多重PCR快速检测急性呼吸道感染住院患儿呼吸道病原体

Katherine Javier, J. Navoa-Ng, Nikki Cotoco-Chu
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摘要

背景:急性呼吸道感染(ARI)是全世界儿童发病和死亡的主要原因,然而,当地关于ARI病因学诊断的数据有限。目的:利用多重聚合酶链式反应测定法(称为呼吸小组)确定急性呼吸道感染住院儿童的患病率和最常检测到的呼吸道病原体,并比较其临床和实验室差异。方法:这是一项对ARI患儿进行多重PCR检测的横断面研究。对2018年1月至2020年2月入院的患者进行回顾性图表回顾。结果:共回顾47例病例,平均年龄4.2岁。在47例患者中,36例(76.6%)的病原体检测呈阳性。呼吸道合胞病毒(RSV)最为常见,其次是甲型流感/H1-2009和人偏肺病毒(hMPV)。2例患者合并病毒感染,所有受试者均未检出细菌。61.7%的患者在入院时开始使用抗生素。发烧和咳嗽分别是最常见的症状和体征。WBC正常(68%以中性粒细胞为主),血小板正常分别为72.3%和70.2%;50%的患者CRP正常,60.5%的患者胸片异常。只有胸部x线检查发现有更高的可能性产生呼吸面板阳性p=0.27。结论:在ARI住院患者中,76.6%的呼吸道病原体检测呈阳性。所有病例均由病毒引起,表现为发热和咳嗽等非特异性症状。临床表现、CBC和CRP与呼吸小组结果无相关性,而异常胸片有较高的可能性产生呼吸小组阳性结果。
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Rapid Detection of Respiratory Pathogens Using a Multiplex PCR Assay Among Hospitalized Children with Acute Respiratory Infection
Background: Acute respiratory infection (ARI) is a major cause of morbidity and mortality among children worldwide however, local data on the etiologic diagnosis of ARI are limited. Objectives: To determine the prevalence and the most commonly detected respiratory pathogens using a multiplex PCR assay, known as the Respiratory Panel, among hospitalized children with ARI and compare their clinical and laboratory differences. Methods: This is a cross sectional study of children with ARI who were tested with a multiplex PCR assay. Retrospective chart review was done on these patients admitted from January 2018 to February 2020. Results: There were 47 charts reviewed, mean age was 4.2 years old. Out of 47 patients, 36 (76.6%) tested positive for a pathogen. Respiratory syncytial virus (RSV) being the most common followed by Influenza A/H1-2009 and Human metapneumovirus (hMPV). Two patients had viral co-infections and no bacteria were detected on all subjects. 61.7% patients were started on antibiotics on admission. Fever and cough were the most common sign and symptom, respectively. Normal WBC (68% with neutrophilic predominance) and platelet were detected in 72.3% and 70.2% of patients, respectively; 50% of patients had normal CRP and 60.5% had abnormal findings on chest x-ray. Only the presence of chest x-ray findings was found to have a higher probability of yielding a positive Respiratory Panel p=0.27. Conclusion: Among admitted patients with ARI, 76.6% tested positive for a respiratory pathogen. All were caused by viruses presenting as nonspecific manifestations – fever and cough. Clinical manifestations, CBC and CRP showed no association with the Respiratory Panel result while abnormal chest x-ray had a higher probability of yielding a positive Respiratory Panel result.
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