| Objective:To observate acute lower respiratory tract infection (ALRTI) in hospitalized children nasopharyngeal suction (NPAs) specimens of respiratory syncytial virus load, combined with the clinical data, discusses the relationship between viral load and disease severity and clinical application value.Subjects and Methods:1. NPAs were collected from hospitalized children in Hunan Provincial People’s Hospital Children’s Medical Center with ALRTI from April 2013 to March 2014.2.Respiratory syncytial virus(RSV),human rhinovirus(HRV) influenza virus A(IFVA), influenza virus B(IFVB), parainfluenza 1-4(PIV1-4), human metapneumovirus (hMPV), enterovirus (EV), human coronaviruses HKU1(HCoV-HKU1), human coronaviruses NL63(HCoV-NL63), adenovirus (ADV) and human bocavirus (HBoV) of NPAs specimens were detected by real-time fluorescence quantitative polymerase chain reaction (RT-FQ PCR).3. To RSV positive cases demographic data for statistical analysis. To RSV positive cases,with eliminated the basic diseases and the single RSV positive detection of viral load in cases of pneumonia and capillary bronchitis combined with clinical data for statistical analysis.Results:1.Among the 603 NPA, viruses were detected in 527 samples(87.4%), RSV(42.6%) was the most common virus.The age younger, the RSV detection rate higher (χ2=21.438, P=0.000), the age group under 6 month had the highest detection rate 55.1%(76/138); both male and female detection rate was no difference (χ2=0.152, P=0.697); the peak prevalence of RSV was in winter and spring; the highest detection rate in children with RSV in cases of bronchiolitis (49%) and pneumonia (40.9);2.257 cases of RSV positive specimens viral loads were 1.08×100-1.57×107copies/μL, RSV loads of gender difference were no statistically significant (t=-0.851,P=0.395); RSV loads in each age group differences were statistically significant (F=9.476, P=0.000), age group of under 6 month had RSV highest average loads were 2.87×104copies/μL±1.96; winter (8.52×103copies/μL± 2.16) and spring (1.21×104 copies/μL±2.21) had the highest loads; the single RSV group average loads (7.76×104copies/μL±1.79) were significantly higher (t=8.002,P=0.000) than mixed other viruses group (7.59×102copies/μL±2.22);3.98 cases of single detected RSV bronchiolitis and pneumonia, each age groups of RSV average loads differences were statistically significant (F=4.894, P=0.003),RSV loads of younger age group was significantly higher than the old age group, RSV loads had negative correlation with age (r=-0.258, P=0.01);RSV loads of gender had no significant differences(t=0.139,P=0.89);winter (1.44×105copies/μL±1.34) and (2.18×105copies/μL±1.52) spring had highest RSV loads;RSV average loads in bronchiolitis group (1.63×105copies/μL±1.63) and in pneumonia group(5.00×104copies/μL± 1.84)had no difference(t=-1.452, P=0.15); RSV average loads in groups of the days of onset was no statistically significant (F=1.214, P=0.309);4. The average viral loads of single RSV detected severe pneumonia (12 cases,5.01×105copies/μL±0.84) were higher than non-severe pneumonia group (40 cases,2.51×104copies/μL±1.95),each of them had statistically significant(t’=-3.296, P=0.002),RSV loads had positively correlated with the disease severity (r=0.335, P=0.015); the RSV loads of each age groups and gender groups (Welch= 1.453, P=0.258 and t=0.486,P=0.629)had no differencet;5. The average viral loads of single RSV detected mild bronchiolitis group (30 cases,1.32×105copies/μL±1.78) and moderate to severe bronchiolitis group (16 cases,2.4×105copies/μL±1.34) had no difference (t=-0.504, P= 0.617); RSV loads of age groups differences were statistically significant (F=5.042, P=0.011), but no differences in gender groups (t=-0.780, P=0.440);Conclusions:1. Virues predominate in the etiology of pediatric ALRTI in Changsha, which ranks first in the RSV detection;2. RSV loads were impacted from ages, seasons, mix other viruses infection or other factors;3. Pneumonia severity had correlation with single RSV detection load, it was expected to be early indicators of disease severity assessment;... |
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