생후 90일 이하의 영아에서 호흡기 바이러스 검출과 관련된 위험인자
Risk Factors Associated with Respiratory Virus Detection in Infants Younger than 90 Days of Age
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목적: 임상적으로 중증 세균성 감염과 바이러스성 질환의 감별이 어려운 어린 영아에서 호흡기 바이러스를 검출하고 이것과 연관된 임상적 위험인자를 분석하였다. 방법: 2011년 9월부터 2012년 8월까지 생후 90일 이하 영아 중 패혈증을 포함한 감염성 질환이 의심된 227명을 대상으로 비인두 검체를 채취하였으며 임상적 특성에 대한 후향적 연구를 시행하였다. 채취한 검체 내 호흡기 바이러스의 검출은 real-time PCR 검사를 통해 측정되었다. 결과: 총 157명(69.2%)의 영아에서 한 가지 이상의 호흡기 바이러스가 검출되었다. 빈도는 RSV (75명), RV (42명), influenza virus (18명), parainfluenza virus (15명), human metapneumovirus (9명), coronavirus (9명), adenovirus (4명), bocavirus (3명) 순이었다. 이 중 24명(10.6%)에서 세균성 감염을 진단하였다. 기침, 호흡기 질환의 가족력이 있는 경우 혹은 가을/겨울 철에 호흡기 바이러스가 의미있게 높은 빈도로 검출되었으며 로지스틱 회귀분석에서도 같은 경향을 확인하였다. 가을과 겨울에는 세균성 감염 환자보다 그렇지 않은 환자에서 호흡기 바이러스 검출이 유의하게 많은 것을 알 수 있었다. 결론: 호흡기 바이러스는 감염성 질환이 의심되어 입원한 어린 영아의 중요한 병원체이며 그 검출률은 호흡기 증상, 가을/겨울철 발생, 호흡기 증상의 가족력이 있는 환자에서 유의하게 높았다.
Abstract
Purpose: This study aimed at determining the detection rate of respiratory viruses and at investigating the risk factors associated with respiratory virus detection in young infants. Methods: From September 2011 to August 2012, nasopharyngeal swabs were obtained from 227 infants aged ≤90 days with suspected infectious diseases, including sepsis. We performed a retrospective analysis of their clinical characteristics. The prevalence of respiratory viruses in their nasopharyngeal swabs was assayed by real-time polymerase chain reaction (real-time PCR). Results: In total, 157 (69.2%) infants had more than one of the following respiratory viruses: respiratory syncytial virus (n= 75), rhinovirus (n=42), influenza virus (n=18), parainfluenza virus (n=15), human metapneumovirus (n=9), coronavirus (n=9), adenovirus (n=4), and bocavirus (n=3). During the same period, bacterial infections were confirmed in 24 infants (10.6%). The detection of respiratory viruses was significantly associated with the presence of cough, a family history of respiratory illness, and a seasonal preference (fall/winter). Using logistic regression analysis, these 3 variables were also identified as significant risk factors. During fall and winter, detection of respiratory viruses was significantly higher in infants who did not have a bacterial infection. Conclusion: Respiratory virus is an important pathogen in young infants admitted to a hospital, who are suspected with infectious diseases. Detection of respiratory viruses in young infants was associated with seasonality (fall/winter), presence of respiratory symptoms and a family history of respiratory illness.
참고문헌 (13)
- Hall CB, "The burden of respiratory syncytial virus infection in young children", N Engl J Med, 360, pp.588~598 (2009)
- Freymuth F, "Comparison of multiplex PCR assays and conventional techniques for the diagnostic of respiratory virus infections in children admitted to hospital with an acute respiratory illness", J Med Virol, 78, pp.1498~1504 (2006)
- van de Pol AC, "Diagnostic value of real-time polymerase chain reaction to detect viruses in young children admitted to the paediatric intensive care unit with lower respiratory tract infection", Crit Care, 10, pp.R61~ (2006)
- Ehlken B, "Economic impact of communityacquired and nosocomial lower respiratory tract infections in young children in Germany", Eur J Pediatr, 164, pp.607~615 (2005)
- Brozanski BS, "Use of polymerase chain reaction as a diagnostic tool for neonatal sepsis can result in a decrease in use of antibiotics and total neonatal intensive care unit length of stay", J Perinatol, 26, pp.688~692 (2006)
- Wishaupt JO, "Clinical impact of RT-PCR for pediatric acute respiratory infections: a controlled clinical trial", Pediatrics, 128, pp.e1113~e1120 (2011)
- Monto AS, "Acute respiratory illness in an American community: the Tecumseh study", JAMA, 227, pp.164~169 (1974)
- Tregoning JS, "Respiratory viral infections in infants: causes, clinical symptoms, virology, and immunology", Clin Microbiol Rev, 23, pp.74~98 (2010)
- Aberle JH, "Single versus dual respiratory virus infections in hospitalized infants: impact on clinical course of disease and Interferon-γ response", Pediatr Infect Dis J, 24, pp.605~610 (2005)
- van Piggelen RO, "Human rhinovirus causes severe infection in preterm infants", Pediatr Infect Dis J, 29, pp.364~365 (2010)
- Simoes EA, "Environmental and demographic risk factors for respiratory syncytial virus lower respiratory tract disease", J Pediatr, 143, pp.S118~S126 (2003)
- Jansen RR, "Frequent detection of respiratory viruses without symptoms: toward defining clinically relevant cutoff values", J Clin Microbiol, 49, pp.2631~2636 (2011)
- Smit PM, "RT-PCR detection of respiratory pathogens in newborn children admitted to a neonatal medium care unit", Pediatr Res, 73, pp.355~361 (2013)