普通儿童呼吸道感染中巨细胞病毒核酸检测的临床意义

Clinical significance of cytomegalovirus nucleic acid detection in common children with respiratory tract infection

目的:探讨普通儿童呼吸道感染中巨细胞病毒核酸检测的临床意义。方法:回顾性分析2019年4月—2020年5月在汕头大学医学院第二附属医院住院的3576例呼吸道感染患儿的咽拭子标本巨细胞病毒DNA检测情况,患儿年龄29 d~14岁,其中男性2136例,女性1440例。结果:3576例咽拭子标本中巨细胞病毒DNA阳性801例,阳性率为22.40%,其中29 d~4个月,>4个月~1岁、>1~2岁、>2~3岁、>3~5岁及>5~14岁患儿巨细胞病毒DNA阳性率分别为22.38%(130/581)、42.99%(279/649)、34.43%(189/549)、20.16%(101/501)、11.51%(70/608)、4.65%(32/688),各年龄段巨细胞病毒DNA阳性率差异有统计学意义(χ^(2)=369.19,P<0.01),其中4个月~1岁年龄组的巨细胞病毒DNA阳性率最高。巨细胞病毒DNA检测阳性的患儿中诊断为巨细胞病毒肺炎的仅有1例,其余800例无巨细胞病毒活动性感染表现,无需相应的抗病毒治疗。结论:普通儿童呼吸道感染咽拭子标本巨细胞病毒DNA阳性率较高,绝大多数为无症状感染者,无需将咽拭子标本巨细胞病毒DNA检测作为呼吸道感染患儿的常规病原学检测项目。

Objective:To investigate the clinical significance of cytomegalovirus nucleic acid detection in common children with respiratory tract infection.Methods:A retrospective analysis was performed on the detection of cytomegalovirus DNA in throat swab specimens of 3576 children with respiratory tract infection hospitalized in the Second Affiliated Hospital of Shantou University Medical College from April 2019 to May 2020.The age of the children was 29 days-14 years old,including 2136 males and 1440 females.Results:801 cases of cytomegalovirus DNA were positive in 3576 cases of throat swabs;the positive rate was 22.40%.The cytomegalovirus DNA positivity rates in children aged 29 d to 4 months,4 months to 1 year,1 to 2 years,2 to 3years,3 to 5 years,and 5 to 14 years were 22.38%(130/581),42.99%(279/649),34.43%(189/549),20.16%(101/501),11.51%(70/608),and 4.65%(32/688),with statistically significant differences in cytomegalovirus DNA positivity in each age group(χ^(2)=369.19,P<0.01).4 months to 1 year group had the highest positive rate of cytomegalovirus DNA.Among the children with positive cytomegalovirus DNA test,only 1 case was diagnosed as cytomegalovirus pneumonia,and the remaining 800 cases had no symptoms of active cytomegalovirus infection,and no corresponding antiviral treatment was needed.Conclusion:The positive rate of cytomegalovirus DNA in throat swab samples of common children with respiratory tract infection is relatively high,and most of them are asymptomatic infections.It is not necessary to use throat swab specimen cytomegalovirus DNA detection as a routine etiological testing item for children with respiratory tract infection.