背景:呼吸道合胞病毒(RSV)是全球呼吸道感染的主要原因,每年导致5岁以下儿童约300万人住院和100,000多人死亡。这是全球医疗保健的主要负担。对于在生命早期预防RSV感染的新药剂和通用策略存在巨大的未满足的需求。由流行病学专家组成的多学科共识发展小组,传染病,呼吸医学,和方法学旨在发展目前的共识,以解决儿童RSV感染的临床问题。
方法:使用电子数据库进行证据搜索和审查,包括PubMed,Embase,WebofScience,还有Cochrane图书馆,使用“呼吸道合胞病毒”术语的变体,\"RSV\",“下呼吸道感染”,“细支气管炎”,“急性”,“病毒性肺炎”,“新生儿”,\"婴儿\"\"儿童\",和“儿科”。
结果:关于诊断的循证建议,治疗,和预防是在高度共识下提出的。尽管支持性护理仍然是RSV感染管理的基石,新的单克隆抗体,疫苗,药物治疗,病毒监测技术正在推广。
结论:这一共识,基于国际和国家科学证据,加强了当前的建议,并整合了最佳护理和预防RSV感染的最新进展。进一步改善RSV感染的管理将需要通过严格设计的研究来产生最高质量的证据,这些研究几乎没有偏见,并且有足够的能力来确定有临床意义的终点。视频摘要(MP4142103KB)。
Respiratory syncytial virus (RSV) is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years, representing a major global healthcare burden. There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life. A multidisciplinary
consensus development group comprising experts in epidemiology, infectious diseases, respiratory medicine, and methodology aims to develop the current
consensus to address clinical issues of RSV infections in children.
The evidence searches and reviews were conducted using electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, using variations in terms for \"respiratory syncytial virus\", \"RSV\", \"lower respiratory tract infection\", \"bronchiolitis\", \"acute\", \"viral pneumonia\", \"neonatal\", \"infant\" \"children\", and \"pediatric\".
Evidence-based recommendations regarding diagnosis, treatment, and prevention were proposed with a high degree of
consensus. Although supportive care remains the cornerstone for the management of RSV infections, new monoclonal antibodies, vaccines, drug therapies, and viral surveillance techniques are being rolled out.
This
consensus, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections. Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.