Epidemiology And Clinical Characterization Of Respiratory Virus Infections In Adult Patients Of Guangzhou

ObjectiveAcute respiratory tract infection(ARTI) is a common disease which is caused by many classes of microorganisms, and virus is one of the most important pathogen. Respiratory viruses include influenza virus(Flu) A and B, parainfluenza virus(HPIV), rhinovirus(HRV), respiratory syncytial virus(RSV), human coronavirus(HCo V), adenovirus(ADV), human metapneumovirus(HMPV) and human bocavirus(HBo V). In China, several groups have reported the prevalence and clinical presentation of viral infectons, but the studies didn’t cover some viruses including HRV、HBo V、HPIV-4. The objective of our study is to determine the epidemiological and clinical characteristics of common and recently discovered respiratory viruses in adults with ARTIs in Guangzhou,and to evaluate antibiotic abuse.MethodologyA 1-year consecutive study was conducted from January,2014 to January,2015. Nose and throat swab or sputum samples from 151 ARTI patients from the Third Affiliated Hospital of Sun-yet-sen University were checked using multiple real-time quantitative reverse transcription polymerase chain reaction assays for 22 respiratory viruses including influenza A viruses( H1N1, H3N2, H1N1-2009, H5N1-Avian, H7N9-Avian),influenza B virus, RSV-A,B,HPIV 1-4, HMPV, HCo V(OC43、229E、NL63、HKU1、SARS、MERS), HRV, ADV and HBo V. Patients’ clinical manifestations, laboratory test results and therapies were recorded for further analysis.ResultsViral pathogens were detected in 26.49%(40/151) of patient samples. HRVs(16.56%,25/151) were the dominant agents detected, followed by Flu A(H3N2)(4.64%,7/151), RSV- A、HPIV 4、Flu B、HMPV and ADV were also detected(<3%),but no HCo V and HBo V was detected. H3N2(50.00%) is the dominant agent detected in inpatients, followed by HRV(30.00%). While HRVs(83.33%) rank the first of the viruses detected in outpatients, followed by H3N2(6,67%) and HPIV-4(6.67%). The patients younger than 20 years old has the highest viral detection and HRV detection.Different patterns of clinical manifestation were associated with different respiratory viruses. Most patients with viral infection presented with fever(100%),cough(87.50%), expectoration(57.50%),runny nose(57.50%)and sore throat(52.50%). Of the 40 patients with viral infection, nine(22.50%) were diagnosed as pneumonia, while 2(5.00%) were diagnosed as severe pneumonia. Most(88.00%) of the patients with HRV infection presented with upper respiratory tract infection, while most(71.43%) of the patients with H3N2 infection were diagnosed as pneumonia. Most(86.67%)of the outpatients with viral infection got antibiotic therapy, with the third generation of cephalosporins ranking the first(46.15%).ConclusionsRespiratory viruses are important cause of acute respiratory infection in Guangzhou, HBV and influenza A virus H3N2 are the dominant agents detected. Patients of different age groups have different viral detection rates. HRV mainly causes upper respiratory tract infection in outpatients, while H3N2 mainly causes lung infection in inpatients. There may be antibiotic abuse in outpatients of ARTI.