호흡기 바이러스 단일감염과 중복감염의 임상적 차이: 2014년 단일기관 연구
Clinical difference between single infection and coinfection with respiratory virus: The 2014 single-center study
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Purpose: We investigated the clinical difference between single infection and coinfection with respiratory virus in hospitalized children with acute respiratory tract infections. Methods: We reviewed 727 patients who were admitted with the diagnosis of acute respiratory infection at the Department of Pediatrics, Bundang Jesaeng Hospital between January and December of 2014. Diagnoses were made using the multiplex reverse transcriptase polymerase chain reaction (RT-PCR) assay targeting 16 viruses in nasopharyngeal swabs. Subjects were classified as the single virus infection and coinfection groups. Results: A total of 439 patients were enrolled; 359 (77.2%) under 24 months. Single virus was detected in 279 (63.6%). Coinfection with multiple virus was detected in 160 (36.4%): 126 (28.7%) with 2 viruses, 30 (6.8%), and 4 (0.9%) with 3 to 4 viruses. Viral coinfection was detected in 28 samples (17.5%), with respiratory syncytial virus (RSV) A and rhinovirus being the most dominating combination. There were no clinical differences between the single infection and coinfection groups, except sputum and the frequency of high RSV load. Sputum was significantly more frequent in the coinfection group (P=0.043), and the frequency of high RSV load was significantly higher in the single infection group (P=0.029). Disease severity (high fever, the duration of fever [≥5 days], and the length of hospital stay [≥5 days], O2 therapy) did not differ significantly between both groups. RSV was a frequent virus of single infection during winter. Coinfection was most common in winter. Conclusion: There were no clinical differences between single infection and coinfection, except sputum and the frequency of high RSV load.
Abstract
Purpose: We investigated the clinical difference between single infection and coinfection with respiratory virus in hospitalized children with acute respiratory tract infections. Methods: We reviewed 727 patients who were admitted with the diagnosis of acute respiratory infection at the Department of Pediatrics, Bundang Jesaeng Hospital between January and December of 2014. Diagnoses were made using the multiplex reverse transcriptase polymerase chain reaction (RT-PCR) assay targeting 16 viruses in nasopharyngeal swabs. Subjects were classified as the single virus infection and coinfection groups. Results: A total of 439 patients were enrolled; 359 (77.2%) under 24 months. Single virus was detected in 279 (63.6%). Coinfection with multiple virus was detected in 160 (36.4%): 126 (28.7%) with 2 viruses, 30 (6.8%), and 4 (0.9%) with 3 to 4 viruses. Viral coinfection was detected in 28 samples (17.5%), with respiratory syncytial virus (RSV) A and rhinovirus being the most dominating combination. There were no clinical differences between the single infection and coinfection groups, except sputum and the frequency of high RSV load. Sputum was significantly more frequent in the coinfection group (P=0.043), and the frequency of high RSV load was significantly higher in the single infection group (P=0.029). Disease severity (high fever, the duration of fever [≥5 days], and the length of hospital stay [≥5 days], O2 therapy) did not differ significantly between both groups. RSV was a frequent virus of single infection during winter. Coinfection was most common in winter. Conclusion: There were no clinical differences between single infection and coinfection, except sputum and the frequency of high RSV load.
참고문헌 (34)
- Henrickson KJ, "Viral pneumonia in children", Semin Pediatr Infect Dis, 9, pp.217~233 (1998)
- Renois F, "Rapid detection of respiratory tract viral infections and coinfections in patients with influenza-like illnesses by use of reverse transcription-PCR DNA microarray systems", J Clin Microbiol, 48, pp.3836~3842 (2010)
- Falsey AR, "Comparison of quantitative reverse transcription-PCR to viral culture for assessment of respiratory syncytial virus shedding", J Clin Microbiol, 41, pp.4160~4165 (2003)
- Mengelle C, "The use of a multiplex real-time PCR assay for diagnosing acute respiratory viral infections in children attending an emergency unit", J Clin Virol, 61, pp.411~417 (2014)
- Imaz MS, "Clinical and epidemiologic characteristics of respiratory syncytial virus subgroups A and B infections in Santa Fe, Argentina", J Med Virol, 61, pp.76~80 (2000)
- DeVincenzo JP, "Respiratory syncytial virus load predicts disease severity in previously healthy infants", J Infect Dis, 191, pp.1861~1868 (2005)
- Semple MG, "Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis", J Infect Dis, 191, pp.382~386 (2005)
- Huang JJ, "Simultaneous multiple viral infections in childhood acute lower respiratory tract infections in southern Taiwan", J Trop Pediatr, 44, pp.308~311 (1998)
- Saunders M, "Nelson textbook of pediatrics", pp.280~ (2011), Elsevier Saunders
- Denny FW, "Acute lower respiratory tract infections in nonhospitalized children", J Pediatr, 108(5 Pt 1), pp.635~646 (1986)
- Korean Academy of Asthma, Allergy and Clinical Immunology, "2015 Korean guideline for asthma", Korean Academy of Asthma, Allergy and Clinical Immunology;Korean Academy of Pediatric Allergy and Respiratory Disease;National Strategic Coordination Center for Clinical Research. Korean guideline for asthma, 33~41 (2015)
- "Acute nasopharyngitis" (2015)[URL]
- Simoes EA, "Environmental and demographic risk factors for respiratory syncytial virus lower respiratory tract disease", J Pediatr, 143(5Suppl), pp.S118~S126 (2003)
- Hall CB, "The burden of respiratory syncytial virus infection in young children", N Engl J Med, 360, pp.588~598 (2009)
- Wilkesmann A, "Human metapneumovirus infections cause similar symptoms and clinical severity as respiratory syncytial virus infections", Eur J Pediatr, 165, pp.467~475 (2006)
- Peng D, "Multipathogen infections in hospitalized children with acute respiratory infection", Virol J, 6, pp.155~ (2009)
- Calvo C, "Multiple simultaneous viral infections in infants with acute respiratory tract infections in Spain", J Clin Virol, 42, pp.268~272 (2008)
- Drews AL, "Dual respiratory virus infections", Clin Infect Dis, 25, pp.1421~1429 (1997)
- Foulongne V, "metapneumovirus infection in young children hospitalized with respiratory tract disease", Pediatr Infect Dis J, 25, pp.354~359 (2006)
- Richard N, "The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis", Pediatr Infect Dis J, 27, pp.213~217 (2008)
- Marguet C, "In very young infants severity of acute bronchiolitis depends on carried viruses", PLoS One, 4, pp.E4596~ (2009)
- Greer RM, "Do rhinoviruses reduce the probability of viral co-detection during acute respiratory tract infections?", J Clin Virol, 45, pp.10~15 (2009)
- 임연주, "생후 90일 이하의 영아에서 호흡기 바이러스 검출과 관련된 위험인자", Pediatric Infection and Vaccine, 21(1), pp.22~28 (2014), 대한소아감염학회
- 김현정, "호흡기 바이러스 및 아토피 소견이 세기관지염의 중증도에 미치는 영향", Allergy Asthma & Respiratory Diseases, 21(4), pp.302~312 (2011), 대한 소아알레르기 호흡기학회
- 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)
- Cebey-López M, "Viral co-Infections in pediatric patients hospitalized with lower tract acute respiratory infections", PLoS One, 10, pp.E0136526~ (2015)
- Papadopoulos NG, "Association of rhinovirus infection with increased disease severity in acute bronchiolitis", Am J Respir Crit Care Med, 165, pp.1285~1289 (2002)
- Jung HD, "Prevalence of respiratory viruses in patients with acute respiratory infections, 2014", Public Health Wkly Rep, 9, pp.26~36 (2014)
- Jartti T, "Persistence of rhinovirus and enterovirus RNA after acute respiratory illness in children", J Med Virol, 72, pp.695~699 (2004)
- Franz A, "Correlation of viral load of respiratory pathogens and coinfections with disease severity in children hospitalized for lower respiratory tract infection", J Clin Virol, 48, pp.239~245 (2010)
- El Saleeby CM, "Respiratory syncytial virus load, viral dynamics, and disease severity in previously healthy naturally infected children", J Infect Dis, 204, pp.996~1002 (2011)
- Brand HK, "Infection with multiple viruses is not associated with increased disease severity in children with bronchiolitis", Pediatr Pulmonol, 47, pp.393~400 (2012)
- Houben ML, "Disease severity and viral load are correlated in infants with primary respiratory syncytial virus infection in the community", J Med Virol, 82, pp.1266~1271 (2010)
- Jansen RR, "Frequent detection of respiratory viruses without symptoms: toward defining clinically relevant cutoff values", J Clin Microbiol, 49, pp.2631~2636 (2011)
