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澳門人偏肺病毒與呼吸道合胞病毒流行特點及疾病譜分析
Epidemiological characteristics and disease spectrum of human metapneumovirus and respiratory syncytial virus in Macau
摘要
目的：了解人偏肺病毒（Human metapneumovirus, hMPV）與呼吸道合胞病毒（Respiratory syncytial virus, RSV）在澳門地區住院呼吸道感染兒童中的流行特點和疾病譜。方法：回顧2014～2017年在本院住院的4880例急性呼吸道感染兒童（≤12歲），留取鼻咽拭子液相懸浮蕊片技術檢測呼吸道病毒，分析人偏肺病毒及呼吸道合胞病毒陽性的病例，比較兩者流行特點及疾病譜。結果：3767例檢出病毒陽性的兒童中，756例（15.5%）檢出RSV陽性，334例（6.8%）檢出hMPV陽性。683例（90.3%）RSV感染兒童及238例（71.3%）hMPV感染兒童年齡<3歲，RSV在3歲以下更常見（P<0.05）。RSV病例診斷分佈：122例（16.2%）急性上呼吸道感染，634例（83.9%）急性下呼吸道感染，269例（35.7%）肺炎，172例（22.8%）診斷為喘息性疾病。hMPV病例診斷分佈：69例（20.7%）急性上呼吸道感染，265例（79.3%）急性下呼吸道感染，160例（47.9%）肺炎，31例（9.3%）診斷為喘息性疾病。RSV常引起喘息性疾病、hMPV在肺炎中為常見（P<0.001）。hMPV感染在春季最為普遍（n=196, 13.9%），高峰為2、3月（n=76, 16.0%）；RSV感染在秋季最為普遍（n=239, 20.3%），高峰為9、2月（n=131, 31.6%）。結論：hMPV和RSV是澳門住院呼吸道感染兒童常見病毒，兩者均易引致下呼吸道感染，高發於嬰幼兒，RSV更易引起喘息症狀，hMPV更易引起肺炎。超過90%的RSV感染發生在嬰幼兒。RSV高發於9月、2月，hMPV高發於2月、3月。
並列摘要
Objective: This study aimed to investigate the epidemiological characteristics and disease spectrum of human metapneumovirus (hMPV) and respiratory syncytial virus (RSV) infections among hospitalized children with acute respiratory infections (ARI) in Macau. Methods: A retrospective study using electronic health records between year 2014 and 2017 in Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from 4880 hospitalized children aged 12 years or younger with acute respiratory infection diseases. xMAP multiplex assays were employed to detect respiratory viruses. Chi-square test was used to analyze the data. Results: Of the 3767 hospitalized children with positive results from viral infection tests, 756 children (15.5%) were tested positive for RSV while 334 (6.8%) were positive for hMPV. 683(90.3%) RSV infected children and 238(71.3%) hMPV infected children aged under 3 years old, which indicated RSV was more common than hMPV among children under 3 years old. Among the patients infected with RSV, 122 (16.2%) children were diagnosed with upper respiratory tract infection, 634 (83.9%) with lower respiratory tract infection, 269 (35.7%) with pneumonia, and 172 (22.8%) with wheezing symptoms. Among the patients infected with hMPV, 69 (20.7%) were diagnosed with upper respiratory tract infection, 265 (79.3%) with lower respiratory tract infection, 160 (47.9%) with pneumonia, and 31 (9.3%) with wheezing symptoms. RSV was more common to cause wheezing symptoms and hMPV was more common in pneumonia (P<0.001). In terms of periodic distribution, RSV infection was more prevalent in September (n=131, 31.6%) and in February (n=72, 21.2%) while hMPV infection was more prevalent in February (n=55, 16.2%) and March (n=76, 16.0%). Out of the four seasons, spring was found as the peak season for hMPV whereas autumn was the peak season of RSV. Conclusion: hMPV and RSV were common among children under 3 years old and in lower respiratory tract infection cases. RSV was more common with wheezing symptoms, and hMPV was easy to cause pneumonia. hMPV was prevalent in February and March while RSV was more prevalent in September and February.