呼吸道病毒感染所致的儿童危重症诊治进展
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摘要
病毒引起的下呼吸道感染(lower respiratory tractinfections,LRTIs)是儿童危重症的常见原因。随着近十年病毒检测技术的发展,病毒引起LRTIs的发病率、病死率、医疗负担与细菌引起的社区获得性肺炎或医院获得性肺炎相差无几。该文阐述了病毒性LRTIs与儿童危重症之间的关系,并讨论了常见的呼吸道病毒感染相关临床特征和管理策略。早期诊断和治疗能够有效地控制呼吸道病毒感染并预防并发症的发生。
Viral lower respiratory tract infections(LRTIs)are common causes of critical illness in children. Recent advances in viral detection techniques over the past decade have demonstrated the rates of morbidity,mortality,and medical burden of LRTIs caused by viruses are comparable to those of bacterial communityacquired and nosocomial pneumonias. In the paper,it described the relationship between viral LRTIs and critical illness,and discuss relevant clinical features and management strategies of the more prevalent respiratory viral pathogens. Early diagnostic and treatment strategies are required to effectively treat these infections and prevent complications.
Viral lower respiratory tract infections(LRTIs)are common causes of critical illness in children. Recent advances in viral detection techniques over the past decade have demonstrated the rates of morbidity,mortality,and medical burden of LRTIs caused by viruses are comparable to those of bacterial communityacquired and nosocomial pneumonias. In the paper,it described the relationship between viral LRTIs and critical illness,and discuss relevant clinical features and management strategies of the more prevalent respiratory viral pathogens. Early diagnostic and treatment strategies are required to effectively treat these infections and prevent complications.
引文
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[29]Siebrasse EA,Nguyen NL,Willby MJ,et al.Multiorgan WUpolyomavirus infection in bone marrow transplant recipient[J].Emerg Infect Dis,2016,22(1):24-31.
[2]Szabo SM,Gooch KL,Bibby MM,et al.The risk of mortality among young children hospitalized for severe respiratory syncytial virus infection[J].Paediatr Respir Rev,2013,13(Suppl 2):S1-8.
[3]Ravindranath TM,Gomez A,Harwayne-Gidansky I,et al.Pediatric acute respiratory distress syndrome associated with human meta?pneumovirus and respiratory syncytial virus[J].Pediatr Pulmonol,2018,53(7):929-935.
[4]Ciancanelli MJ,Huang SX,Luthra P,et al.Infectious disease.Lifethreatening influenza and impaired interferon amplification in human IRF7 deficiency[J].Science,2015,348(6233):448-453.
[5]Ghazaly M,Nadel S.Overview of prevention and management of acute bronchiolitis due to respiratory syncytial virus[J].Expert Rev Anti Infect Ther,2018,16(12):913-928.
[6]Levin D,Tribuzio M,Green-Wrzesinki T,et al.Empiric antibi?otics are justified for infants with respiratory syncytial virus low?er respiratory tract infection presenting with respiratory failure:a prospective study and evidence review[J].Pediatr Crit Care Med,2010,11(3):390-395.
[7]Kawaguchi A,Bates A,Lee BE,et al.Virus detection in critically ill children with acute respiratory disease:a new profile in view of new technology[J].Acta Paediatr,2018,107(3):504-510.
[8]Zhao YJ,Shen J,Wu BJ,et al.Genotypic diversity and epidemi?ology of human rhinovirus among children with severe acute re?spiratory tract infection in Shanghai,2013-2015[J].Front Mi?crobiol,2018,9:1836.
[9]Lambert KA,Prendergast LA,Dharmage SC,et al.The role of human rhinovirus(HRV)species on asthma exacerbation severity in children and adolescents[J].J Asthma,2018,55(6):596-602.
[10]Lu X,Schneider E,Jain S,et al.Rhinovirus viremia in patients hospitalized with community-acquired pneumonia[J].J Infect Dis,2017,216(9):1104-1111.
[11]Xie L,Zhang B,Zhou J,et al.Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia[J].Virol J,2018,15:123.
[12]Rajkumar V,Chiang CS,Low JM,et al.Risk factors for severe adenovirus infection in children during an outbreak in Singa?pore[J].Ann Acad Med Singapore,2015,44(2):50-59.
[13]Hong JY,Lee HJ,Piedra PA,et al.Lower respiratory tract in?fections due to adenovirus in hospitalized Korean children:ep?idemiology,clinical features,and prognosis[J].Clin Infect Dis,2001,32(10):1423-1429.
[14]Committee on Infectious Diseases.Recommendations for pre?vention and control of influenza in children,2018-2019[J].Pediatrics,2018,142(4):pii e20182367.
[15]Hernández-Bou S,Novell CB,Alins JG,et al.Hospitalized children with influenza A H1N1(2009)infection:a Spanish multicenter study[J].Pediatr Emerg Care,2013,29(1):49-52.
[16]Jornist I,Muhsen K,Ram D,et al.Characterization of human parainfluenza virus-3 circulating in Israel,2012-2015[J].JClin Virol,2018,107:19-24.
[17]Shafagati N,Williams J.Human metapneumovirus-what we know now[J].F1000Res,2018,7:135.
[18]García-García ML,Calvo C,Casas I,et al.Human metapneu?movirus bronchiolitis in infancy is an important risk factor for asthma at age 5[J].Pediatr Pulmonol,2007,42(5):458-464.
[19]Howard LM,Edwards KM,Zhu Y,et al.Clinical features of human metapneumovirus infection in ambulatory children aged 5-13years[J].J Pediatric Infect Dis Soc,2018,7(2):165-168.
[20]Seki M,Yoshida H,Gotoh K,et al.Severe respiratory failure due to co-infection with human metapneumovirus and streptococcus pneumoniae[J].Respir Med Case Rep,2014,12:13-15.
[21]Liu WK,Liu Q,Chen DH,et al.Epidemiology of HBo V1 infection and relationship with meteorological conditions in hospitalized pediatric patients with acute respiratory illness:a 7-year study in a subtropical region[J].BMC Infect Dis,2018,18:329.
[22]Ghietto LM,Majul D,Ferreyra SP,et al.Comorbidity and high viral load linked to clinical presentation of respiratory human bocavirus infection[J].Arch Virol,2015,160(1):117-127.
[23]Ursic T,Steyer A,Kopriva S,et al.Human bocavirus as the cause of a life-threatening infection[J].J Clin Microbiol,2011,49(3):1179-1181.
[24]Al-Dorzi HM,Alsolamy S,Arabi YM.Critically ill patients with Middle East respiratory syndrome coronavirus infec?tion[J].Crit Care,2016,20:65.
[25]Arabi YM,Arifi AA,Balkhy HH,et al.Clinical course and out?comes of critically ill patients with Middle East respiratory syn?drome coronavirus infection[J].Ann Intern Med,2014,160(6):389-397.
[26]Thabet F,Chehab M,Bafaqih H,et al.Middle East respiratory syndrome coronavirus in children[J].Saudi Med J,2015,36(4):484-486.
[27]Wattier RL,Vázquez M,Weibel C,et al.Role of human poly?omaviruses in respiratory tract disease in young children[J].Emerg Infect Dis,2008,14(11):1766-1768.
[28]Uda K,Koyama-Wakai C,Shoji K,et al.WU polyomavirus de?tected in children with severe respiratory failure[J].J Clin Vi?rol,2018,107:25-28.
[29]Siebrasse EA,Nguyen NL,Willby MJ,et al.Multiorgan WUpolyomavirus infection in bone marrow transplant recipient[J].Emerg Infect Dis,2016,22(1):24-31.