비인두 흡입물 접종 후 4일 배양세포에서의 respiratory syncytial virus 및 parafinfluenza virus의 검출

박순영,강희정,이규만 대한임상병리학회 1996 대한임상병리학회지 Vol.16 No.4

Respiratory syncytial virus로 인한 급성 하기도 감염 입원 환자에서 Palivizumab 예방요법 유무에 따른 비교 분석

민성주,송정숙,최장환,선한수,강은경,김도현,김희섭 대한소아감염학회 2011 Pediatric Infection and Vaccine Vol.18 No.2

Purpose:The aim of this study was to identify the clinical characteristics of lower respiratory tract infection due to respiratory syncytial virus (RSV) in young children and to provide information for an effective guideline for palivizumab administration in Korea. Methods:We reviewed medical charts of 167 patients under 3 years of age who were hospitalized in Dongguk University Ilsan Hospital for lower respiratory tract infection between January 2007 and February 2011. Diagnosis of the virus was made based on the multiplex real time polymerase chain reaction. Results:There were 113 patients who were infected by respiratory syncytial virus. 90 patients were term infants and 23 patients were preterm infants. No difference was shown between term and preterm infants except the days of admission which was 9.0±6.0 days and 12.6±21.0 days respectively. In the preterm group their mean age at the time of admission was 5.21±4.9 months and the mean gestational age was 33.1±4.3 weeks, and the mean birth weight was 2,152±950 g. Only 4 patients were born under 28 weeks gestational age and were candidates for palivizumab administration. Conclusion:Most of the patients with severe RSV lower respiratory tract infection were term or near term infants who were not candidates for palivizumab prophylaxis. A nationwide study is needed to make a new risk stratified guideline for RSV prophylaxis for our country. 목적:Respiratory syncytial virus (RSV)에 의한 급성 하기도 감염은 소아기에 입원을 요하는 중요한 질환이다. 우리나라에서는 현재 미숙아와 후기미숙아의 출생률과 생존률이 증가하고 있으며, palivizumab (SynagisⓇ) 예방요법을 시행하고 있으나 아직 경제효과에 대한 연구가 없는 실정이다. 이에 저자들은 RSV로 인한 하기도 감염으로 입원한 미숙아들의 인구학적, 임상적 특성을 알아보고 우리나라에 적절한 예방요법 대상을 정하는데 도움이 되는 정보를 제공하고자 하였다. 방법:2007년 1월부터 2011년 2월까지 동국대학교 일산병원에 입원한 3세 미만의 급성 하기도 감염 환자 중 multiplex RT-PCR을 통해 원인 바이러스를 밝힌 167명의 의무기록을 후향적으로 조사하였다. 결과:167명 중 RSV 감염으로 밝혀진 환자는 총 113 명이었으며, 만삭아가 90명, 미숙아가 23명이었다. 이들의 평균 입원기간은 만삭아군이 9.0일, 미숙아군이 12.6일로 통계학적인 차이를 보였으며 이외 입원당시 나이, 발열 및 호흡기 증상, 혈액소견등은 유의한 차이를 보이지 않았다. RSV 감염으로 입원한 미숙아 22명을 조사하였을때(다른 질병과의 동반감염이 있었던 한 명 제외), 28주 미만이 4명, 28주 이상 32주 미만이 2명, 32주 이상이 16명(72.7%)으로 대부분이 palivizumab 예방요법의 대상이 아닌 미숙아들이었다. 이들 중 3명은 중환자실에서의 치료를 받았고 한 명만 28주미만의 환아로 palivizumab 투여를 받았으며 나머지 두 명은 32주 이상의 환아들로 기관지폐이형성 등 다른 위험요소가 없어 palivizumab을 투여 받지 않았다. 중환자실에서 치료받은 미숙아군과 만삭아군에서도 임상양상과 혈액학적 소견은 모두 유의한 차이를 보이지 않았다. 결론:RSV에 의한 급성 하기도 감염으로 입원하는 환자들은 대부분 만삭아이거나 기관지폐이형성증과 같은 위험요인이 없는, palivizumab 투여 대상이 아닌 미숙아들이었다. 따라서 우리나라에서도 기관지폐이형성증 이외의 위험요인을 평가하고 더욱 최적의 시기에 palivizumab을 투여 하는 우리나라만의 예방요법지침이 하루속히 필요하다고 생각된다.

바이러스성 호흡기 감염의 역학 조사 및 각종 검체의 바이러스 동정률 비교

김순선,조영걸,김유겸,홍수종,김은순,우영대,주용규 대한감염학회 1999 감염 Vol.31 No.4

소아 급성 하기도 감염의 원인 바이러스 및 이의 유행양상

윤보영,이환종,김미란,윤종구 대한감염학회 1995 감염 Vol.27 No.4

목적: croup, 모세기관지염, 기관 기관지염, 및 폐렴 등의 하기도 감염증에 이환된 소아에서 원인 바이러스를 규명함으로써, 우리나라 소아의 하기도 감염증에 있어서 계절, 연령, 임상형 등에 따른 respiratory syncytial virus(RSV), parainfluenza virus type 1, 2, 3, influenza virus A, B 및 adenovirus 등의 각 호흡기 바이러스의 유행 양상을 밝힌다. 이로써 소아 하기도 감염증의 진단, 치료, 예방에 도움을 얻고, 향후 국내 소아의 호흡기 감염증 연구의 방향을 가늠하는 기초 자료로 활용하고자 한다. 방법: 1990년 11월부터 1994년 4월까지 서울대학교 어린이병원에 입원하거나 외래 또는 응급실을 방문한 소아중 croup, 기관 기관지염, 모세기관지염, 폐렴 등의 하기도 감염증으로 진단받은 환아 712명에서 804회에 걸쳐 비흡인물(nasal aspirate)을 채취하여 단일 클론 항체를 이용한 면역 형광 검사법 및 바이러스 배양으로 369예(45.9%)에서 바이러스성 하기도 감염증을 진단하였다. 결과: 1) 바이러스성 하기도 감염증으로 진단된 환아들의 연령 분포는 2중에서 14년 5개월(중앙 연령 9개월)이었고, 남녀비가 1.75:1이었다. 6개월 미만이 36.3%로 가장 많았고, 연령이 증가 할수록 빈도가 감소하는 추세를 보였다. 이들중 선행 질환이 있었던 경우가 170예(46.1%)였다. 2) 369개(45.9%)의 비흡인물에서 381균주의 바이러스가 확인되었다. RSV가 219예(27.2%)로 가장 많이 분리되었고, 그 다음으로 parainfluenza virus type 3가 63예(7.8%)였으며, 그외 influenza A 및 B virus가 42예(5.2%), adenovirus가 31예(3.9%), parainfluenza virus type 1이 14예(1.7%) 등의 순서로 분리되었다. 혼합 감염증은 12예(3.3%)였다. 3) 바이러스성 하기도 감염증으로 진단된 환아들의 임상상은 폐렴(56.6%), 모세기관지염(35.2%), croup(6.5%), 기관 기관지염(1.6%) 등 이었다. 4) RSV, parainfluenza viruses(type 1, 3), influenza viruses(A, B) 등의 감염증은 주로 유행성으로 발생하였으며, adenovirus 감염증은 연중 산발적으로 발생하였다. 42개월의 연구 기간중 RSV는 가장 큰 유행을 일으켰으며, 연구 기간중 4변의 유행 기간이 있었다. 결론: 하기도 감염증을 가진 대상 환아중 45.9%에서 수종의 호흡기 바이러스가 분리되어 바이러스가 우리나라 소아 하기도 감염증의 주요한 원인으로 생각되며, 이중 특히 RSV가 차지하는 비중이 크다. 각 호흡기 바이러스마다 임상 양상이나 유행시기가 다르고 다른 나라의 보고와 차이점이 있는 부분도 있었다. 향후 우리나라에서도 바이러스성 하기도 감염증의 중요성이 인식되고 더욱 많은 연구가 활발히 진행되어 환자 진단, 치료 및 질병 예방에 이용되어야 할 것으로 사료된다. Background:Respiratory tract infection is the leading cause of morbidity and mortality in children. Causes of acute lower respiratory tract infections(ALRI) in infants and children are diverse and include bacteria, mycoplasma, and respiratory viruses. There is, however, a wide geographic variation regarding the relative importance of each agent. It is necessary to identify the etiology and epidemiology of ALRI in each community to employ control measures including vaccine policy. In Korea, there haeve been no published data regarding the the viral etiology and epidemiology of ALRI. Methods:Viral etiologic agents of ALRI were studied from November 1990 through April 1994 in Korean children. 804 nasal aspirates were collected from 712 children, who visited or were admitted to Seoul National University Children's Hospital due to acute LRI, and viral agents were detected by virus isolation and/or antigen detection by indirect immunofluorescent staining. Results:One or more viral agents were identified in 369(45.9%) cases, of which 3.3% were mixed (two viral) infections. The pathogens identified were respiratory syncytial virus(RSV)(27.2%), parainfluenza virus type 3(7.8%), influenza A virus(3.9%), adenovirus(3.9%), parainfluenza virus type 1(1.7%), influenza B virus(1.4%), parainfluenza virus type 2(0.5%), measles virus(0.1%), and others(0.9%). The clinical patterns of viral LRI included pneumonia(56.6%), bronchiolitis(35.2%), croup(6.5%), and tracheobronchitis(1.6%). Infections with RSV, parainfluenza virus type 1 and 3, and influenza A and B virus occurred in epidemics, while adenovirus was isolated sporadically throughout the study period. Conclusion: We studied the etiologic agents and epidemiology of viral ALRI in Korean children, the results of which may be helpful to the clinicians and researchers interested in the control of LRI.

CT findings in viral lower respiratory tract infections caused by parainfluenza virus, influenza virus and respiratory syncytial virus

Kim, Min-Chul,Kim, Mi Young,Lee, Hyun Joo,Lee, Sang-Oh,Choi, Sang-Ho,Kim, Yang Soo,Woo, Jun Hee,Kim, Sung-Han Wolters Kluwer Health 2016 Medicine Vol.95 No.26

<P><B>Abstract</B></P><P>Viral lower respiratory tract infections (LRTIs) can present with a variety of computed tomography (CT) findings. However, identifying the contribution of a particular virus to CT findings is challenging due to concomitant infections and the limited data on the CT findings in viral LRTIs. We therefore investigate the CT findings in different pure viral LRTIs.</P><P>All patients who underwent bronchoalveolar lavage (BAL) and were diagnosed with LRTIs caused by parainfluenza virus (PIV), influenza virus, or respiratory syncytial virus (RSV) between 1998 and 2014 were enrolled in a tertiary hospital in Seoul, South Korea. A pure viral LRTI was defined as a positive viral culture from BAL without any positive evidence from respiratory or blood cultures, or from polymerase chain reaction (PCR), or from serologic tests for bacteria, fungi, mycobacteria, or other viruses.</P><P>CT images of 40 patients with viral LRTIs were analyzed: 14 with PIV, 14 with influenza virus, and 12 with RSV. Patch consolidation (≥1 cm or more than 1 segmental level) was found only in PIV (29%) (<I>P</I> = 0.03), by which CT findings caused by PIV could resemble those seen in bacterial LRTIs. Ground-glass opacities were seen in all cases of influenza virus and were more frequent than in PIV (71%) and RSV (67%) (<I>P</I> = 0.05). Bronchial wall thickening was more common in influenza virus (71%) and RSV (67%) LRTIs than PIV LRTIs (21%) (<I>P</I> = 0.02). With respect to anatomical distribution, PIV infections generally affected the lower lobes (69%), while influenza virus mostly caused diffuse changes throughout the lungs (57%), and RSV frequently formed localized patterns in the upper and mid lobes (44%).</P><P>The CT findings in LRTIs of PIV, influenza virus, and RSV can be distinguished by certain characteristics. These differences could be useful for early differentiation of these viral LRTIs, and empirical use of appropriate antiviral agents.</P>

소아에서 human metapneumovirus와 respiratory syncytial virus에 의한 호흡기질환의 비교

정우진 ( Woo Jin Chung ),강성실 ( Sung Shil Kang ),방경원 ( Kyong Won Bang ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong Seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ),이준성 ( Joon Sung Lee ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.2

Purpose: Human metapneumovirus (hMPV) is known to result in clinical manifestation similar to respiratory syncytial virus (RSV) in children. But some recent studies showed different features. This study compared the clinical manifestation of respiratory disease between hMPV and RSV. Methods: A total of 801 children who admitted to Seoul St. Mary`s Hospital for respiratory infection from January to June, 2012 were enrolled. Respiratory viral polymerase chain reaction (PCR) using nasopharyngeal swab was performed in all children. We grouped hMPV positive children and RSV positive children and compared clinical features between them by retrospective chart review. Results: Among 801 children, 365 showed one virus PCR positive with 44 showing hMPV and 41 showing RSV. Respiratory diseases were upper respiratory infection, acute bronchitis, acute bronchiolitis and pneumonia. The peak season was March and April for hMPV and February and March for RSV. Fever incidence, fever duration and neutrophil percent of complete blood cell count were higher in hMPV group than RSV group (P<0.05). The mean age of hMPV group was higher than RSV group (P<0.05). But in acute bronchiolitis children, there was no mean age difference between two group. Acute bronchiolitis incidence declined with increased age for both group (P<0.05). The hMPV group showed relatively lower bronchiolitis and higher pneumonia incidence than RSV group, suggesting relation with age. Conclusion: Respiratory infection by hMPV developed at late winter and spring, slightly later than RSV and at older age. The lower incidence of acute bronchiolitis for hMPV infection than RSV is maybe due to older age than RSV. (Allergy Asthma Respir Dis 2013;1:157-163)Allergy Asthma Respir Dis 2013;1:157-163)

소아에서 human metapneumovirus와 respiratory syncytial virus에 의한 호흡기질환의 비교

정우진 ( Woo Jin Chung ),강성실 ( Sung Shil Kang ),방경원 ( Kyong Won Bang ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong Seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ),이준성 ( Joon Sung Lee ) 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.2

Purpose: Human metapneumovirus (hMPV) is known to result in clinical manifestation similar to respiratory syncytial virus (RSV) in children. But some recent studies showed different features. This study compared the clinical manifestation of respiratory disease between hMPV and RSV. Methods: A total of 801 children who admitted to Seoul St. Mary’s Hospital for respiratory infection from January to June, 2012 were enrolled. Respiratory viral polymerase chain reaction (PCR) using nasopharyngeal swab was performed in all children. We grouped hMPV positive children and RSV positive children and compared clinical features between them by retrospective chart review. Results: Among 801 children, 365 showed one virus PCR positive with 44 showing hMPV and 41 showing RSV. Respiratory diseases were upper respiratory infection, acute bronchitis, acute bronchiolitis and pneumonia. The peak season was March and April for hMPV and February and March for RSV. Fever incidence, fever duration and neutrophil percent of complete blood cell count were higher in hMPV group than RSV group (P<0.05). The mean age of hMPV group was higher than RSV group (P<0.05). But in acute bronchiolitis children, there was no mean age difference between two group. Acute bronchiolitis incidence declined with increased age for both group (P<0.05). The hMPV group showed relatively lower bronchiolitis and higher pneumonia incidence than RSV group, suggesting relation with age. Conclusion: Respiratory infection by hMPV developed at late winter and spring, slightly later than RSV and at older age. The lower incidence of acute bronchiolitis for hMPV infection than RSV is maybe due to older age than RSV. (Allergy Asthma Respir Dis 2013;1:157-163)

소아에서 발병한 human metapneumovirus와 respiratory syncytial virus에 의한 호흡기 감염의 임상 양상

김유경 ( Yu Kyung Kim ),김진우 ( Jin Woo Kim ),위영선 ( Young Sun Wee ),유은경 ( Eun Gyong Yoo ),한만용 ( Man Yong Han ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2009 소아알레르기 및 호흡기학회지 Vol.19 No.1

목적: 국내에서 호발하는 hMPV와 RSV 감염의 임상 양상의 차이가 아직 명확하지 않아 이를 확인하고자 한다. 방법: 2006년 8월부터 2007년 7월까지 분당차병원에 하부 호흡기 감염으로 입원한 환아 1,104명을 대상으로 비인강 흡입법과 RT-PCR을 이용하여 바이러스를 검출하였다. 이중 hMPV와 RSV 감염 양성인 환자 각각 51명과 138명을 대상으로 후향적인 의무기록분석을 통해 검출 시기, 연령, 성별, 임상 진단명, 임상 양상 및 검사 소견을 비교 분석하였다. 결과: hMPV감염은 4월에, RSV감염은 11월에 가장 많이 발생하였다. 두 군 모두 1세 미만의 영아가 가장 많았으나 6개월 이하의 군에서 hMPV는 25% RSV는 40%를 차지하였다. 2세 이상의 군에서는 hMPV가 33.4%, RSV는 19%였다. 진단명은 두 군 모두 폐렴, 급성 세기관지염, 급성 기관지염 순으로 차이를 보이지 않았다. 말초 혈액 백혈구수는 RSV 감염시 더 높았고, 입원 당시 열이 있는 환아의 비율은 hMPV군에서 더 높았다. 결론: 본 연구에서 hMPV는 영유아에서 바이러스성 하부 호흡기 감염의 네 번째로 흔한 원인으로, hMPV 감염의 임상양상은 RSV 감염과 유사하였다. 향후 이러한 연구가 호흡기 바이러스 감염의 효율적인 관리에 도움이 될 것이라 여겨진다. Purpose: To identify the clinical features of human metapneumovirus (hMPV) and the respiratory syncytial virus (RSV) infection in children. Methods: The participants of our study were 1,104 children who were admitted to Bung-dang CHA hospital for lower respiratory infection from August 2006 through July 2007. Nasopharyngeal swabs were taken from the patients, and viruses were identified by RT-PCR. The clinical features of 51 patients with hMPV infection and 138 patients with RSV infection were compared by retrospective review of their medical records. Results: The peak incidence of hMPV infection was noted in April, and that of RSV was noted in November. Both viruses had the highest incidence in patients age <1 year and hMPV infections occurred in 40% and 25% of patients age <6 months, respectively. In the hMPV group, 33.4% of the patients were age ≥2 years, while in the RSV group, 19% were age ≥2 years. In both groups, pneumonia was the most common clinical diagnosis, followed by acute bronchiolitis, acute bronchitis, and asthma. The white blood cell counts were higher in the RSV group, and fever was more frequent on admission in the hMPV group. Conclusion: hMPV was the fourth most common virus causing lower respiratory tract infections in children. The clinical features of hMPV infection were similar to those of RSV infection. This study may be helpful for the effective treatment of lower respiratory tract infection in children. [Pediatr Allergy Respir Dis(Korea) 2009;19:12-19]

소아에서 발병한 human metapneumovirus와 respiratory syncytial virus에 의한 호흡기 감염의 임상 양상

김유경,유은경,김진우,위영선,한만용 대한 소아알레르기 호흡기학회 2009 Allergy Asthma & Respiratory Disease Vol.19 No.1

Purpose : To identify the clinical features of human metapneumovirus (hMPV) and the respiratory syncytial virus (RSV) infection in children. Methods : The participants of our study were 1,104 children who were admitted to Bungdang CHA hospital for lower respiratory infection from August 2006 through July 2007. Nasopharyngeal swabs were taken from the patients, and viruses were identified by RT-PCR. The clinical features of 51 patients with hMPV infection and 138 patients with RSV infection were compared by retrospective review of their medical records. Results : The peak incidence of hMPV infection was noted in April, and that of RSV was noted in November. Both viruses had the highest incidence in patients age <1 year and hMPV infections occurred in 40% and 25% of patients age <6 months, respectively. In the hMPV group, 33.4% of the patients were age ≥2 years, while in the RSV group, 19% were age ≥2 years. In both groups, pneumonia was the most common clinical diagnosis, followed by acute bronchiolitis, acute bronchitis, and asthma. The white blood cell counts were higher in the RSV group, and fever was more frequent on admission in the hMPV group. Conclusion : hMPV was the fourth most common virus causing lower respiratory tract infections in children. The clinical features of hMPV infection were similar to those of RSV infection. This study may be helpful for the effective treatment of lower respiratory tract infection in children. 목 적 : 국내에서 호발하는 hMPV와 RSV감염의 임상 양상의 차이가 아직 명확하지 않아 이를 확인하고자 한다. 방 법 : 2006년 8월부터 2007년 7월까지 분당 차병원에 하부 호흡기 감염으로 입원한 환아 1,104명을 대상으로 비인강 흡입법과 RT-PCR을 이용하여 바이러스를 검출하였다. 이중 hMPV와 RSV 감염 양성인 환자 각각 51명과 138명을 대상으로 후향적인 의무기록분석을 통해 검출 시기, 연령, 성별, 임상 진단명, 임상 양상 및 검사 소견을 비교 분석하였다. 결 과 : hMPV감염은 4월에, RSV감염은 11월에 가장 많이 발생하였다. 두 군 모두 1세 미만의 영아가 가장 많았으나 6개월 이하의 군에서 hMPV는 25% RSV는 40%를 차지하였다. 2세 이상의 군에서는 hMPV가 33.4%, RSV는 19%였다. 진단명은 두 군 모두 폐렴, 급성 세기관지염, 급성 기관지염 순으로 차이를 보이지 않았다. 말초 혈액 백혈구수는 RSV 감염시 더 높았고, 입원 당시 열이 있는 환아의 비율은 hMPV군에서 더 높았다. 결 론 : 본 연구에서 hMPV는 영유아에서 바이러스성 하부 호흡기 감염의 네 번째로 흔한 원인으로, hMPV 감염의 임상양상은 RSV 감염과 유사하였다. 향후 이러한 연구가 호흡기 바이러스 감염의 효율적인 관리에 도움이 될 것이라 여겨진다.

Evaluation of Three Multiplex Real-time Reverse Transcription PCR Assays for Simultaneous Detection of SARS-CoV-2, Influenza A/B, and Respiratory Syncytial Virus in Nasopharyngeal Swabs

Yun Jiwon,Park Jae Hyeon,Kim Namhee,Roh Eun Youn,Shin Sue,Yoon Jong Hyun,Kim Taek Soo,Park Hyunwoong 대한의학회 2021 Journal of Korean medical science Vol.36 No.48

Background: In the coronavirus disease 2019 (COVID-19) pandemic era, the simultaneous detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus (Flu), and respiratory syncytial virus (RSV) is important in the rapid differential diagnosis in patients with respiratory symptoms. Three multiplex real-time reverse transcription polymerase chain reaction (rRT-PCR) assays have been recently developed commercially in Korea: PowerChek™ SARS-CoV-2, Influenza A&B Multiplex Real-time PCR Kit (PowerChek; KogeneBiotech); STANDARD™ M Flu/SARS-CoV-2 Real-time Detection Kit (STANDARD M; SD BioSensor); and Allplex™ SARS-CoV-2/FluA/FluB/RSV Assay (Allplex; Seegene). We evaluated the analytical and clinical performances of these kits. Methods: A limit of detection tests were performed and cross-reactivity analysis was executed using clinical respiratory samples. Ninety-seven SARS-CoV-2-positive, 201 SARS-CoV-2- negative, 71 influenza A-positive, 50 influenza B-positive, 78 RSV-positive, and 207 other respiratory virus-positive nasopharyngeal swabs were tested using the three assays. The AdvanSure™ respiratory viruses rRT-PCR assay (AdvanSure; LG Life Sciences) was used as a comparator assay for RSV. Results: Except in influenza B, in SARS-CoV-2 and influenza A, there were no significant differences in detecting specific genes of the viruses among the three assays. All three kits did not cross-react with common respiratory viruses. All three kits had greater than 92% positive percent agreement and negative percent agreement and ≥ 0.95 kappa value in the detection of SARS-CoV-2 and flu A/B. Allplex detected RSV more sensitively than AdvanSure. Conclusion: The overall performance of three multiplex rRT-PCR assays for the concurrent detection of SARS-CoV-2, influenza A/B, and RSV was comparable. These kits will promote prompt differential diagnosis of COVID-19, influenza, and RSV infection in the COVID-19 pandemic era.