급성모세기관지염의 원인 바이러스에 따른 중증도 차이
Bronchiolitis severity according to the infected viruses
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Purpose: The aim of this study was to evaluate the severity of disease in children with acute bronchiolitis according to the type of infected virus. Methods: From November 2007 to May 2015, 768 patients under 2 years of age who underwent real time-polymerase chain reaction of nasopharyngeal aspirates admitted to the Department of Pediatrics of Dongguk University Ilsan Hospital for acute bronchiolitis were enrolled. Severe bronchiolitis was defined as presence of one or more kinds among tachypnea, chest retraction, needs of O2 inhalation or ventilator care. Results: The severity of bronchiolitis was increased with shorter fever duration (P<0.001) and previous wheezing episodes (P=0.005). In the case of single infection, respiratory syncytial virus (RSV) A only increased the severity of acute bronchiolitis (P=0.012). However, the severity of illness decreased when RSV A coinfected with adenovirus (P=0.034), human rhinovirus (P=0.038), or human coronavirus NL63 (P=0.042). On the other hand, when human rhinovirus was coinfected with enterovirus (P=0.013) or parainfluenza 3 (P=0.019), the severity was increased. When human metapneumovirus coinfected with human bocavirus, the severity was increased (P=0.038). Conclusion: Acute bronchiolitis was associated with increased severity only when RSV A infected solely, but several viruses increased or decreased the severity when coinfection occurred. Therefore, it may be helpful in predicting the course of the acute bronchiolitis according to the affected virus.
Abstract
Purpose: The aim of this study was to evaluate the severity of disease in children with acute bronchiolitis according to the type of infected virus. Methods: From November 2007 to May 2015, 768 patients under 2 years of age who underwent real time-polymerase chain reaction of nasopharyngeal aspirates admitted to the Department of Pediatrics of Dongguk University Ilsan Hospital for acute bronchiolitis were enrolled. Severe bronchiolitis was defined as presence of one or more kinds among tachypnea, chest retraction, needs of O2 inhalation or ventilator care. Results: The severity of bronchiolitis was increased with shorter fever duration (P<0.001) and previous wheezing episodes (P=0.005). In the case of single infection, respiratory syncytial virus (RSV) A only increased the severity of acute bronchiolitis (P=0.012). However, the severity of illness decreased when RSV A coinfected with adenovirus (P=0.034), human rhinovirus (P=0.038), or human coronavirus NL63 (P=0.042). On the other hand, when human rhinovirus was coinfected with enterovirus (P=0.013) or parainfluenza 3 (P=0.019), the severity was increased. When human metapneumovirus coinfected with human bocavirus, the severity was increased (P=0.038). Conclusion: Acute bronchiolitis was associated with increased severity only when RSV A infected solely, but several viruses increased or decreased the severity when coinfection occurred. Therefore, it may be helpful in predicting the course of the acute bronchiolitis according to the affected virus.
참고문헌 (33)
- 노의정, "전국 146개 응급실에 내원한 급성 세기관지염 환자에 대한 통계적 관찰", Allergy Asthma & Respiratory Disease, 3(5), pp.334~340 (2015), 대한 소아알레르기 호흡기학회[DOI]
- Coastes BM, "Nelson textbook of pediatrics", pp.2044~2048 (2016), Elsevier
- Bordley WC, "Diagnosis and testing in bronchiolitis: a systematic review", Arch Pediatr Adolesc Med, 158, pp.119~126 (2004)[DOI]
- Skjerven HO, "Virus type and genomic load in acute bronchiolitis: severity and treatment response with inhaled adrenaline", J Infect Dis, 213, pp.915~921 (2016)[DOI]
- 강수영, "소아에서 발생한 Human metapneumovirus 감염의 임상-역학적특징: Respiratory Syncytial Virus A and B 감염과의 비교", Pediatric Infection and Vaccine, 20(3), pp.168~177 (2013), 대한소아감염학회
- Ralston SL, "Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis", Pediatrics, 134, pp.e1474~e1502 (2014)[DOI]
- 박현진, "반복적인 모세기관지염, 과반응 기관지염을 보인 영유아의 임상양상, 치료와 자연경과", Pediatric Infection and Vaccine, 21(1), pp.37~42 (2014), 대한소아감염학회
- Colby TV, "Bronchiolitis. Pathologic considerations", Am J Clin Pathol, 109, pp.101~109 (1998)[DOI]
- 정영상, "중증도 평가점수를 이용한 급성 세기관지염의 입원 기간영향 요인 연구", Allergy Asthma & Respiratory Disease, 4(6), pp.429~435 (2016), 대한 소아알레르기 호흡기학회[DOI]
- Walsh EE, "Severity of respiratory syncytial virus infection is related to virus strain", J Infect Dis, 175, pp.814~820 (1997)[DOI]
- Mansbach JM, "Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis", Arch Pediatr Adolesc Med, 166, pp.700~706 (2012)[DOI]
- Rhedin S, "Clinical utility of PCR for common viruses in acute respiratory illness", Pediatrics, 133, pp.e538~e545 (2014)[DOI]
- 임정숙, "소아에서 13종 호흡기 바이러스에 의한 급성 하기도 감염의 임상 양상", Clinical and Experimental Pediatrics, 53(3), pp.373~379 (2010), 대한소아청소년과학회
- 김금향, "하기도 감염으로 입원한 소아에서 12종 바이러스의 검출 및 임상 양상", Clinical and Experimental Pediatrics, 51(8), pp.834~841 (2008), 대한소아청소년과학회
- Choi EH, "The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000-2005", Clin Infect Dis, 43, pp.585~592 (2006)[DOI]
- Huguenin A, "Broad respiratory virus detection in infants hospitalized for bronchiolitis by use of a multiplex RT-PCR DNA microarray system", J Med Virol, 84, pp.979~985 (2012)[DOI]
- Hasegawa K, "Risk factors for requiring intensive care among children admitted to ward with bronchiolitis", Acad Pediatr, 15, pp.77~81 (2015)[DOI]
- Rolfsjord LB, "The severity of acute bronchiolitis in infants was associated with quality of life nine months later", Acta Paediatr, 105, pp.834~841 (2016)[DOI]
- Mikalsen IB, "The outcome after severe bronchiolitis is related to gender and virus", Pediatr Allergy Immunol, 23, pp.391~398 (2012)[DOI]
- 김우경, "Human rhinoviruses and asthma in children", Clinical and Experimental Pediatrics, 53(2), pp.129~135 (2010), 대한소아청소년과학회
- Rodriguez R, "Respiratory syncytial virus: how, why and what to do", J Infect, 68(Suppl 1), pp.S115~S118 (2014)[DOI]
- Boivin G, "Human respiratory syncytial virus and other viral infections in infants receiving palivizumab", J Clin Virol, 42, pp.52~57 (2008)[DOI]
- Martin ET, "Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children", Influenza Other Respir Viruses, 6, pp.71~77 (2012)[DOI]
- 박준수, "소아 급성 바이러스 하기도염", Clinical and Experimental Pediatrics, 52(3), pp.269~276 (2009), 대한소아청소년과학회
- Harada Y, "Does respiratory virus coinfection increases the clinical severity of acute respiratory infection among children infected with respiratory syncytial virus?", Pediatr Infect Dis J, 32, pp.441~445 (2013)[DOI]
- Rodriguez DA, "Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region", Pediatr Pulmonol, 49, pp.269~276 (2014)[DOI]
- Asner SA, "Is virus coinfection a predictor of severity in children with viral respiratory infections", Clin Microbiol Infect, 21, pp.264.e1~264.e6 (2015)[DOI]
- Brand HK, "Infection with multiple viruses is not associated with increased disease severity in children with bronchiolitis", Pediatr Pulmonol, 47, pp.393~400 (2012)[DOI]
- Calvo C, "Respiratory syncytial virus coinfections with rhinovirus and human bocavirus in hospitalized children", Medicine (Baltimore), 94, pp.e1788~ (2015)[DOI]
- Mohapatra SS, "Epidemiologic, experimental, and clinical links between respiratory syncytial virus infection and asthma", Clin Microbiol Rev, 21, pp.495~504 (2008)[DOI]
- Yun HJ, "Respiratory syncytial virus infection and asthma", Pediatr Allergy Respir Dis, 9, pp.24~31 (1999)
- Ojosnegros S, "Competition-colonization dynamics in an RNA virus", Proc Natl Acad Sci U S A, 107, pp.2108~2112 (2010)[DOI]
- Greensill J, "Human metapneumovirus in severe respiratory syncytial virus bronchiolitis", Emerg Infect Dis, 9, pp.372~375 (2003)[DOI]