Etiology and Clinical Outcomes of Acute Respiratory Virus Infection in Hospitalized Adults
2
조회
0
다운로드
8
인용
0
참고문헌
키워드
초록
Background: Etiologies and clinical profiles of acute respiratory viral infections need to be clarified to improve preventive andtherapeutic strategies. Materials and Methods: A retrospective observational study at a single, university-affiliated center was performed to evaluate therespiratory viral infection etiologies in children compared to that in adults and to document the clinical features of common viralinfections for adults from July 2009 to April 2012. Results: The common viruses detected from children (2,800 total patients) were human rhinovirus (hRV) (31.8%), adenovirus (AdV)(19.2%), respiratory syncytial virus (RSV) A (17.4%), RSV B (11.7%), and human metapneumovirus (hMPV) (9.8%). In comparison,influenza virus A (IFA) had the highest isolation rate (28.5%), followed by hRV (15.5%), influenza virus B (IFB) (15.0%), andhMPV (14.0%), in adults (763 total patients). Multiple viruses were detected in single specimens from 22.4% of children and 2.0%of adults. IFA/IFB, RSV A/B, and hMPV exhibited strong seasonal detection and similar circulating patterns in children and adults. Adult patients showed different clinical manifestations according to causative viruses; nasal congestion and rhinorrhea were morecommon in hRV and human coronavirus (hCoV) infection. Patients with RSV B, hRV, or AdV tended to be younger, and those infectedwith RSV A and hMPV were likely to be older. Those with RSV A infection tended to stay longer in hospital, enter the intensivecare unit more frequently, and have a fatal outcome more often. The bacterial co-detection rate was 26.5%, and those caseswere more likely to have lower respiratory tract involvement (P = 0.001), longer hospital stay (P = 0.001), and higher mortality (P= 0.001). Conclusions: The etiologic virus of an acute respiratory infection can be cautiously inferred based on a patient’s age and clinicalfeatures and concurrent epidemic data. Large-scale prospective surveillance studies are required to provide more accurateinformation about respiratory viral infection etiology, which could favorably influence clinical outcomes.
Abstract
Background: Etiologies and clinical profiles of acute respiratory viral infections need to be clarified to improve preventive andtherapeutic strategies. Materials and Methods: A retrospective observational study at a single, university-affiliated center was performed to evaluate therespiratory viral infection etiologies in children compared to that in adults and to document the clinical features of common viralinfections for adults from July 2009 to April 2012. Results: The common viruses detected from children (2,800 total patients) were human rhinovirus (hRV) (31.8%), adenovirus (AdV)(19.2%), respiratory syncytial virus (RSV) A (17.4%), RSV B (11.7%), and human metapneumovirus (hMPV) (9.8%). In comparison,influenza virus A (IFA) had the highest isolation rate (28.5%), followed by hRV (15.5%), influenza virus B (IFB) (15.0%), andhMPV (14.0%), in adults (763 total patients). Multiple viruses were detected in single specimens from 22.4% of children and 2.0%of adults. IFA/IFB, RSV A/B, and hMPV exhibited strong seasonal detection and similar circulating patterns in children and adults. Adult patients showed different clinical manifestations according to causative viruses; nasal congestion and rhinorrhea were morecommon in hRV and human coronavirus (hCoV) infection. Patients with RSV B, hRV, or AdV tended to be younger, and those infectedwith RSV A and hMPV were likely to be older. Those with RSV A infection tended to stay longer in hospital, enter the intensivecare unit more frequently, and have a fatal outcome more often. The bacterial co-detection rate was 26.5%, and those caseswere more likely to have lower respiratory tract involvement (P = 0.001), longer hospital stay (P = 0.001), and higher mortality (P= 0.001). Conclusions: The etiologic virus of an acute respiratory infection can be cautiously inferred based on a patient’s age and clinicalfeatures and concurrent epidemic data. Large-scale prospective surveillance studies are required to provide more accurateinformation about respiratory viral infection etiology, which could favorably influence clinical outcomes.
참고문헌 (17)
- Murray CJ, "Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study", Lancet, 349, pp.1436~1442 (1997)
- Mäkelä MJ, "Viruses and bacteria in the etiology of the common cold", J Clin Microbiol, 36, pp.539~542 (1998)
- Henrickson KJ, "Advances in the laboratory diagnosis of viral respiratory disease", Pediatr Infect Dis J, 23(1Suppl), pp.S6~S10 (2004)
- Pierangeli A, "Rhinovirus frequently detected in elderly adults attending an emergency department", J Med Virol, 83, pp.2043~2047 (2011)
- Garbino J, "Respiratory viruses and severe lower respiratory tract complications in hospitalized patients", Chest, 125, pp.1033~1039 (2004)
- Garbino J, "Respiratory viruses in bronchoalveolar lavage: a hospital-based cohort study in adults", Thorax, 64, pp.399~404 (2009)
- Gambarino S, "Development of a RT real-time PCR for the detection and quantification of human rhinoviruses", Mol Biotechnol, 42, pp.350~357 (2009)
- Lieberman D, "Respiratory viruses in adults with community-acquired pneumonia", Chest, 138, pp.811~816 (2010)
- Stefanska I, "Co-infections with influenza and other respiratory viruses", Adv Exp Med Biol, 756, pp.291~301 (2013)
- Calvo C, "Multiple simultaneous viral infections in infants with acute respiratory tract infections in Spain", J Clin Virol, 42, pp.268~272 (2008)
- Brouard J, "Viral co-infections in immunocompetent infants with bronchiolitis: prospective epidemiologic study", Arch Pediatr, 7(Suppl 3), pp.531s~535s (2000)
- Nascimento MS, "High rate of viral identification and coinfections in infants with acute bronchiolitis", Clinics (Sao Paulo), 65, pp.1133~1137 (2010)
- McCullers JA, "Influenza enhances susceptibility to natural acquisition of and disease due to Streptococcus pneumoniae in ferrets", J Infect Dis, 202, pp.1287~1295 (2010)
- Writing Committee of the WHOCoCAoPI, "Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection", N Engl J Med, 362, pp.1708~1719 (2010)
- Falsey AR, "Bacterial complications of respiratory viral illness: a comprehensive evaluation", J Infect Dis, 208, pp.432~441 (2013)
- Yu X, "Etiology and clinical characterization of respiratory virus infections in adult patients attending an emergency department in Beijing", PLoS One, 7, pp.e32174~ (2012)
- Ren L, "Prevalence of human respiratory viruses in adults with acute respiratory tract infections in Beijing, 2005-2007", Clin Microbiol Infect, 15, pp.1146~1153 (2009)