■呼吸道合胞病毒(RSV)是引起儿童社区获得性肺炎(CAP)的最常见病毒之一。为了指导预防,RSV的诊断和治疗,我们旨在分析住院CAP患儿中RSV的流行病学。
■对2010年1月至2019年12月的9,837例CAP住院儿童(≤14岁)进行了回顾。使用实时聚合酶链反应(RT-PCR),收集口咽拭子标本并进行RSV测试,流感病毒A(INFA),乙型流感病毒(INFB),副流感病毒(PIV),肠道病毒(EV),冠状病毒(CoV),人偏肺病毒(HMPV),人类博卡病毒(HBoV),人鼻病毒(HRV),和腺病毒(ADV)为每个患者。
■RSV的检出率为15.3%(1,507/9,837)。2010-2019年RSV检出率呈波浪状变化(χ2=166.982,P<0.001),2011年检出率最高(158/636,24.8%)。RSV可以全年检测到,2月检出率最高(123/482,25.5%)。0.5岁以下儿童检出率最高(410/1,671,24.5%)。男性儿童RSV检出率(1,024/6,226,16.4%)高于女性儿童(483/3,611,13.4%)(P<0.001)。17.7%(266/1,507)的RSV阳性病例也与其他病毒共感染,INFA(41/266,15.4%)是最常见的合并感染病毒。在调整了潜在的混杂因素后,RSV阳性儿童与重症肺炎风险增加相关[比值比(OR)1.26,95%置信区间(CI):1.04~1.53,P=0.019].此外,重症肺炎患儿的RSV周期阈值(CT)值明显低于无重症肺炎患儿(28.88±3.89vs.30.42±3.33,P<0.01)。合并感染患者(38/266,14.3%)发生重症肺炎的风险高于未合并感染患者(142/1,241,11.4%),但差异无统计学意义(OR1.39,95%CI:0.94~2.05,P=0.101)。
■CAP住院儿童RSV的检出率随年份的变化而变化,月,年龄,和性别。CAP住院的RSV患儿比没有RSV的患儿更容易发生重症肺炎。决策者和医生应及时调整预防措施,基于这些流行病学特征的医疗资源和治疗方案。
UNASSIGNED: Respiratory syncytial virus (RSV) is one of the most common virus causing community-acquired pneumonia (CAP) in children. To guide the prevention, diagnosis and treatment of RSV, we aimed to analyze the epidemiology of RSV in hospitalized children with CAP.
UNASSIGNED: A total of 9,837 hospitalized children (≤14 years old) with CAP from January 2010 to December 2019 were reviewed. Using the real-time polymerase chain reaction (RT-PCR), the oropharyngeal swab specimens were collected and tested for RSV, influenza virus A (INFA), influenza virus B (INFB), parainfluenza virus (PIV), enterovirus (EV), coronavirus (CoV), human metapneumovirus (HMPV), human bocavirus (HBoV), human rhinovirus (HRV), and adenovirus (ADV) for each patient.
UNASSIGNED: The detection rate of RSV was 15.3% (1,507/9,837). From 2010 to 2019, the RSV detection rate showed a wavy change (χ2=166.982, P<0.001), with the highest detection rate in 2011 (158/636, 24.8%). RSV can be detected throughout the year, with the highest detection rate in February (123/482, 25.5%). Children younger than 0.5 years old had the highest detection rate (410/1,671, 24.5%). The detection rate of RSV in male children (1,024/6,226, 16.4%) was higher than that in female children (483/3,611, 13.4%) (P<0.001). A proportion of 17.7% (266/1,507) of RSV positive cases were also co-infected with other viruses, and INFA (41/266, 15.4%) was the most common coinfection virus. After adjusting for potential confounders, the RSV-positive children were associated with increased risk of severe pneumonia [odds ratio (OR) 1.26, 95% confidence interval (CI): 1.04 to 1.53, P=0.019]. Moreover, children with severe pneumonia had significantly lower cycle threshold (CT) values of RSV than those without severe pneumonia (28.88±3.89 vs. 30.42±3.33, P<0.01). Patients with coinfection (38/266, 14.3%) had a higher risk of severe pneumonia than those without coinfection (142/1,241, 11.4%), but the difference was not statistically significant (OR 1.39, 95% CI: 0.94 to 2.05, P=0.101).
UNASSIGNED: The detection rate of RSV in CAP hospitalized children changed by years, months, ages, and sexes. CAP hospitalized children with RSV are more likely to develop severe pneumonia than those without RSV. Policy makers and doctors should make timely adjustments to prevention measures, medical resources and treatment options based on these epidemiological characteristics.