呼吸道合胞病毒(respiratory syncytial virus,RSV)26.6%、腺病毒3.2%、副流感病毒Ⅰ型2.7%、Ⅲ型4.0%,未检测到副流感Ⅱ型病毒。RSV全年均有流行,流感A、B型病毒则主要在冬、春季流行。男性患儿RSV阳性率高于女性患儿(P<0.05);流感病毒、RSV、腺病毒、副流感病毒在不同年龄段SARI患儿的阳性率差异皆有统计学意义(P<0.05)。病毒检测阳性患儿咳嗽、喘息及肺炎的发生率显著高于阴性患儿(P<0.05);RSV及副流感病毒在肺炎患儿中的检出率明显高于其他诊断(P<0.05)。纳入研究的SARI患儿平均住院天数7.38天,中位数为7天。SARI患儿在病程中接受糖皮质激素治疗与住院时间密切相关。结论 苏州地区5岁以下SARI住院患儿病毒检出率最高的是RSV和流感病毒,病毒感染可能是加重SARI病例临床症状的原因之一;不同病毒感染所致疾病特征有所差异,流感病毒以上呼吸道感染和肺炎为主,RSV以毛细支气管肺炎为主。 相似文献
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用ELISA双夹心法、病毒分离和IFA法,平行检测了72例急性下呼吸道感染患儿鼻咽分泌物中呼吸道合胞病毒(RSV)抗原,结果诊断RSV感染的阳性率分别为72.2%(52例)、81.9%(53例)和81.1%(44例)。同病毒分离比较,ELISA的敏感性、特异性和诊断符合率分别为86.4%,92.3%和87.57%,IFA的敏感性、特异性和诊断符合率分别为74.6%、100.0%和79.2%。患儿年蛉,病情和标本采集时间等因素,对ELISA敏感性有一定影响。ELISA检测RSV抗原特异、敏感、快速(收到标本后7 h内可获得结果),适用于婴幼儿,尤其9月龄以内小儿RSV感染的早期诊断。 相似文献
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目的:探讨调节激活正常T细胞表达、分泌的细胞因子(RANTES)-403G/A、单核细胞趋化蛋白1(MCP-1)-2518A/G基因多态性与呼吸道合胞病毒(RSV)毛细支气管炎易感性的相关性。方法:应用聚合酶链反应-限制性酶切片段长度多态性技术(PCR-RFLP)检测150例RSV毛细支气管炎患儿和120例正常儿童上述位点单核苷酸多态性(SNPs)。结果:病例组RANTES-403G/A基因型和等位基因型频率分别为GG20.7%、GA63.3%、AA16.0%、G52.3%、A47.7%,对照组为GG37.5%、GA46.7%、AA15.8%、G60.8%、A39.2%,两组基因型频率差异有显著性(P〈0.05);病例组A等位基因频率高于对照组(P〈0.05),与G等位基因携带者相比,A等位基因携带者患病风险增加(OR=1.415,P〈0.05)。两组MCP-1-2518基因型和等位基因频率差异无显著性(均P〉0.05)。结论:RANTES-403A等位基因与RSV毛细支气管炎易感性相关,其可能是影响发病的一个重要候选基因;未发现MCP-1-2518A/G基因多态性与RSV毛细支气管炎易感性存在关联。 相似文献