Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Detection and clinical manifestations of twelve respiratory viruses in hospitalized children with acute lower respiratory tract infections : Focus on human metapneumovirus, human rhinovirus and human coronavirus

하기도 감염으로 입원한 소아에서 12종 바이러스의 검출 및 임상 양상

  • Kim, Kum Hyang (Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Lee, Jung Ho (Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Sun, Dong Shin (Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Kim, Yong Bae (Department of Preventive Medicine, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Choi, Young Jin (Department of Laboratory Medicine, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Park, Joon Soo (Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Kim, Chang Jin (Department of Pathology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine) ;
  • Jung, Dong Jun (Department of Pathology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine)
  • 김금향 (순천향대학교 의과대학 소아과학교실) ;
  • 이정호 (순천향대학교 의과대학 소아과학교실) ;
  • 선동신 (순천향대학교 의과대학 소아과학교실) ;
  • 김용배 (순천향대학교 의과대학 예방의학교실) ;
  • 최영진 (순천향대학교 의과대학 진단검사의학교실) ;
  • 박준수 (순천향대학교 의과대학 소아과학교실) ;
  • 김창진 (순천향대학교 의과대학 병리학교실) ;
  • 정동준 (순천향대학교 의과대학 병리학교실)
  • Received : 2008.01.28
  • Accepted : 2008.07.11
  • Published : 2008.08.15
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Abstract

Purpose : This study was perfomed to analyze in detail the viral etiology of acute lower respiratory tract infections (ALRI) in Cheunan, Korea by multiplex RT-PCR, including human rhinovirus (hRV) and newly identified viruses such as human metapneumovirus (hMPV) and human coronavirus (HCoV-OC43, HCoV-229E/NL63). Method : Nasopharyngeal aspirates (NPA) were collected from 863 hospitalized children with ALRI on the first day of admission at Soonchunhyang University Cheonan Hospital and analyzed by multiplex RT-PCR from December 2005 to November 2006. Results : Viral agents were detected from 474 subjects (54.9%). The identified viral pathogens were hRV 9.2%, hMPV 6.8%, HCoV-229E/NL63 1.4%, and HCoV-OC43 2.1%. Coinfections with ${\geq}2$ viruses were observed in 108 patients (22.8%). The major period of viral ALRI was the first year of life. Clinical diagnoses of viral ALRI were pneumonia (59.5%), bronchiolitis (24.7%), tracheobronchitis (11.4%), and croup (4%). The most common causes of bronchiolitis was respiratory syncytial virus B (RSV B), whereas hMPV, hRV, HCoV-229E/NL63, and HCoV-OC43 were commonly found in patients with pneumonia. The number of hMPV infections peaked between March and May 2006. HCoV-OC43 was prevalent from November to February 2006, whereas HCoV-229E and hRV were detected throughout the year. Conclusion : Although the study was confined to one year, hMPV was not detected during winter and peaked between March and April, which was not consistent with previous studies'. This present study indicates that HCoV is a less common respiratory pathogen in cases of ALRI in Korean children

목 적 : 급성 바이러스성 하기도 감염의 원인으로 알려진 바이러스의 임상 양상 및 역학 을 연구하고자 하였으며, 특히 새롭게 밝혀진 hRV, HCoV-229E/NL63, HCoV-OC43, hMPV를 중심으로 하였다. 방 법 : 2005년 12월부터 2006년 11월까지 순천향대학교 천안병원 소아과에 하기도 감염으로 입원한 환아들 중 863명을 대상으로 환아들의 비인두 흡인물에서 multiplex RT-PCR 법을 이용하여 총 12개의 바이러스를 검출하였다. 결 과 : 총 12개의 호흡기 바이러스에 대하여 검사를 하였을 때 863명 중 474명(54.9%)에서 바이러스 양성이 나타났다. hMPV이 6.8%, HCoV-229E/NL63 1.4%, HCoV-OC43 2.1%, hRV 9%로 검출되었고, 혼합감염은 22.8%였다. 급성 바이러스성 하기도 감염은 1세 미만에서 가장 흔하게 나타났다. 임상진단은 폐렴이 59.5%로 가장 많았고, 세기관지염이 24.7%, 기관기관지염이 11.4%, 크룹이 4% 순이었다. 세기관지염의 가장 흔한 원인 바이러스는 RSV B이고, 반면에 hMPV, hRV, HCoV-229E/NL63은 폐렴의 주요 원인 바이러스로 나타났다. 바이러스별 유행 양상은 hMPV는 3월부터 5월까지 유행하였고, HCoV-OC43은 11월부터 2월까지 유행하였다. 반면에 HCoV-OC43, HCoV-229E/NL63과 hRV는 연중 고른 분포를 보였다. 결 론 : 본 연구는 비록 연구 기간이 1년으로 짧았지만, 다른 나라의 경우와 비교해 hMPV가 겨울엔 검출되지 않고 3월에서 4월까지 주로 검출된다는 점과 HCoV가 우리나라에서는 별로 검출되지 않아 하기도 감염에서는 그 비중이 매우 미미하다는 점을 알 수 있었다.

Keywords

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