• Pediatric Infection and Vaccine
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• 제21권1호
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• pp.22-28
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• 2014

목적: 임상적으로 중증 세균성 감염과 바이러스성 질환의 감별이 어려운 어린 영아에서 호흡기 바이러스를 검출하고 이것과 연관된 임상적 위험인자를 분석하였다. 방법: 2011년 9월부터 2012년 8월까지 생후 90일 이하 영아 중 패혈증을 포함한 감염성 질환이 의심된 227명을 대상으로 비인두 검체를 채취하였으며 임상적 특성에 대한 후향적 연구를 시행하였다. 채취한 검체 내 호흡기 바이러스의 검출은 real-time PCR 검사를 통해 측정되었다. 결과: 총 157명(69.2%)의 영아에서 한 가지 이상의 호흡기 바이러스가 검출되었다. 빈도는 RSV (75명), RV (42명), influenza virus (18명), parainfluenza virus (15명), human metapneumovirus (9명), coronavirus (9명), adenovirus (4명), bocavirus (3명) 순이었다. 이 중 24명(10.6%)에서 세균성 감염을 진단하였다. 기침, 호흡기 질환의 가족력이 있는 경우 혹은 가을/겨울 철에 호흡기 바이러스가 의미있게 높은 빈도로 검출되었으며 로지스틱 회귀분석에서도 같은 경향을 확인하였다. 가을과 겨울에는 세균성 감염 환자보다 그렇지 않은 환자에서 호흡기 바이러스 검출이 유의하게 많은 것을 알 수 있었다. 결론: 호흡기 바이러스는 감염성 질환이 의심되어 입원한 어린 영아의 중요한 병원체이며 그 검출률은 호흡기 증상, 가을/겨울철 발생, 호흡기 증상의 가족력이 있는 환자에서 유의하게 높았다.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.269-276
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• 2009

Viruses are the most common cause of lower respiratory tract infections (LRTIs) in infants and young children and are a major public health problem in this age group. Viruses were identified in 54.9-70.4% of hospitalized infants and children with LRTIs in Korea. The viral pathogens identified included respiratory syncytial virus (RSV) A and RSV B, influenza (Inf) A, Inf B, parainfluenza (PIV)1, PIV2, human bocavirus (hBoV), human rhinovirus (hRV), adenovirus (ADV), human metapneumovirus (hMPV), human coronavirus (hCoV)-OC 43, hCoV-229E, hCoV-NL63, hCoV-HKU1, and human enterovirus (hEV). Coinfections with ${\geq}$2 viruses were observed in 11.5-22.8% of children. The occurrence of LRTIs was the highest in the first year of life. The specific viruses are frequently associated with specific clinical syndromes of LRTIs. LRTIs caused by RSV were predominant among younger infants. hRV accounted for a larger proportion of LRTIs in young infants than ADV and hBoV. hMPV was frequently detected in children >24 months old. The number of hMPV infections peaked between February and May, whereas hRV was detected throughout the year. Thus far, hCoV is a less common respiratory pathogen in cases of ALRI and URI in Korean children.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.95-100
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• 2013

Background: This study was performed to investigate the epidemiologic and clinical features of acute respiratory viral infection in hospitalized children. Methods: From 2010 to 2012, we tested nasopharyngeal swab specimen in 1,584 hospitalized children with multiple real-time polymerase chain reactions to identify 10 kinds of respiratory viruses (including influenza virus A, B (FluA, FluB), respiratory syncytial virus (RSV), human metapneumovirus (MPV), adenovirus (AdV), human coronavirus (CoronaV), human enterovirus (HEV), human bocavirus (HBoV), parainfluenza virus (PIV), and human rhinovirus (Rhinovirus)). We analyzed the positive rate, annual and seasonal variations, and clinical features (respiratory tract and non-respiratory tract) according to the retrospective review of medical records. Results: Respiratory viruses were detected from 678 (42.8%) of 1,584 patients. The most common detected virus was RSV (35.0%), and then AdV (19.0%), HEV (18.1%). The critical period of the respiratory viral infection was during the first 12 months of a child's life. PIV increased by 8.4%, 12.1%, and 21.1% annually. Bronchiolitis was most frequently caused by RSV, and croup was frequently caused by PIV. The most common cause of meningitis was HEV. Hepatitis-associated respiratory virus was developed 111 in 678 cases. Conclusion: Although this study was confined to a single medical center for three years, we identified the epidemiology and clinical feature of respiratory viruses in Daegu from 2010 to 2012. Future surveillance will be necessary for annual and seasonal variations.

• 한국환경보건학회지
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• 제37권4호
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• pp.306-314
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• 2011

Objectives: Respiratory virus infections are the most common disease among all ages in all parts of the world and occur through airborne transmission. The purpose of this study was to detect and quantitate human respiratory viruses in residential environments. Methods: Air samples were collected from the residential space of apartments in the Seoul/Gyeonggi-do area. The samples were collected from indoor and outdoor air. Among respiratory viruses, influenza A virus, influenza B virus, parainfluenza virus, metapneumovirus, respiratory syncytial virus, and adenovirus were investigated by multiplex polymerase chain reaction. Among the virus-positive samples, we performed adenovirus quantification by real-time polymerase chain reaction. Results: Virus detection rates were 44.0%, 3.8%, 3.4%, and 17.3% in spring, summer, autumn, and winter, respectively. The virus detection rate was higher in winter and spring than in summer and autumn. Adenovirus was most commonly detected, followed by influenza A virus and parainfluenza virus. Virus distribution was not significantly different between indoor and outdoor environments. Conclusions: Although virus concentrations were not high in residential environments, residents in houses with detected viruses may have an increased risk of exposure to airborne respiratory viruses, especially in winter and spring.

• Clinical and Experimental Pediatrics
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• 제57권1호
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• pp.29-34
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• 2014

Purpose: In this study, we aimed to investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI) and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods: We investigated the sources for acute LRTIs in children admitted to our hospital from May 2010 to April 2011. The 6 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction in 309 children; respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV), human metapneumovirus (hMPV), rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific Immunoglobulin E level measured using UniCAP (Pharmacia) was over 0.35 IU/mL. Results: RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infection was more prevalent in asthma exacerbations compared to other LRTIs. AV and hMPV were more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion: RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

• Clinical and Experimental Pediatrics
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• 제61권6호
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• pp.180-186
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• 2018

Purpose: Despite the availability of molecular methods, identification of the causative virus in children with acute respiratory infections (ARIs) has proven difficult as the same viruses are often detected in asymptomatic children. Methods: Multiplex reverse transcription polymerase chain reaction assays were performed to detect 15 common respiratory viruses in children under 15 years of age who were hospitalized with ARI between January 2013 and December 2015. Viral epidemiology and clinical profiles of single virus infections were evaluated. Results: Of 3,505 patients, viruses were identified in 2,424 (69.1%), with the assay revealing a single virus in 1,747 cases (49.8%). While major pathogens in single virus-positive cases differed according to age, human rhinovirus (hRV) was common in patients of all ages. Respiratory syncytial virus (RSV), influenza virus (IF), and human metapneumovirus (hMPV) were found to be seasonal pathogens, appearing from fall through winter and spring, whereas hRV and adenovirus (AdV) were detected in every season. Patients with ARIs caused by RSV and hRV were frequently afebrile and more commonly had wheezing compared with patients with other viral ARIs. Neutrophil-dominant inflammation was observed in ARIs caused by IF, AdV, and hRV, whereas lymphocyte-dominant inflammation was observed with RSV A, parainfluenza virus, and hMPV. Monocytosis was common with RSV and AdV, whereas eosinophilia was observed with hRV. Conclusion: In combination with viral identification, recognition of virus-specific clinical and laboratory patterns will expand our understanding of the epidemiology of viral ARIs and help us to establish more efficient therapeutic and preventive strategies.

• Clinical and Experimental Pediatrics
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• 제55권12호
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• pp.470-473
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• 2012

Purpose: The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD) by using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD. Methods: RT-PCR assays were carried out to screen for the presence of respiratory syncytial virus A and B, adenovirus, rhinovirus, parainfluenza viruses 1 to 4, influenza virus A and B, metapneumovirus, bocavirus, coronavirus OC43/229E and NL63, and enterovirus in nasopharyngeal secretions of 55 KD patients and 78 control subjects. Results: Virus detection rates in KD patients and control subjects were 32.7% and 30.8%, respectively (P=0.811). However, there was no significant association between the presence of any of the 15 viruses and the incidence of KD. Comparisons between the 18 patients with positive RT-PCR results and the other 37 KD patients revealed no significant differences in terms of clinical findings (including the prevalence of incomplete presentation of the disease) and coronary artery diameter. Conclusion: A positive RT-PCR for currently epidemic respiratory viruses should not be used as an evidence against the diagnosis of KD. These viruses were not associated with the incomplete presentation of KD and coronary artery dilatation.

• Journal of Microbiology and Biotechnology
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• 제23권2호
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• pp.267-273
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• 2013

Multiplex RT-PCR was used to detect respiratory viruses in 5,318 clinical samples referred to the laboratory of a tertiary teaching hospital from December 2006 to November 2010. The acquired data were analyzed with respect to types, ratio, and co-infection trends of infected respiratory viruses. Trends in respiratory viral infection according to sex, age, and period of infection were also analyzed. Of the 5,318 submitted clinical samples, 3,350 (63.0%) specimens were positive for at least one respiratory virus. The infection rates were 15.8% for human rhinovirus, 14.4% for human respiratory syncytial virus A, 9.7% for human respiratory syncytial virus B, 10.1% for human adenovirus, 5.4% for influenza A virus, 1.7% for influenza B virus, 4.7% for human metapneumovirus, 2.3% for human coronavirus OC43, 1.9% for human coronavirus 229E/NL63, 3.7% for human parainfluenza virus (HPIV)-1, 1.1% for HPIV-2, and 5.3% for HPIV-3. The co-infection analysis showed 17.1% of double infections, 1.8% of triple infections. The median age of virus-positive patients was 1.3 years old, and the 91.5% of virus-positive patients were under 10 years old. Human respiratory syncytial virus was the most common virus in children < 5 years of age and the influenza A virus was most prevalent virus in children over 5 years of age. These results help in elucidating the tendency of respiratory viral infections.

• Pediatric Infection and Vaccine
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• 제21권3호
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• pp.207-213
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• 2014

목적: 본 연구는 소아에서 호흡기바이러스 감염과 폐렴구균의 상기도 보균율 간의 연관성을 분석하고자 하였다. 방법: 2009년 5월부터 2010년 6월까지 서울대학교 어린이병원에 호흡기 증상을 주소로 내원한 18세 미만 소아로부터 채취한 비인두 흡인물을 대상으로 폐렴구균을 배양하고 RT-PCR을 통해 호흡기 바이러스(influenza virus A와 B, parainfluenza virus 1, 2와 3, respiratory syncytial virus A와 B, adenovirus, rhinovirus A/B, human metapneumovirus, human coronavirus 229E/NL63, OC43/HKU1)를 검출하여 호흡기바이러스 검출과 폐렴구균 보균 사이의 연관성을 분석하였다. 결과: 대상 환자의 중앙 연령은 27개월이었다. 총 1,367건의 비인두 흡인물 중 폐렴구균이 배양된 검체는 228개(16.7%)이었고, 호흡기바이러스가 검출된 검체는 731개(53.5%)이었다. 흔히 분리된 바이러스는, rhinovirus(18.4%), respiratory syncytial virus (RSV) A (10.6%), adenovirus (6.9%), influenza virus A (6.8%) 순으로 나타났다. 폐렴구균 보균율은 호흡기바이러스 양성인 경우가 21.3% (156/731)로 음성인 경우 11.3% (72/636)보다 높았다(P<0.001). 검출된 호흡기바이러스의 종류에 따라서는 influenza virus A [24.7% (23/93) vs 16.1% (205/1274), P=0.001], RSV A [28.3% (41/145) vs 15.3% (187/1222), P=0.001], RSV B [31.3% (10/32) vs 16.3% (218/1335), P=0.042], rhino-virus A/B [22.6% (57/252) vs 15.3% (171/1115), P=0.010]가 양성인 소아는 음성인 소아에 비하여 폐렴구균 보균율이 높게 나타났다. 결론: 본 연구 결과, 호흡기 증상이 있는 소아에서 호흡기바이러스가 검출된 경우 폐렴구균 보균율이 높았다. 향후 호흡기바이러스와 폐렴구균의 보균에 의한 호흡기 감염병의 임상발현 기전을 밝히는 데 도움이 될 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제51권8호
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• pp.834-841
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• 2008

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.