儿童下呼吸道博卡病毒混合感染的临床分析

目的 研究博卡病毒混合感染对儿童急性下呼吸道感染临床特征的影响,分析其高危因素。方法 收集2017年11月-2019年10月苏州大学附属儿童医院呼吸科因急性下呼吸道感染住院儿童的鼻咽分泌物标本3 350例,进行呼吸道多病原学检测。结果 3 350例标本中博卡病毒(hBoV)阳性167例(5.0%),其中hBoV单纯感染102例(61.1%),混合感染65例(38.9%),混合感染主要病原有病毒26例(15.6%)、肺炎支原体16例(9.6%)、细菌11例(6.6%)、混合2种以上病原12例(7.2%)。hBoV单纯感染、hBoV混合病毒、hBoV混合支原体、hBoV混合细菌和hBoV混合2种以上病原各组在咳嗽、喘息、发热、呼吸困难、肺部啰音、住院时间等方面比较,差异均无统计学意义(P＞0.05)。hBoV混合细菌感染组发生重症肺炎的比例高于hBoV混合病毒及hBoV混合支原体感染组(χ²=15.648, P＜0.05)。Logistic回归分析显示入院前病程＞7 d是混合感染的独立危险因素(OR=1.040, 95%CI:1.002~1.079)。结论 hBoV有较高的混合感染率。hBoV混合细菌感染可能会加重病情。入院前病程＞7 d的患儿应警惕hBOV混合感染。

Clinical analysis of coinfection of hBov in children with lower respiratory infection

Objective To analyze the impacts of polyinfection on clinical characteristics of children with acute lower respiratory tract infection due to hBoV,and to analyze the high risk factors of the polyinfection.Method From November 2017 to October 2019,totally 3350 samples of nasopharyngeal aspirates were collected for respiratory tract multi-pathogen detection from children with lower respiratory tract infection in the Respiratory Department of Children′s Hospital Affiliated to Soochow University.Results Among the 3350 samples,hBoV was found positive in 167 samples(5.0%),of which 102(61.1%)were hBoV mono-infected and 65(38.9%)poly-infected.In the polyinfected samples,the main pathogens included the virus(26,15.6%),mycoplasma pneumonia(16,9.6%)and bacteria(11,6.6%),12 samples(7.2%)were poly-infected with two or more pathogens.In terms of cough,wheezing,fever,dyspnea,lung rales and hospitalization stay,there was no statistically significant difference among the groups of mono-hBoV infected samples,poly-virus infected samples,poly-mycoplasma infected samples,poly-bacteria infected samples,and poly-infected samples with two or more of the pathogens(P>0.05).The proportion of severe pneumonia in poly-bacteria infected samples was significantly higher than that in poly-virus and poly-mycoplasma infected samples(χ²=15.648,P<0.05).Logistic regression analysis indicated that pre-admission course exceeded 7 days was a risk factor for hBoV polyinfection(OR=1.040,95%CI:1.002-1.079).Conclusions hBoV has a higher polyinfection rate.AND hBoV poly-bacterial infection may aggravate the disease.Children with pre-admission course>7 days should be alerted for hBoV polyinfection.