Acute lower respiratory tract infections by human metapneumovirus in children in Southwest China: A 2‐year study

Human metapneumovirus (hMPV) has been reported to cause both upper and lower respiratory tract diseases in susceptible populations, particularly in children and the elderly. In this study, we describe a hospital‐based epidemiological study of hMPV in patients presenting to a children's hospital and show the demographic and clinical characteristics associated with hMPV infection in China, retrospectively. Specimens were collected over a 2‐year period from children hospitalized with acute lower respiratory tract infections (ALRTI) and analyzed for the presence of hMPV using real‐time RT‐PCR assays. The presence of hMPV was detected in 227 (25.9%) of the 878 children studied and may circulate year‐round in the area, peaking during the winter–spring season. Younger children (aged less than 6 months) had the highest positive rate. Infections by hMPV showed similar epidemiology and clinical manifestations as for respiratory syncytial virus (RSV) and were found in high co‐infections with RSV. Subgroup A2 hMPV was the most predominant genotype identified during the study period. This study indicates that hMPV is one of the major respiratory pathogens found in children in southwest China and vaccine development should be under consideration. Pediatr. Pulmonol. 2010; 45:824–831. © 2010 Wiley‐Liss, Inc.     

Incidence and morbidity of human metapneumovirus and other community‐acquired respiratory viruses in lung transplant recipients

A. Weinberg, D.M. Lyu, S. Li, J. Marquesen, M.R. Zamora. Incidence and morbidity of human metapneumovirus and other community‐acquired respiratory viruses in lung transplant recipients
Transpl Infect Dis 2010: 12: 330–335. All rights reserved. Abstract: To determine the role of human metapneumovirus (HMPV) in respiratory tract infections (RTIs) of lung transplant recipients, 60 patients were prospectively enrolled in this study spanning from September 2005 to November 2007. Community‐acquired respiratory viruses (CARVs) were identified by polymerase chain reaction and tissue culture in respiratory secretions. Of 112 RTIs, 51 were associated with ≥1 CARV, including 7 HMPV, 13 respiratory syncytial virus (RSV), 19 parainfluenza virus 1, 2, or 3 (PIV), 16 influenza A or B (FLU), and 3 human rhinoviruses (HRV). Sixteen CARV‐RTIs had multiple pathogens. While the standard protocol was to admit all paramyxoviral RTIs for inhaled ribavirin, 16% CARV‐RTIs required hospitalization because of the severity of their respiratory compromise, including 25% of HPMV‐single‐agent RTI, 38% of RSV single‐agent RTI, 10% of PIV‐single‐agent RTI, and 19% of multiple‐agent RTIs. None of those with non‐CARV RTIs required hospitalization. The incidence of clinically diagnosed acute graft rejection in the first 2 months after an RTI varied from 0 for single‐agent HRV to 88% for single‐agent RSV (25% for single‐agent HMPV). A new diagnosis of chronic graft rejection in the first year after an RTI was made in approximately 25% of the RTIs and did not significantly vary with the etiologic agent. No deaths occurred during this study. In conclusion, HMPV was associated with 6% of the RTIs in lung transplant recipients and its morbidity was similar to the average moribidity of CARVs.     

小儿支气管哮喘与反复呼吸道感染相关性研究

目的探讨小儿支气管哮喘与反复呼吸道感染的相关性。方法收集在该院诊疗87例小儿支气管哮喘患者(试验组)及同期门诊体检儿童73例(对照组)作为研究对象,对所有患儿检测病毒、支原体衣原体以及细菌感染情况,并行对比分析。结果试验组患儿合并呼吸道感染占35.63%明显高于对照组的6.85%(P0.01)。试验组呼吸道感染病原检出率为74.71%高于对照组24.66%,(P0.01);试验组病毒检出率为37.93%高于对照组12.33%(P0.01);试验组支原体、衣原体检出率为24.14%高于对照组9.59%(P0.05);试验组细菌检出率为12.64%高于对照组2.74%(P0.05)。结论哮喘发作与反复呼吸道感染有密切相关性,呼吸道病毒感染、支原体、衣原体和细菌感染是小儿哮喘急性发作和加重的主要诱因。     

A 3‐year prospective study of the epidemiology of acute respiratory viral infections in hospitalized children in Shenzhen,China

Background

The epidemiology of local viral etiologies is essential for the management of viral respiratory tract infections. Limited data are available in China to describe the epidemiology of viral respiratory infections, especially in small–medium cities and rural areas.

Objectives

To determine the viral etiology and seasonality of acute respiratory infections in hospitalized children, a 3-year study was conducted in Shenzhen, China.

Methods

Nasopharyngeal aspirates from eligible children were collected. Influenza and other respiratory viruses were tested by molecular assays simultaneously. Data were analyzed to describe the frequency and seasonality.

Results

Of the 2025 children enrolled in the study, 971 (48·0%) were positive for at least one viral pathogen, in which 890 (91·7%) were <4 years of age. The three most prevalent viruses were influenza A (IAV; 35·8%), respiratory syncytial virus (RSV; 30·5%) and human rhinovirus (HRV; 21·5%). Co-infections were found in 302 cases (31·1%), and dual viral infection was dominant. RSV, HRV and IAV were the most frequent viral agents involved in co-infection. On the whole, the obvious seasonal peaks mainly from March to May were observed with peak strength varying from 1 year to another.

Conclusions

This study provides a basic profile of the epidemiology of acute respiratory viral infection in hospitalized children in Shenzhen. The spectrum of viruses in the study site is similar to that in other places, but the seasonality is closely related to geographic position, different from that in big cities in northern China and neighboring Hong Kong.     

Human metapneumovirus and respiratory syncytial virus infections in older children with cystic fibrosis

BACKGROUND: Human metapneumovirus (hMPV) has been isolated from children with acute respiratory infection worldwide. Its epidemiology remains to be defined in children with cystic fibrosis (CF). We describe the epidemiology and clinical impact of hMPV in CF children and compared it to respiratory syncytial virus (RSV). METHODS: CF children ages 7-18 years were studied prospectively during the 1998 -1999 RSV season. Nasopharyngeal specimens were collected during acute respiratory illnesses and tested for respiratory viruses. Blood specimens were drawn early, mid, and end of the RSV season, and tested for serological evidence of hMPV and RSV infections. Rates of lower respiratory tract illnesses (LRTI) and hospitalizations for pulmonary exacerbations were compared during the time intervals they developed serological evidence of infection to their non-infection intervals. RESULTS: Six of 44 CF children had a virus positive respiratory illness in 56 LTRI events and 18 hospitalizations. Serological evidence of hMPV and RSV infections occurred in 16 and 20 CF children, respectively; 8 had infections with both viruses. A greater proportion of CF children had >or=1 LRTI during their infection intervals compared to their non-infection intervals (13/25 vs. 5/25; P=0.03). A trend for higher rates of LRTI was observed in the infection intervals compared to non-infection intervals (9.5 +/- 11.0 vs. 4.2 +/- 9.9 per 1,000 child-days; P=0.06), and it was significantly greater with a more conservative estimate (one event per child per interval; 7.4 +/- 7.7 vs. 2.6 +/- 5.4 per 1,000 child-days; P 相似文献   

Precautions against COVID-19 reduce respiratory virus infections among children in Southwest China

Acute respiratory tract infections pose a serious threat to the health of children worldwide, with viral infections representing a major etiology of this type of disease. Protective measures such as mask-wearing, social distancing, and hand hygiene can be effective in curbing the spread of severe acute respiratory syndrome coronavirus 2. These precautions may also have an impact on the spread of other respiratory viruses. In this study, we retrospectively compared the respiratory virus infections of children in Southwest China before and after the outbreak of COVID-19. Nasopharyngeal swabs were collected from 1578 patients under 14 years old with acute respiratory tract infection symptoms before and after COVID-19 pandemic. Nine common respiratory viruses including human bocavirus, human rhinoviruses, human coronaviruses, human adenoviruses, human metapneumovirus, respiratory syncytial virus, influenza A virus, influenza B virus, and parainfluenza virus were measured by advanced fragment analysis. The respiratory virus infection rates among children of all ages and genders in Southwest China under the precautions against COVID-19 pandemic were significantly lower than that of the same period before the pandemic. Our findings indicate that public health measures implemented during the COVID-19 pandemic, including strict mask-wearing, social distancing, and hand hygiene, may be effective in preventing the transmission of other respiratory viruses in children, thereby controlling the spread of infections.     

Impact of viral infections in children with community‐acquired pneumonia: results of a study of 17 respiratory viruses

Please cite this paper as: Esposito et al. (2012) Impact of viral infections in children with community‐acquired pneumonia: results of a study of 17 respiratory viruses. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750‐2659.2012.00340.x. Background Little is known about the prevalence of viral infections in children with community‐acquired pneumonia (CAP). Objectives To describe the clinical and virological data collected from children with radiographically confirmed CAP in whom 17 respiratory viruses were sought in respiratory secretion samples during the acute phase of the disease. Patients and methods The study involved 592 children with radiographically confirmed CAP whose respiratory secretion samples were tested using the Luminex xTAG Respiratory Virus Panel Fast assay, which simultaneously detects influenza A virus, influenza B virus, respiratory syncytial virus (RSV)‐A and ‐B, parainfluenzavirus‐1, ‐2, ‐3, and ‐4, adenovirus, human metapneumovirus, coronaviruses 229E, NL63, OC43, and HKU1, enterovirus/rhinovirus, and bocavirus. A real‐time PCR assay was used to identify the rhinovirus in the enterovirus/rhinovirus‐positive samples. Results A total of 435 children (73·5%) were positive for at least one virus: the most frequently detected was RSV, which was found in 188 (31·7%), followed by rhinovirus (n = 144, 24·3%), bocavirus (n = 60, 10·1%), influenza viruses (n = 57, 9·6), and hMPV (n = 49, 8·2%). Viral co‐infections were found in 117 children (19·7% of the enrolled children; 26·9% of those with viral infections). Marginal differences were found between the infections owing to a single virus. Co‐infections showed radiographic evidence of alveolar pneumonia significantly more frequently than single infections (OR 1·72, 95% CI 1·05–2·81). Conclusions The findings of this study highlight the importance of respiratory viruses (mainly RSV and rhinovirus) in children with CAP and show the characteristics of both the single infections and co‐infections associated with the disease.     

广东地区急性呼吸道感染儿童人类博卡病毒的流行状况

目的 了解广东地区急性呼吸道感染患儿人类博卡病毒(HBoV)的感染情况.方法 收集广东地区2007年6月至2008年5月期间呼吸道感染患儿的鼻咽分泌物447份,采用PCR法检测HBoV衣壳蛋白(VP)基因片段,阳性标本作核酸序列测定,并与基冈库中的已知序列进行序列比对和系统进化树分析.结果 447例呼吸道感染患儿标本中HBoV阳件率为5.1%.其中10例患儿与其他病毒混合感染,占阳性标本的43.5%.阳件患儿的主要临床诊断为喘息性肺炎、毛细支气管炎和支气管肺炎,年龄分布从42 d到6岁,主要集中在1岁以内,HBoV感染的季节分布偏向夏、秋及晚春.经序列比对和进化树分析.阳性株的VP基因片段与瑞典株ST1的核酸及氨基酸序列同源性分别为97.8%～98.8%及99.3%～100.0%.结论 HBoV是广东地区儿童下呼吸道感染的重要病原之一,且在1岁以内患儿中高发.该地区HBoV流行株的VP基因片段较为保守,但也存在导致氨基酸改变的突变株.     

Human bocavirus and human metapneumovirus in hospitalized children with lower respiratory tract illness in Changsha,China

Background

Lower respiratory tract illness is a major cause of morbidity and mortality in children worldwide, however, information about the epidemiological and clinical characteristics of LRTIs caused by HMPV and HBoV in China is limited.

Objectives

Human bocavirus (HBoV) and human metapneumovirus (HMPV) are two important viruses for children with lower respiratory tract infections (LRTI). We aimed to assay the correlation between viral load and clinical characteristics of HBoV and HMPV with LRTI in Changsha, China.

Methods

Nasopharyngeal aspirates (NPAs) from children with LRTI were collected. Real‐time PCR was used to screen HBoV and HMPV. Analyses were performed using SPSS 16.0 software.

Results

Pneumonia was the most frequent diagnosis. There was no significant difference between HBoV‐ and HMPV‐positive patients in age (P = .506) or hospitalization duration (P = .280); 24.1% and 18.2% were positive for HBoV and HMPV. HBoV infections peaked in summer (32.2%), and HMPV infections peaked in winter (28.9%). The HBoV‐positive patients had a shorter hospitalization duration than the HBoV‐negative patients (P = .021), and the HMPV‐positive patients had a higher prevalence of fever than the HMPV‐negative patients (P = .002). The HBoV viral load was significantly higher among patients aged <1 year (P = .006). The mean HBoV and HMPV viral loads were not significantly different between patients with single infections and coinfections. Patients infected with HBoV only were older than those coinfected with HBoV and other respiratory viruses (P = .005). No significant difference was found in the clinical characteristics of patients infected with HMPV only and those coinfected with HMPV and other respiratory viruses.

Conclusion

Pneumonia was the most frequent diagnosis caused by HBoV and HMPV. Neither HBoV nor HMPV viral load was correlated with disease severity.     

婴幼儿支原体肺炎后反复发作性呼吸道感染因素分析

目的探讨婴幼儿支原体肺炎感染后反复呼吸道感染的影响因素分析。方法选取2013年6月~2013年12月我院儿科收治的150例支原体肺炎患儿作为研究对象,跟踪患儿治愈出院前后的MP-Ig M、MP-Ig G双抗体滴度及免疫功能,并记录呼吸道感染情况及一年内的用药情况。采用统计学方法进行多因素分析。结果 150例支原体肺炎患儿中,发生RRTI 45例,发生率为30.0%。多因素结果显示,年龄为3~6岁(OR=2.31,95%CI:1.23~4.68)、HP抗体阳性或转阳(OR=4.51,95%CI:1.56~13.27)、CD_4~+/CD_8~+下降(OR=10.33,95%CI:3.45~32.02)及Ig A下降(OR=1.96,95%CI:1.12~3.47)是诱发RRTI的危险因素;使用免疫增强剂(OR=0.31,95%CI:0.14~0.82)是有效预防反复呼吸道感染的保护因素。结论年龄3~6岁、HP抗体阳性或转阳、CD_4~+/CD_8~+下降及Ig A下降是RRTI发生的危险因素;MP肺炎治愈后发生免疫功能障碍的患儿易发生RRTIs;免疫增强剂的使用可有效减少RRTI的发生,提高患儿的生活质量。     

儿童反复呼吸道感染易感因素的临床研究简

目的 探讨儿童反复呼吸道感染的易感因素.方法 选择2011.2-2013.2我院收治呼吸道反复感染患儿（观察组）及门诊体检的健康儿童（对照组）各150例.采用自制的儿童反复呼吸道感染易感因素调查表,记录两组儿童血常规、血金属元素及血免疫球蛋白等检查结果.采用卡方检验和t检验进行易感因素的单因素分析,采用非条件Logistic回归模型进行易感因素的多因素分析.结果 观察组的血钙、铁元素、血IgA和IgG明显低于对照组,具有显著性差异（P〈0.05）.将与儿童反复呼吸道感染相关的因素引入多因素Logistic回归分析,结果显示：胎次≥3次（OR=2.988,95%CI 1.249-5.147）、被动吸烟（OR=6.812,95%CI 2.143-13.764）、低钙血症（OR=3.304,95%CI 1.203-6.056）、血清IgA〈230 mg/L（OR=5.237,95%CI 1.103-10.721）和IgG〈5 g/L（OR=5.408,95%CI 1.282-11.302）、抗生素与激素的使用（OR=8.542,95%CI 3.762-16.997）、生活环境（幼儿园） （OR=3.251,95%CI 1.377-6.223）为儿童反复呼吸道感染的独立易感因素.结论儿童反复呼吸道感染多种因素有关,应针对易感因素做好预防工作.     

WU多瘤病毒在儿童急性呼吸道感染中的作用

目的了解急性呼吸道感染儿童中WU多瘤病毒(WUPyV)的感染情况及其作用。方法采集天津市儿童医院急性下呼吸道感染住院儿童的鼻咽吸取物(NPA)标本174份,急性上呼吸道感染的咽拭子标本68份以及无呼吸道症状的对照咽拭子标本43份,用PCR法进行WUPyV基因检测,对NPA阳性标本采用PCR和多重PCR同时检测其他常见呼吸道病毒。结果174份NPA标本中共28份检出WUPyV核酸,占16.1%。患者平均年龄为11.7个月(12 d~39个月),其中≤6个月10例(35.7%),6个月~1岁10例(35.7%),1~2岁7例(25.0%),2~5岁1例(3.6%);男19例(67.9%),女9例(32.1%);与其他呼吸道病毒混合感染20例,占71.4%,50%为两种病毒混合感染,混合感染率最高的为RSVB(32.1%),其次为HboV(21.4%)和Rhino、PIV3(均为14.3%)。检查68例急性上呼吸道感染者的咽拭子标本,3例为WUPyV阳性,其中2例患儿为3岁,1例2岁;女2例,男1例。43例无呼吸道症状者的咽拭子标本均为WUPyV阴性。结论急性呼吸道感染儿童中存在WUPyV感染,下呼吸道感染患儿中检...