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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(3): 294-300, 2020 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-32187935

RESUMO

Objective: To understand the genetic variation and epidemiological characteristics of human respiratory syncytial virus (HRSV) in Guangzhou. Methods: Nasopharyngeal swabs specimens were collected from 0-6 year old children hospitalized with acute respiratory infection, then HRSV was tested and genotyped by RT-PCR. Phylogenetic tree was bulit using MEGA 6.0 software. NetNGlyc 1.0 server was used to predict the potential N-linked glycosylation sites. Results: A total of 1 225 nasopharyngeal specimens were collected, including 783 males and 442 females. The median (P(25), P(75)) age was 8 (3, 24) months. Among the 209 HRSV-positive cases (17.06%), 117 cases (55.98%) were HRSV-A and 92 cases (44.02%) were HRSV-B. The two distinct subgroups (HRSV-A and HRSV-B) alternately played dominant role to cause HRSV infection and exchange almost once every two years. The HRSV prevalence rate decreased with age. The HRSV-positive rate among children under 2 years old was 18.83% (196 cases), accounting for 93.78% of the total positive cases. There were 32 HRSV positive cases co-infected with at least one respiratory virus, with the co-infection rate of 15.31%. Phylogenetic tree analysis of the second hypervariable region (HVR2) of the G protein classified the HRSV-A specimens into ON1 (n=62) and NA1 (n=2) genotypes while all HRSV-B specimens belonged to BA genotype (n=53). The HVR2 of the G protein varied in using stop condon, amino acid substitutions, glycosylation sites. Conclusion: Children under 2 years old were the high risk population of HRSV infection in Guangzhou. ON1 genotype turned into a primary genetype of the HRSV-A subgroup while BA genotype dominated the HRSV-B subgroup. A greater diversification of amino acid substitutions, and some deletion and insertion of glycosylation sites embodied the polymorphism of G protein as main protective antigen.


Assuntos
Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Criança , Criança Hospitalizada , Pré-Escolar , China/epidemiologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Epidemiologia Molecular , Filogenia , Infecções por Vírus Respiratório Sincicial/diagnóstico
2.
Arch Virol ; 165(5): 1069-1077, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32144544

RESUMO

We investigated the molecular epidemiology of respiratory syncytial virus (RSV) isolated from children during 28 consecutive seasons (1990-2018) and the genetic variability of the duplication region of RSV genotypes ON1 and BA in South Korea. RSV was identified using culture-based methods in Hep-2 cells and was grouped as RSV-A or RSV-B by an immunofluorescence assay. The second hypervariable region of the G gene was sequenced for genotyping. The nucleotide and deduced amino acid sequences of the duplication region of RSV ON1 and BA were analyzed. A total of 670 RSV-A and 233 RSV-B isolates were obtained. For RSV-A, the NA1 genotype predominated during the 2004/2005-2011/2012 seasons. The ON1 genotype was first detected in 2011 and has since replaced all other genotypes. For RSV-B, the GB3 genotype predominated during the 1999/2000-2005/2006 seasons, but the BA genotype also replaced all other genotypes of RSV-B after the first season in which it was isolated (2005/2006). In ON1 and BA genotype RSV strains, novel sequence types of the duplication region of the G gene were identified in 50-95% and 33-80% of the isolates, respectively, in each season. The ON1 and BA9 genotypes are responsible for the current epidemics of RSV infection in South Korea. The sequences in the duplication region of the G gene have evolved continuously and might be sufficient for the identification of specific strains of the RSV-A ON1 and RSV-B BA genotypes.


Assuntos
Variação Genética , Genótipo , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/classificação , Proteínas Virais de Fusão/genética , Duplicação Gênica , Humanos , Epidemiologia Molecular , República da Coreia/epidemiologia , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Análise de Sequência de DNA
3.
BMC Infect Dis ; 20(1): 132, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32050912

RESUMO

BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading worldwide causes of childhood morbidity and mortality. Its disease burden varies by age and etiology and is time dependent. We aimed to investigate the annual and seasonal patterns in etiologies of pediatric CAP requiring hospitalization. METHODS: We conducted a retrospective study in 30,994 children (aged 0-18 years) with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Mycoplasma pneumoniae (MP) pneumonia was clinically classified as macrolide-sensitive MP, macrolide-less effective MP (MLEP), and macrolide-refractory MP (MRMP) based on fever duration after initiation of macrolide treatment, regardless of the results of in vitro macrolide sensitivity tests. RESULTS: MP and respiratory syncytial virus (RSV) were the two most commonly identified pathogens of CAP. With the two epidemics of MP pneumonia (2011 and 2015), the rates of clinical MLEP and MRMP pneumonia showed increasing trends of 36.4% of the total MP pneumonia. In children < 2 years of age, RSV (34.0%) was the most common cause of CAP, followed by MP (9.4%); however, MP was the most common cause of CAP in children aged 2-18 years of age (45.3%). Systemic corticosteroid was most commonly administered for MP pneumonia. The rate of hospitalization in intensive care units was the highest for RSV pneumonia, and ventilator care was most commonly needed in cases of adenovirus pneumonia. CONCLUSIONS: The present study provides fundamental data to establish public health policies to decrease the disease burden due to CAP and improve pediatric health.


Assuntos
Infecções Comunitárias Adquiridas/etiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia Viral/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Adenoviridae/tratamento farmacológico , Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/etiologia , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Macrolídeos/uso terapêutico , Masculino , Pneumonia por Mycoplasma/tratamento farmacológico , Pneumonia por Mycoplasma/etiologia , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/etiologia , República da Coreia/epidemiologia , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/etiologia , Vírus Sincicial Respiratório Humano/patogenicidade , Estudos Retrospectivos , Estações do Ano
4.
BMC Infect Dis ; 20(1): 157, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32075581

RESUMO

BACKGROUND: Respiratory syncytial virus (RSV) infection is a major cause of hospitalization in young children in Canada, despite routine immunoprophylaxis in those with medical risk factors. We aimed to determine if cold temperatures are associated with RSV hospitalization. METHODS: We conducted a population-based nested case-control study of children in Ontario, Canada, using health administrative data. We compared children hospitalized for RSV between September 1, 2011 and August 31, 2012 to age and sex matched controls. We used multivariable logistic regression to identify associations between minimum daily temperature and RSV hospitalizations with adjustment for sociodemographic and environmental factors. RESULTS: We identified 1670 children with RSV hospitalizations during the study period and 6680 matched controls. Warmer temperatures (OR = 0.94, 95%CI: 0.93, 0.95) were associated with lower odds of RSV hospitalization. Southern ecozone (OR = 1.6, 95%CI: 1.2, 2.1), increased ozone concentration (OR = 1.03, 95%CI: 1.01, 1.06) and living in a lower income neighbourhood (OR = 1.3, 95%CI: 1.1, 1.5) significantly increased the odds of RSV hospitalization, as did living in a household with a larger number of siblings in a sub-cohort of children (OR = 1.34, 95%CI: 1.26, 1.41). CONCLUSIONS: In Ontario, the likelihood of having an RSV hospitalization is associated with colder temperature exposures and socioeconomic factors.


Assuntos
Hospitalização/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Imunização , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Ontário/epidemiologia , Pobreza , Fatores de Risco , Fatores Socioeconômicos , Temperatura , Tempo (Meteorologia)
5.
Intern Med ; 59(2): 247-252, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31941871

RESUMO

Studies reporting chest images of respiratory syncytial virus (RSV)-induced lower respiratory tract infection (LRTI) in an outbreak setting and their relationship to the clinical manifestation are limited. During a genetically confirmed RSV outbreak, eight patients underwent both chest X-ray and computed tomography (CT). Among these, 5 cases had newly appearing abnormalities on CT, although chest X-ray was able to detect abnormalities in only 2 cases (40%). Although bronchial wall thickening was common, other findings and their distribution were variable, even in an outbreak setting. All patients with both a history of anticancer chemotherapy against hematological cancer and lower respiratory symptoms, such as wheezing, sputum, and hypoxemia, had abnormalities on CT, suggesting that these two factors might be important for predicting the existence of LRTI in RSV-infected patients.


Assuntos
Infecções por Vírus Respiratório Sincicial/diagnóstico por imagem , Infecções Respiratórias/diagnóstico por imagem , Idoso , Surtos de Doenças , Humanos , Japão/epidemiologia , Pessoa de Meia-Idade , Sons Respiratórios , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
6.
Int J Infect Dis ; 90: 5-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31634614

RESUMO

BACKGROUND: Human respiratory syncytial virus (RSV) is one of the most important pathogens that cause acute respiratory infections in children and immunocompromised adults. This work was conducted to understand the epidemiological and phylogenetic features of RSV in southern China during 2011-2016. METHODS: A total of 16 024 nasopharyngeal swabs were collected from patients with respiratory infections in 14 hospitals, and screened for RSV and seven other respiratory viruses using real-time PCR. Six hundred and twenty-three RSV-positive samples from 13 hospitals were further analyzed for subtypes. G gene sequencing and phylogenetic analysis were performed based on 46 RSV-A and 15 RSV-B strains. RESULTS: RSV was detected in 9.5% of the 16 024 specimens, the highest among the eight respiratory viruses screened. Most of these specimens came from inpatients and children under 3 years of age. The incidence of RSV-A (9.4%) was higher than that of RSV-B (4.4%) in children (<15 years), but not in adults (0.64% vs. 0.58%). A 2-year RSV-A dominance followed by a 1-year RSV-B dominance pattern was found. The co-detection rate of RSV was 25.1%. The main prevalent genotypes were NA1, ON1, and BA9. The prevalent RSV-A genotype in 2011-2012 was NA1, close to Chongqing and Brazil, but a new Hong Kong ON1 genotype was introduced and became the prevalent genotype in Guangzhou in 2014-2015. Deduced amino acid sequence analysis confirmed the ongoing evolution and a high selection pressure of RSV-A and B strains, especially in RSV-A ON1 and NA1 genotypes. CONCLUSIONS: This study demonstrated the molecular epidemiological characteristics of RSV in patients with respiratory infections in southern China.


Assuntos
Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/genética , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Feminino , Genótipo , Hong Kong/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Filogenia , Prevalência , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/classificação , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/epidemiologia , Adulto Jovem
7.
Int J Infect Dis ; 90: 170-180, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31669592

RESUMO

OBJECTIVES: The present study provides a comprehensive review of the recently published data on RSV epidemiology in adults and the elderly in Latin America. METHODS: A systematic literature search was carried out in Medline, Scielo, Lilacs, and Cochrane Library. The search strategy aimed at retrieving studies focusing on RSV prevalence, burden, risk factors, and the routine clinical practice in the prevention and management of RSV infections in Latin American countries. Only articles published between January 2011 and December 2017 were considered. RESULTS: Eighteen studies were included. Percentages of RSV detection varied highly across included studies for adult subjects with respiratory infections (0% to 77.9%), influenza-like illness (1.0% to 16.4%) and community-acquired pneumonia (1.3% to 13.5%). Considerable percentages of hospitalization were reported for RSV-infected adults with influenza-like illness (40.9% and 69.9%) and community-acquired pneumonia (91.7%). CONCLUSIONS: Recent RSV data regarding adult populations in Latin America are scarce. RSV was documented as a cause of illness in adults and the elderly, being identified in patients with acute respiratory infections, influenza-like illness and community-acquired pneumonia. The studies suggest that RSV infections may be a significant cause of hospitalization in adult populations in Latin America, including younger adults.


Assuntos
Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/virologia , Feminino , Hospitalização , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/classificação , Vírus Sincicial Respiratório Humano/genética , Fatores de Risco , Adulto Jovem
8.
Nat Commun ; 10(1): 5512, 2019 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-31797866

RESUMO

A key question for infectious disease dynamics is the impact of the climate on future burden. Here, we evaluate the climate drivers of respiratory syncytial virus (RSV), an important determinant of disease in young children. We combine a dataset of county-level observations from the US with state-level observations from Mexico, spanning much of the global range of climatological conditions. Using a combination of nonlinear epidemic models with statistical techniques, we find consistent patterns of climate drivers at a continental scale explaining latitudinal differences in the dynamics and timing of local epidemics. Strikingly, estimated effects of precipitation and humidity on transmission mirror prior results for influenza. We couple our model with projections for future climate, to show that temperature-driven increases to humidity may lead to a northward shift in the dynamic patterns observed and that the likelihood of severe outbreaks of RSV hinges on projections for extreme rainfall.


Assuntos
Clima , Epidemias , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Humanos , Umidade , Incidência , Influenza Humana/epidemiologia , Influenza Humana/transmissão , Masculino , México/epidemiologia , Infecções por Vírus Respiratório Sincicial/transmissão , Estações do Ano , Temperatura
9.
Arch Med Res ; 50(6): 377-383, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31678896

RESUMO

BACKGROUND: Lower respiratory tract infections (LRTI) are one of the most common causes of death worldwide. Respiratory syncytial virus (RSV) is a leading cause of LRTI in children. Despite of its epidemiological importance, there is limited information regarding the impact of this virus in Latin America. AIMS OF THE STUDY: We carried out a prospective study to establish the frequency and characteristics of RSV infections in hospitalized Mexican children. METHODS: 1,252 children hospitalized between November, 2012 and December, 2015 because of LRTI were included in the study. A respiratory sample was obtained for RSV detection by RT-PCR and information regarding clinical presentation, hospital course, and outcome was recorded. RESULTS: RSV was detected in 43.7% of children admitted with LRTI, in 43.3% of those admitted to the intensive care unit (ICU), and in 36.4% of those who died. Infants with RSV infection were younger, were diagnosed with bronchiolitis more frequently, and were less likely to have underlying disorders than those with RSV-negative LRTI. Among RSV-positive infants, admission to the ICU was associated with the presence of underlying conditions, pneumonia diagnosis, and young age. Four (0.73%) of the 547 infants with RSV infection died; death was more common in those with underlying disorders than previously healthy infants (3.8 vs. 0.2%, respectively; p = 0.02). CONCLUSION: RSV contributes to a large proportion of LRTI hospital admissions. Most children admitted with RSV infection do not have underlying conditions. However, severe infection requiring ICU admission and death are more common in those with underlying disorders.


Assuntos
Hospitalização/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/patologia , Infecções Respiratórias/epidemiologia , Adolescente , Criança , Criança Hospitalizada , Pré-Escolar , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , México , Estudos Prospectivos , Infecções Respiratórias/virologia
10.
Braz J Infect Dis ; 23(6): 427-434, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31734172

RESUMO

To investigate the genetic variation and molecular epidemiology characteristics of Human Respiratory Syncytial Virus (HRSV) in Guizhou Province, nasopharyngeal aspirates were collected from patients with acute respiratory infection (ARI) in Guizhou Provincial People's Hospital, from December 2017 to March 2018, and inoculated to Hep-2 cells to isolate HRSV. Cells that showed cytopathic effect (CPE) were then confirmed by indirect immunofluorescence assay and reverse transcription. The sequence of the PCR products was determined for HRSV isolates, and the genetic variation was analyzed. Out of 196 nasopharyngeal aspirate samples, HRSV were isolated in 39. The second hypervariable region at the 3' terminal of glycoprotein gene (HVR2) sequence analysis showed that subgroup A was dominant. Seventy-nine percent of the isolates belonged to subgroup A, ON1 genotype, and 21 % belonged to subgroup B, BA9 genotype, which indicates that the dominant HRSV circulating in Guizhou Province was subgroup A, genotype ON1, co-circulating with a less prevalent subgroup B, genotype BA9.


Assuntos
Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/virologia , Pré-Escolar , China/epidemiologia , Genótipo , Humanos , Epidemiologia Molecular , Cavidade Nasal/virologia , Filogenia , Reação em Cadeia da Polimerase , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia , Análise de Sequência de DNA
11.
Rural Remote Health ; 19(4): 5267, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31759384

RESUMO

INTRODUCTION: Respiratory syncytial virus (RSV) is the leading viral cause of acute lower respiratory infections globally, accounting for high morbidity and mortality burden among children aged less than 5 years. As candidate RSV vaccine trials in pregnant women and infants are underway a greater understanding of RSV epidemiology is now needed, especially in paediatric populations with high rates of acute and chronic respiratory disease. The objective was to identify RSV prevalence in children living in northern Australia, a region with a high respiratory disease burden. METHODS: Data were sourced from 11 prospective studies (four hospital and seven community-based) of infants and children with acute and chronic respiratory illnesses, as well as otitis media, conducted between 1996 and 2017 inclusive. The data from northern Australian children in these trials were extracted and, where available and consented, their nasopharyngeal swabs (biobanked at -80ºC) were tested by polymerase chain reaction assays for RSV-A and B, 16 other viruses and atypical respiratory bacterial pathogens. RESULTS: Overall, 1127 children were included. Their median age was 1.8 years (interquartile range 0.5-4.9); 58% were male and 90% Indigenous, with 81% from remote communities. After human rhinoviruses (HRV), RSV was the second most prevalent virus (15%, 95% confidence interval (CI) 13-18). RSV prevalence was greatest amongst children aged less than 2 years hospitalised with bronchiolitis (47%, 95%CI 41.4-52.4), with more than two-thirds with RSV aged less than 6 months. In contrast, the prevalence of RSV was only 1-3.5% in other age groups and settings. In one-third of RSV cases, another respiratory virus was also detected. Individual viruses other than RSV and HRV were uncommon (0-9%). CONCLUSION: Combined data from 11 hospital and community-based studies of children aged less than 18 years who lived in communities with a high burden of acute and chronic respiratory illness showed that RSV was second only to HRV as the most prevalent virus detected across all settings. RSV was the most frequently detected virus in infants hospitalised with bronchiolitis, including those aged less than 6 months. In contrast, RSV was uncommonly detected in children in community settings. In northern Australia, effective maternal and infant RSV vaccines could substantially reduce RSV bronchiolitis-related hospitalisations, including admissions of Indigenous infants from remote communities.


Assuntos
Hospitalização/estatística & dados numéricos , Prevalência , Infecções por Vírus Respiratório Sincicial/epidemiologia , População Rural/estatística & dados numéricos , Austrália/epidemiologia , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Vigilância da População , Estudos Prospectivos , Fatores de Risco
12.
Indian J Med Microbiol ; 37(2): 248-254, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31745027

RESUMO

Introduction: Human respiratory syncytial virus (HRSV) an RNA virus belonging to Pneumoviridae family, is an important cause of acute respiratory infections (ARIs) in young children. HRSV circulates as two subgroups A and B, which are further categorised into several genotypes. New genotypes may replace existing ones over successive epidemic seasons and multiple genotypes may cocirculate in the same community rendering it important to monitor them at the molecular level. The present study assessed the circulating genotypes of HRSV in Chennai. Materials and Methods: Two hundred and sixty-seven children with ARI were recruited during the study from April 2016 to March 2018 for detecting HRSV A and B by real-time reverse transcription-polymerase chain reaction. Phylogeny and selection pressure analysis were done. Results: Fifty-seven of the 267 samples (21.3%) were positive for HRSV, of which 7.1% and 14.2% were HRSV A and B, respectively, indicating that HRSV B was the major subgroup circulating in Chennai. Peak activity of HRSV was observed during the monsoon and winter months. Phylogenetic analysis of 2nd hypervariable region (HVR) of attachment glycoprotein gene (G gene) revealed that the HRSV A strains belonged to ON1 and HRSV B strains belonged to BA9 genotypes. Several unique amino acid substitutions were observed among the study strains. The Shannon entropy plot revealed that the HRSV A strains from our study have a high potential for amino acid substitutions in the 2nd HVR of G gene. Conclusion: This study underlines the genetic diversity of HRSV and emphasises the need for continued molecular surveillance for infection management and prevention strategies.


Assuntos
Variação Genética , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/genética , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Criança , Pré-Escolar , Entropia , Evolução Molecular , Humanos , Índia/epidemiologia , Lactente , Mutação , Filogenia , Vigilância da População , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Infecções por Vírus Respiratório Sincicial/diagnóstico , Vírus Sincicial Respiratório Humano/classificação , Infecções Respiratórias/diagnóstico , Estações do Ano , Análise de Sequência de DNA
13.
Adv Exp Med Biol ; 1222: 55-62, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31529287

RESUMO

In uncomplicated bronchiolitis, chest radiography (CR) is not routinely recommended, yet it is still frequently made. This study seeks to evaluate the use of CR in children with bronchiolitis due to a lower respiratory tract infection (RSV-RTI) with respiratory syncytial virus (RSV) and the influence of CR on patient treatment during the 2010-2017 seasons. There were 581 children included into the study: 459 with bronchiolitis (390 RSV-RTI and 69 non-RSV), 65 with RSV pneumonia and 57 with RSV bronchitis. We found that CR was performed in 28.6% (166/581) patients. CR was much more frequent in patients with RSV than non-RSV infections (61% vs. 31%). CR prognostic sensitivity and specificity in guiding antibiotic treatment was low, 78% and 58%, respectively. Positive and negative predicted values of CR were 78% and 58%, respectively and the number needed to diagnose was 2.777. Children in whom CR was performed (irrespective of the result) were at 22.9-fold higher risk of antibiotic therapy (95%CI: 14.1-37.1; p < 0.01), while those with a positive CR were only at 4.4-fold higher risk of antibiotic therapy (95%CI: 2.2-8.9; p < 0.01). Children with CR required a longer hospital stay than those without it (10 vs. 8 days, respectively; p < 0.01). The percentage of CR decreased from 78% in 2010 to 33% in 2017, with the lowest value of 11% in 2015. The additional cost of CR, which had no influence on treatment, would have been €381 had it been performed in each patient, which amounts to 1% of the total hospitalization cost. We conclude that CR is overused and in most cases it has no influence on the patient management. The recognition of practical meaning of CR is essential to avoid unnecessary radiation of children.


Assuntos
Bronquiolite/diagnóstico por imagem , Hospitalização/estatística & dados numéricos , Radiografia/métodos , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia , Bronquiolite/epidemiologia , Bronquiolite/virologia , Pré-Escolar , Humanos , Lactente , Tempo de Internação , Pneumonia/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia
14.
BMC Res Notes ; 12(1): 581, 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-31521197

RESUMO

OBJECTIVES: We have assessed the risk factors for the occurrence of hospital-acquired (HA) and community-acquired (CA) viral acute respiratory tract infections (ARTIs) in children. Children (1-60 months) who were having ARTI on admission (CA) and develops ARTI following 48 h after admission or 3 days of discharge (HA) were included. Indirect immunofluorescence assay (IFA) was performed and multivariable analyses were done to determine the risk factors for the development of viral CA and HA-ARTI. RESULTS: Total of 818 with ARTIs, 226 (27.6%) RSV cases were detected. Out of 226, 86 (38.0%) HA-RSV cases were detected. CA-viral-ARTI was significantly high (p < 0.05). Compared to CA-RSV-ARTI immunodeficiency, seizures, trisomy-21 and congenital heart disease (CHD) were having 2.3, 3.2, 1.8- and 2.2-times risk for acquiring HA-RSV respectively. The number of deaths was significantly high following HA-RSV. The associated burden was significant following HA-RSV and it was 429.77 disability-adjusted life years. Children who are having immunodeficiency, CHD, seizure episodes and trisomy 21 would lead to the acquisition of nosocomial RSV infections in great. Adherence to meticulous infection control practices will be helpful to minimize the HA-viral ARTIs in great.


Assuntos
Infecção Hospitalar/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Doença Aguda , Pré-Escolar , Imunodeficiência de Variável Comum/complicações , Infecção Hospitalar/virologia , Estudos Transversais , Síndrome de Down/complicações , Feminino , Cardiopatias Congênitas/complicações , Hospitalização , Humanos , Lactente , Masculino , Infecções por Vírus Respiratório Sincicial/mortalidade , Vírus Sincicial Respiratório Humano , Infecções Respiratórias/mortalidade , Fatores de Risco , Convulsões/complicações , Sri Lanka
15.
Infect Genet Evol ; 76: 104039, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31521788

RESUMO

Acute respiratory infection (ARI) is the most common infection in children under 5 years of age and it is frequently caused by two pneumoviruses, human respiratory syncytial virus (HRSV) and human metapneumovirus (HMPV). Epidemic seasons of these viruses overlap and disease manifestations are highly similar, including severe lower ARI such as bronchiolitis or pneumonia. Reinfections with pneumoviruses are frequent and limited prevention treatment is available. Genetic diversity of HRSV and HMPV strains circulating in Croatia was monitored during four consecutive years (2014-2017). Co-circulation of multiple lineages was observed for both viruses. Within HRSV group A, ON1 strains gained strong predominance during the 4-year period, while previously dominant genotype NA1 was detected only sporadically. Similarly, newly occurring HMPV genotype A2c gained predominance over genotype A2b during this period, resulting in all infection in 2017 being caused by A2c. Along with phylogenetic analysis based on the commonly used fragments for detection and genotyping of these viruses, full length G and SH genes were also analysed. Evolutionary dynamics showed that inferred substitution rates of HRSV and HMPV are between 2.51 × 10-3 and 3.61 × 10-3 substitutions/site/year. This study established presence of recently described HMPV strains containing large duplications in the G gene in Croatia. Viruses with either of the two duplications belong to a subcluster A2c, which has completely replaced all other group A subclusters in 2017.


Assuntos
Metapneumovirus/classificação , Infecções por Paramyxoviridae/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/classificação , Infecções Respiratórias/virologia , Criança , Pré-Escolar , Croácia/epidemiologia , Substituição de Medicamentos , Evolução Molecular , Feminino , Humanos , Lactente , Masculino , Metapneumovirus/genética , Metapneumovirus/isolamento & purificação , Epidemiologia Molecular , Filogenia , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação
16.
Hosp Pediatr ; 9(10): 794-800, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31540911

RESUMO

OBJECTIVES: Bronchiolitis, the leading cause of infant hospitalizations in the United States, is associated with increased risk of childhood asthma. We hypothesized that factors during a bronchiolitis hospitalization were associated with subsequent asthma. METHODS: This is a retrospective cohort study at an urban, tertiary-care children's hospital of infants <12 months old, hospitalized for bronchiolitis. The primary outcome measure was an asthma diagnosis, defined as a billing code for an asthma visit or a prescription for controller medication, within 5 years of discharge from the bronchiolitis hospitalization. RESULTS: There were 534 infants hospitalized for bronchiolitis, of which 294 (55.1%) were diagnosed with asthma, and 102 (19.1%) were hospitalized for asthma within 5 years of discharge. There was significant interaction between age and family history. In both models, female sex was protective (odds ratio [OR] 0.46). Age and race were only associated with asthma in infants without a family history of asthma: age (OR 1.19; 95% confidence interval 1.08-1.32) and race (OR 4.06; 95% confidence interval 1.56-10.58). Hospitalization length, ICU stay, albuterol treatments received, supplemental oxygen, respiratory support, highest respiratory rate, and respiratory syncytial virus infection were not associated with asthma diagnosis. CONCLUSIONS: More than 55% of infants hospitalized for bronchiolitis developed asthma within 5 years of discharge. Demographic and family history variables were independently associated with asthma. However, hospital-based variables during the bronchiolitis hospitalization were not independently associated with asthma. These results can direct further research and differentiate anticipatory guidance for infants with bronchiolitis at risk for asthma.


Assuntos
Asma/epidemiologia , Bronquiolite/epidemiologia , Hospitalização , Infecções por Vírus Respiratório Sincicial/epidemiologia , Fatores Etários , Pré-Escolar , Grupos Étnicos , Feminino , Seguimentos , Humanos , Lactente , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco
17.
BMJ ; 366: l5021, 2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31506273

RESUMO

Human respiratory syncytial virus (RSV) belongs to the recently defined Pneumoviridae family, Orthopneumovirus genus. It is a negative sense, single stranded RNA virus that results in epidemics of respiratory infections that typically peak in the winter in temperate climates and during the rainy season in tropical climates. Generally, one of the two genotypes (A and B) predominates in a single season, alternating annually, although regional variation occurs. RSV is a cause of disease and death in children, older people, and immunocompromised patients, and its clinical effect on adults admitted to hospital is clarified with expanded use of multiplex molecular assays. Among adults, RSV produces a wide range of clinical symptoms including upper respiratory tract infections, severe lower respiratory tract infections, and exacerbations of underlying disease. Here we discuss the latest evidence on the burden of RSV related disease in adults, especially in those with immunocompromise or other comorbidities. We review current therapeutic and prevention options, as well as those in development.


Assuntos
Carga Global da Doença , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sinciciais Respiratórios/genética , Infecções Respiratórias/epidemiologia , Adulto , Antivirais/uso terapêutico , Epidemias , Genótipo , Humanos , Hospedeiro Imunocomprometido , Imunoglobulinas Intravenosas/uso terapêutico , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/terapia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/patogenicidade , Infecções Respiratórias/imunologia , Infecções Respiratórias/terapia , Infecções Respiratórias/virologia , Ribavirina/uso terapêutico , Estações do Ano
18.
BMC Infect Dis ; 19(1): 729, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429710

RESUMO

BACKGROUND: No comparison data have been reported on viral and epidemiological profiles of hospitalized children with severe acute respiratory infection (SARI) in Beijing or Shanghai, China. METHODS: We collected 700 nasopharyngeal aspirates (NPA) from hospitalized children with SARI in Beijing (northern China) and Shanghai (southern China). Multiple respiratory viruses (including 15 common viruses) were screened by validated polymerase chain reaction (PCR) or real-time reverse transcription-PCR assays and confirmed by sequencing. Demographic data and the distribution of viral infections were also examined. RESULTS: Of 700 samples, 547 (78.1%) tested positive for viral infections. The picornaviruses (PIC), which included rhinovirus (RV) and enterovirus (EV), were the most common (34.0%), followed by respiratory syncytial virus (RSV) (28.3%), human bocavirus (HBoV) (19.1%), adenovirus (ADV) (13.7%), human coronaviruses (HCoV) (10.7%), influenza A and B (8.9%), parainfluenza virus (PIV 1-3) (7.9%), and human metapneumovirus (HMPV) (5.0%). PIC (RV/EV) and RSV were the most prevalent etiological agents of SARI in both cities. The total and age-matched prevalence of RSV, HCoV, and hMPV among SARI children under 5 years old were significantly higher in Beijing than in Shanghai. Different age and seasonal distribution patterns of the viral infections were found between Beijing and Shanghai. CONCLUSIONS: Viral infection was tested and shown to be the most prevalent etiological agent among children with SARI in either the Beijing or the Shanghai area, while showing different patterns of viral and epidemiological profiles. Our findings provide a better understanding of the roles of geographic location and climate in respiratory viral infections in hospitalized children with SARI.


Assuntos
Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/virologia , Pequim/epidemiologia , Pré-Escolar , China/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Infecções por Paramyxoviridae/epidemiologia , Infecções por Paramyxoviridae/virologia , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Infecções por Picornaviridae/epidemiologia , Infecções por Picornaviridae/virologia , Prevalência , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Infecções por Respirovirus/epidemiologia , Infecções por Respirovirus/virologia
19.
Epidemiol Infect ; 147: e221, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-31364539

RESUMO

Several studies have reported evidence of interference between respiratory viruses: respiratory viruses rarely reach their epidemic peak concurrently and there appears to be a negative association between infection with one respiratory virus and co-infection with another. We used results spanning 16 years (2002-2017) of a routine diagnostic multiplex panel that tests for nine respiratory viruses to further investigate these interactions in Victoria, Australia. Time series analyses were used to plot the proportion positive for each virus. The seasonality of all viruses included was compared with respiratory syncytial virus (RSV) and influenza A virus using cross-correlations. Logistic regression was used to explore the likelihood of co-infection with one virus given infection with another. Seasonal peaks were observed each year for influenza A and RSV and less frequently for influenza B, coronavirus and parainfluenza virus. RSV circulated an average of 6 weeks before influenza A. Co-infection with another respiratory virus was less common with picornavirus, RSV or influenza A infection. Our findings provide further evidence of a temporal relationship in the circulation of respiratory viruses. A greater understanding of the interaction between respiratory viruses may enable better prediction of the timing and magnitude of respiratory virus epidemics.


Assuntos
Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Adenoviridae/isolamento & purificação , Adolescente , Adulto , Distribuição por Idade , Austrália/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Coinfecção/epidemiologia , Coronavirus/isolamento & purificação , Testes Diagnósticos de Rotina , Feminino , Humanos , Vírus da Influenza A/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Vírus da Parainfluenza 1 Humana/isolamento & purificação , Vírus da Parainfluenza 2 Humana/isolamento & purificação , Prevalência , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Análise de Sobrevida , Vitória/epidemiologia , Adulto Jovem
20.
Epidemiol Infect ; 147: e246, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-31364578

RESUMO

We aimed to provide comprehensive estimates of laboratory-confirmed respiratory syncytial virus (RSV)-associated hospitalisations. Between 2012 and 2015, active surveillance of acute respiratory infection (ARI) hospitalisations during winter seasons was used to estimate the seasonal incidence of laboratory-confirmed RSV hospitalisations in children aged <5 years in Auckland, New Zealand (NZ). Incidence rates were estimated by fine age group, ethnicity and socio-economic status (SES) strata. Additionally, RSV disease estimates determined through active surveillance were compared to rates estimated from hospital discharge codes. There were 5309 ARI hospitalisations among children during the study period, of which 3923 (73.9%) were tested for RSV and 1597 (40.7%) were RSV-positive. The seasonal incidence of RSV-associated ARI hospitalisations, once corrected for non-testing, was 6.1 (95% confidence intervals 5.8-6.4) per 1000 children <5 years old. The highest incidence was among children aged <3 months. Being of indigenous Maori or Pacific ethnicity or living in a neighbourhood with low SES independently increased the risk of an RSV-associated hospitalisation. RSV hospital discharge codes had a sensitivity of 71% for identifying laboratory-confirmed RSV cases. RSV infection is a leading cause of hospitalisation among children in NZ, with significant disparities by ethnicity and SES. Our findings highlight the need for effective RSV vaccines and therapies.


Assuntos
Custos Hospitalares , Hospitalização/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Distribuição por Idade , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Hospitalização/economia , Humanos , Lactente , Armazenamento e Recuperação da Informação , Masculino , Nova Zelândia/epidemiologia , Vigilância da População , Infecções por Vírus Respiratório Sincicial/economia , Estudos Retrospectivos , Medição de Risco , Estações do Ano , Distribuição por Sexo
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