Clinical and epidemiologic factors related to subsequent wheezing after virus-induced lower respiratory tract infections in hospitalized pediatric patients younger than 3?years

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• 作者：Aya Takeyama (1) (2)
  Koichi Hashimoto (2)
  Masatoki Sato (2)
  Toshiko Sato (2)
  Yoichi Tomita (1)
  Ryo Maeda (1)
  Masaki Ito (1)
  Masahiko Katayose (1)
  Yukihiko Kawasaki (2)
  Mitsuaki Hosoya (2)
  
• 关键词：Virus ; induced wheezing ; Subsequent wheezing ; 3 ; year follow ; up ; Lower respiratory tract infection
• 刊名：European Journal of Pediatrics
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：173
• 期：7
• 页码：959-966
• 全文大小：
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• 作者单位：Aya Takeyama (1) (2)
  Koichi Hashimoto (2)
  Masatoki Sato (2)
  Toshiko Sato (2)
  Yoichi Tomita (1)
  Ryo Maeda (1)
  Masaki Ito (1)
  Masahiko Katayose (1)
  Yukihiko Kawasaki (2)
  Mitsuaki Hosoya (2)
  
  1. Department of Pediatrics, Soma General Hospital, 142 Tubogasaku-Niinuma, Soma City, Fukushima, 976-0011, Japan
  2. Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
  
• ISSN：1432-1076

文摘

Most wheezing episodes in infants are caused and exacerbated by virus-induced lower respiratory tract infections. However, there are few reports of epidemiologic and clinical virus-specific research with a focus on virus-induced wheezing. The purpose of the current study was to characterize the clinical presentation of virus-induced wheezing in pediatric patients <3?years of age who were hospitalized with lower respiratory tract infections. Of the 412 patients in the study, 216 were followed for 3?years. Nasopharyngeal aspirates collected from the patients at the time of admission were examined for the presence of respiratory syncytial virus (RSV), rhinovirus (RV), parainfluenza-3 virus (PIV-3), human metapneumovirus (hMPV), and influenza virus (Flu) using reverse-transcription polymerase chain reaction and rapid diagnostic tests. Clinical signs were assessed using a severity scoring system. In patients with wheezing at the time of admission, RSV, RV, RSV+RV, Flu, PIV-3, and hMPV were detected in 33, 14, 8, 8, 5, and 3?% of samples, respectively. There were no differences in age and severity scores between patients harboring more prevalent viruses (RSV and RV) and those with less common infections. Patients with wheezing and RV-positive aspirates at the time of admission were more likely to develop subsequent wheezing during the following 3?years. Conclusion: RSV and RV infections are factors in the development and exacerbation of wheezing after virus-induced lower respiratory tract infections. Moreover, RV-induced wheezing may be associated with subsequent recurrent wheezing and the development of asthma.