在咳嗽儿童中，百日咳和病毒同时感染呼吸道较为罕见
2011/05/12
摘要
背景：病例报道、前瞻性研究和回顾性研究均显示，咳嗽儿童可同时存在百日咳杆菌感染和病毒性呼吸道感染，但出现的频率报道结果不一致。
方法：在0～17岁住院患者和非卧床患者中进行为期1年的前瞻性研究。多聚酶链反应用于检测鼻咽分泌物(NPA)样本的病毒（流感病毒A和B；副流感病毒1和3；呼吸道合胞病毒；变型肺病毒；腺病毒）和细菌（包括百日咳杆菌、副百日咳杆菌）。研究主要目的是评价病毒性呼吸道感染患者未被怀疑的百日咳感染的发生率。次要目的是检测病毒性呼吸道感染与百日咳感染并发的发生率。
结果：在1059个NPA样本中，分别在21名(2.0%)和5 (0.5%)名患者的NPA样本中找到百日咳和副百日咳杆菌的DNA。877例NPA样本中检测到呼吸道病毒、百日咳或副百日咳杆菌；427例(48.7%)存在>1种以上病毒；877例NPA样本中，10 (1.1%)例患者找到百日咳，但仅2名患者(0.2%)同时有病毒感染和百日咳感染。268例RSV阳性样本，1例(0.37%)同时有百日咳感染，27例hMPV阳性样本，同样有1例百日咳感染。
结论：百日咳和副百日咳杆菌感染在咳嗽儿童中较罕见，因此，病毒性与结合杆菌同时感染的可能性很小。我们认为病毒性和结核杆菌同时感染主要是机会性感染。
（陈欣 审校）
Pediatr Infect Dis J. 2011 Mar 14. [Epub ahead of print]
Bordetella pertussis and Concomitant Viral Respiratory Tract Infections Are Rare in Children With Cough Illness.
Heininger U, Burckhardt MA.
From the Department of Pediatric Infectious Diseases, University Children’s Hospital Basel, Switzerland.
Abstract
BACKGROUND: Case reports, case series, and retrospective and prospective studies have reported concomitant Bordetella pertussis and viral respiratory tract pathogen infections in children with cough illness with conflicting results regarding their frequency.
METHOD: A prospective 1-year study was performed in ambulatory and hospitalized patients aged 0 to 17 years with a cough illness. Polymerase chain reaction for viral (influenza A and B, parainfluenza 1 and 3, respiratory syncytial, metapneumovirus, and adenovirus) and bacterial pathogens including B. pertussis and B. parapertussis was applied to nasopharyngeal aspirate (NPA) specimens. The primary goal of the study was to assess the frequency of unsuspected Bordetella infections in patients thought to have a viral respiratory tract infection. The secondary goal was to determine the frequency of concomitant viral respiratory tract and Bordetella infections.
RESULTS: B. pertussis and B. parapertussis DNA was amplified in 21 (2.0%) and 5 (0.5%) cases, respectively, of 1059 NPA specimens. Of the 1059 NPA specimens, 877 were tested in parallel for respiratory viruses, B. pertussis, and B. parapertussis; >1 virus was identified in 427 (48.7%) and Bordetella species was identified in 10 (1.1%) of these 877 NPA specimens but only 2 (0.2%) concomitant virus/Bordetella infections were identified. Specifically, of 268 NPAs positive for RSV, 1 (0.37%) was concomitant with B. pertussis infection as was 1 (3.7%) of 27 NPAs positive for hMPV.
CONCLUSIONS: B. pertussis and B. parapertussis infections were rare in patients with cough illness and so were concomitant virus/Bordetella infections. We propose that virus/Bordetella coinfections primarily occur by chance.
Pediatr Infect Dis J. 2011 Mar 14. [Epub ahead of print]
背景：病例报道、前瞻性研究和回顾性研究均显示，咳嗽儿童可同时存在百日咳杆菌感染和病毒性呼吸道感染，但出现的频率报道结果不一致。
方法：在0～17岁住院患者和非卧床患者中进行为期1年的前瞻性研究。多聚酶链反应用于检测鼻咽分泌物(NPA)样本的病毒（流感病毒A和B；副流感病毒1和3；呼吸道合胞病毒；变型肺病毒；腺病毒）和细菌（包括百日咳杆菌、副百日咳杆菌）。研究主要目的是评价病毒性呼吸道感染患者未被怀疑的百日咳感染的发生率。次要目的是检测病毒性呼吸道感染与百日咳感染并发的发生率。
结果：在1059个NPA样本中，分别在21名(2.0%)和5 (0.5%)名患者的NPA样本中找到百日咳和副百日咳杆菌的DNA。877例NPA样本中检测到呼吸道病毒、百日咳或副百日咳杆菌；427例(48.7%)存在>1种以上病毒；877例NPA样本中，10 (1.1%)例患者找到百日咳，但仅2名患者(0.2%)同时有病毒感染和百日咳感染。268例RSV阳性样本，1例(0.37%)同时有百日咳感染，27例hMPV阳性样本，同样有1例百日咳感染。
结论：百日咳和副百日咳杆菌感染在咳嗽儿童中较罕见，因此，病毒性与结合杆菌同时感染的可能性很小。我们认为病毒性和结核杆菌同时感染主要是机会性感染。
（陈欣 审校）
Pediatr Infect Dis J. 2011 Mar 14. [Epub ahead of print]
Bordetella pertussis and Concomitant Viral Respiratory Tract Infections Are Rare in Children With Cough Illness.
Heininger U, Burckhardt MA.
From the Department of Pediatric Infectious Diseases, University Children’s Hospital Basel, Switzerland.
Abstract
BACKGROUND: Case reports, case series, and retrospective and prospective studies have reported concomitant Bordetella pertussis and viral respiratory tract pathogen infections in children with cough illness with conflicting results regarding their frequency.
METHOD: A prospective 1-year study was performed in ambulatory and hospitalized patients aged 0 to 17 years with a cough illness. Polymerase chain reaction for viral (influenza A and B, parainfluenza 1 and 3, respiratory syncytial, metapneumovirus, and adenovirus) and bacterial pathogens including B. pertussis and B. parapertussis was applied to nasopharyngeal aspirate (NPA) specimens. The primary goal of the study was to assess the frequency of unsuspected Bordetella infections in patients thought to have a viral respiratory tract infection. The secondary goal was to determine the frequency of concomitant viral respiratory tract and Bordetella infections.
RESULTS: B. pertussis and B. parapertussis DNA was amplified in 21 (2.0%) and 5 (0.5%) cases, respectively, of 1059 NPA specimens. Of the 1059 NPA specimens, 877 were tested in parallel for respiratory viruses, B. pertussis, and B. parapertussis; >1 virus was identified in 427 (48.7%) and Bordetella species was identified in 10 (1.1%) of these 877 NPA specimens but only 2 (0.2%) concomitant virus/Bordetella infections were identified. Specifically, of 268 NPAs positive for RSV, 1 (0.37%) was concomitant with B. pertussis infection as was 1 (3.7%) of 27 NPAs positive for hMPV.
CONCLUSIONS: B. pertussis and B. parapertussis infections were rare in patients with cough illness and so were concomitant virus/Bordetella infections. We propose that virus/Bordetella coinfections primarily occur by chance.
Pediatr Infect Dis J. 2011 Mar 14. [Epub ahead of print]
