Abstract | Infekcija dišnog sustava vodeći je uzrok hospitalizacije djece, posebice mlađe od godinu dana. U ovom istraživanju upotrebljena je brza i osjetljiva metoda (multipleks PCR test) za detekciju 12 respiratornih patogena uključujući virus influence A, virus influence B, virus parainfluence (PIV) tip 1, 2 i 3, respiratorni sincicijski virus (RSV) grupe A i B, adenovirus, ljudski rinovirus A i B, ljudski metapneumovirus (MPV), te koronaviruse OC43/HKU1 i 229E/NL63 u uzorcima iz respiratornog sustava 62 djeteta liječena u tromjesečnom razdoblju (veljača-svibanj) zbog infekcije dišnog sustava u Klinici za dječje bolesti u Zagrebu. Virusi su identificirani u 54 (87,1%) djece. Influenca A i influenca B virusi nisu detektirani, RSV je detektiran u 29 (46,8%), PIV u 25 (40,3%), rinovirus u 17 (27,4%), MPV u devet (14,5%), adenovirus u šest (9,7%) i koronavirusi u tri (4,8%) istraživana pacijenta. Koinfekcija s dva ili više virusa opažena je u 27 (50%) djece. Osamnaest pacijenata (60%) inficiranih RSV-om imalo je koinfekciju, dok je šest od devet pacijenata u kojih je dokazan MPV imalo koinfekciju (2/3). RSV je bio značajno udružen s infekcijama donjeg dišnog sustava (χ²=10,6; p<0,01). Prisutnost višestruke infekcije nije bila značajno povezana s težinom ili lokalizacijom infekcije (p>0,05). Multipleks PCR test je u dijagnostici najznačajnijih virusa koji izazivaju respiratorne infekcije osjetljiviji od konvencionalnih metoda, a rezultati su dostupni u klinički relevantnom vremenu. Daljnja istraživanja su potrebna da bi se bolje shvatilo značenje višestrukih infekcija. |
Abstract (english) | Acute respiratory tract infection is a leading cause of hospitalization of children, particulary infants younger than one year. This study used a rapid and sensitive method (multiplex PCR assay) to detect 12 different respiratory pathogens including influenza A, influenza B, parainfluenza (PIV) types 1, 2 and 3, respiratory syncytial virus (RSV) groups A and B, adenovirus, human rhinovirus, human metapneumovirus (MPV) and human coronavirus OC43/HKU1 and 229E/NL63 from respiratory specimens of 62 children treated over 3-month period (February-May) for acute respiratory tract infections in the Clinic for children diseases in Zagreb. Viruses were identified in 54 (87.1%) of the children. Influenza A and influenza B viruses were not detected, RSV was detected in 29 (46.8%), PIV in 25 (40.3%), rhinovirus in 17 (27.4%), MPV in nine (14.5%), adenovirus in six (9.7%) and coronaviruses in three (4.8%) of the patients. Coinfections with two or more viruses were observed in 27 (50%) patients. Eighteen patients (60%) infected with RSV had a coinfection, while six out of nine patients tested positive for MPV had a coinfection (2/3). RSV was significantly associated with lower respiratory tract infections (χ²=10.6; p<0.01). Presence of a multiple infection was not significantly associated with severity or localization of the infection (p>0.05). Multiplex PCR assay is more sensitive for diagnosis of the main viruses that cause respiratory tract infections compared with conventional methods and obtains results in a clinically relevant time period. Further investigations are needed to broaden our understanding of the significance of multiple infections. |