Rol del virus sincicial respiratorio en una cohorte de adultos mayores / Respiratory Syncytial Virus in the elderly adults

El rol de los virus respiratorios distintos de influenza en las infecciones respiratorias agudas en los adultos mayores ha sido probablemente subestimado. En los últimos años, los avances en técnicas moleculares de diagnóstico han hecho posible la identificación rápida del virus sincicial respiratorio humano (HRSV). Realizamos un estudio prospectivo observacional para evaluar el rol del HRSV en mayores de 65 años que se hospitalizaron por infecciones respiratorias en nuestra institución, ubicada en la ciudad de La Plata, provincia de Buenos Aires. Fueron reclutados 124 pacientes y el HRSV se detectó en 13, influenza B en 9 e influenza A en 8. La presentación clínica más frecuente de los The role of respiratory viruses other than influenza in acute respiratory tract infections among elderly adults has probably been underestimated. Recent advances in molecular diagnosis have made the rapid identification of human respiratory syncitial virus HRSV infection possible. We conducted a prospective observational study to evaluate the role of HRSV in elderly patients (>65 years of age) hospitalized for acute respiratory infections. A total of 124 patients were recruited, HRSV infection was identified in 13 patients, Influenza B in 9 patients and influenza A in 8 patients. The most frequent clinical presentation was bronchospasm and the infection was prevalent in patients with comorbidities. HRSV infections accounted for an important number of hospital admissions and has been associated with high mortality rates (23%). pacientes con HRSV fue el broncoespasmo y afectó principalmente a personas con comorbilidades. HRSV fue responsable de un número importante de internaciones por enfermedad respiratoria aguda en mayores de 65 años en nuestra institución y se asoció a mortalidad elevada (23%).

The role of respiratory viruses other than influenza in acute respiratory tract infections among elderly adults has probably been underestimated. Recent advances in molecular diagnosis have made the rapid identification of human respiratory syncitial virus HRSV infection possible. We conducted a prospective observational study to evaluate the role of HRSV in elderly patients (>65 years of age) hospitalized for acute respiratory infections. A total of 124 patients were recruited, HRSV infection was identified in 13 patients, Influenza B in 9 patients and influenza A in 8 patients. The most frequent clinical presentation was bronchospasm and the infection was prevalent in patients with comorbidities. HRSV infections accounted for an important number of hospital admissions and has been associated with high mortality rates (23%).

Análise da prevalência de vírus respiratórios em crianças atendidas em um hospital universitário do sul de Minas Gerais / Analysis of respiratory virus prevalence in assisted children in a university hospital of southern of minas gerais

INTRODUÇÃO: As infecções respiratórias virais são doenças de alta incidência no nosso meio. Os vírus circulam durante todo ano, todavia, a incidência destas infeccões aumentam com a sazonalidade. Grande parte destas infecções ocorrem em crianças por serem mais susceptíveis do ponto de vista imunológico. OBJETIVO: Analisar a prevalência dos patógenos virais nas infecções respiratórias em crianças de 0 a 9 anos no Hospital das Clinicas Samuel Libanio(HCSL), Pouso Alegre - MG. MÉTODOS: Foi realizada uma revisão sistemática dos dados coletados a partir de aspirados de orofaringe, para pesquisa de vírus pela equipe da Comissão de Controle de Infecções Hospitalares (CCIH), entre os anos de 2010 e 2014. RESULTADOS: Foram analisados 310 amostras e cerca de 26,4% foram positivas para algum vírus. O vírus sincicial respiratório (VSR) foi o mais prevalente nas crianças menores de um e também na faixa etária de 1 a 4 anos (25,3% e 11,1 %, respectivamente), estatisticamente significante (p<0,001). Já no grupo entre 5 a 9 anos prevaleceu o virus Influenza A H1N1 com 13,8%. CONCLUSÃO: As infecções virais contribuem para um alto número de hospitalizações que oneram o serviço público de saúde, principalmente na faica etária pediátrica. Deste modo, medidas preventiva como campanhas de vacinação devem continuar a ser incentivadas, de preferência abrangendo os vírus mais prevalentes para uma determinada faixa etária. (AU)

Introduction: Viral respiratory infections are of high incidence diseases in our midst. Viruses circulate throughout the year, however, the incidence of these infections increase with seasonality. Most of these infections occur in children because they are more likely immunologically. Objective: To analyze the prevalence of viral pathogens in respiratory infections in children aged 0 to 9 years old at the Samuel Libânio Clinical Hospital, Pouso Alegre-MG. Methods: A systematic review of data collected from aspirates oropharynx was performed to search for viruses by the Commission's Team of Nosocomial Infection Control between the years 2010 and 2014. Results: 310 samples were analyzed and about 26.4% of the samples were positive for a virus. Respiratory syncytial virus (RSV) was the most prevalent in children under one year old and also in the age group 1-4 years (25.3% and 11.1%, respectively), statistically significant (p<0.001). In the group between 5 and 9 years prevailed the virus Influenza A H1N1 with 13.8%. Conclusions: Viral infections contribute to a high number of hospitalizations that burden the public health system, especially in the pediatric age group. Thus, preventive measures such as vaccination campaigns should continue to be encouraged, preferably covering the most prevalent virus for a certain age group (AU)

Performance of indirect immunofluorescence assay, immunochromatography assay and reverse transcription-polymerase chain reaction for detecting human respiratory syncytial virus in nasopharyngeal aspirate samples

Comparison of the use of indirect immunofluorescence assay (IFA), immunochromatography assay (ICA-BD) and reverse transcription-polymerase chain reaction (RT-PCR) for detecting human respiratory syncytial virus (HRSV) in 306 nasopharyngeal aspirates samples (NPA) was performed in order to assess their analytical performance. By comparing the results obtained using ICA-BD with those using IFA, we found relative indices of 85.0 percent for sensitivity and 91.2 percent for specificity, and the positive (PPV) and negative (NPV) predictive values were 85.0 percent and 91.2 percent, respectively. The relative indices for sensitivity and specificity as well as the PPV and NPV for RT-PCR were 98.0 percent, 89.0 percent, 84.0 percent and 99.0 percent, respectively, when compared to the results of IFA. In addition, comparison of the results of ICA-BD and those of RT-PCR yielded relative indices of 79.5 percent for sensitivity and 95.4 percent for specificity, as well as PPV and NPV of 92.9 percent and 86.0 percent, respectively. Although RT-PCR has shown the best performance, the substantial agreement between the ICA-BD and IFA results suggests that ICA-BD, also in addition to being a rapid and facile assay, could be suitable as an alternative diagnostic screening for HRSV infection in children.

Utilidad de la reacción de polimerasa en cadena en tiempo real en el diagnóstico de infecciones por virus respiratorio sincicial en adultos / Utility of real time polymerase chain reaction in the diagnosis of respiratory syncytial virus infection among adult patients

Introducción: Las infecciones respiratorias virales (IRV) son causa importante de morbilidad en adultos. Virus respiratorio sincicial (VRS) causa hasta 20 por ciento de las IRV en esta edad; sin embargo, su diagnóstico es subestimado debido a una menor sensibilidad de las técnicas diagnosticas convencionales (IF y ELISA). Objetivos: Evaluar el impacto del uso de reacción de la polimerasa en cadena en tiempo real (TR-RPC en tiempo real) en el diagnóstico de IRV por VRS en adultos y caracterizar su perfil clínico. Pacientes y Métodos: Durante ocho semanas del año 2005, los adultos hospitalizados en Hospital Clínico de la Universidad Católica con sospecha de IRV, e IFD negativa para VRS, FLU-A, -B, paraFLU-1, 2, 3 y ADV de muestra de hisopado nasofaríngeo, fueron sometidos a detección de VRS por TR-RPC en tiempo real. Se confeccionó una base de datos con los antecedentes clínicos, laboratorio y evolución de cada paciente. Resultados: De 114 pacientes con IFD negativa en 17 (14,9 por ciento) se detectó VRS. Fiebre, congestión faríngea, tos y signos de obstrucción bronquial, configuraron en más de 80 por ciento de los casos el perfil clínico de los pacientes. Treinta por ciento presentaba enfermedad crónica y 47 por ciento eran inmunocomprometidos. Tres de 17 (18 por ciento) presentaron descompensación de la enfermedad de base y 1/17 (6 por ciento) requirió ventilación mecánica. No hubo mortalidad asociada. Conclusiones: El uso de TR-RPC en tiempo real permitió duplicar la detección de infecciones por VRS en adultos hospitalizados respecto a las diagnosticadas por IFD. Se recomienda considerar el empleo la técnica de TR-RPC en tiempo real en aquellos pacientes con sospecha clínica de VRS durante la temporada de VRS y estudio viro lógico negativo por métodos convencionales.

Introduction: Viral respiratory infections (VRI) are a frequent cause of morbidity among adult population. Respiratory syncytial virus (RSV) produces 20 percent> of VRI, however diagnosis is limited for a low sensitivity of conventional (FDA and ELISA) tests. Aim: To assess the impact of real time reverse transcriptase-polymerase chain reaction (real time RT-PCR) technique in RSV diagnosis in adult hospitalized patients; to characterize RSV infection among these patients. Patients and Methods: All adults hospitalized in Hospital Clínico Universidad Católica during 8 weeks of winter season, with clinical picture of VRI, and with negative DFA for influenza A and B, parainfluenza 1, 2, 3 and adenovirus were included. Real time RT-PCR was performed from nasopharyngeal sample. Clinical information, general laboratory exams and chest X ray reports were collected. Results: Out of 114 patients with negative DFA, 17 (14.9 percento) Debe decir: RSV cases were demonstrated using real time RT- PCR. Fever, pharyngeal congestion, cough and bronchial obstruction were present in 80 percent> of patients. Thirty percent of them had a baseline chronic disease and 47 percent> were immunocompromised. One out of 17 patients (6 percent) required mechanical ventilation. No mortality was observed. Conclusions: Use of RT-PCR allowed increasing detection of RSV infection over 100 percent> among adults with VRI without virological diagnosis with conventional techniques. It is necessary to consider RSV RT-PCR test among patients with clinical picture of VRI during RSV season, with negative virological screening tests.

Incidência de doença de vias aéreas pelo vírus sincicial respiratório humano em coorte de recém nascidos do município de São Paulo: comparação de técnicas diagnósticas e caracterização molecular / Incidence of respiratory illness by human respiratory syncytial virus in a cohort of newborn in São Paulo city: comparison of techniques and genetic diversity

A incidência de doença respiratória pelo vírus sincicial respiratório humano (VSRH) avaliada em uma coorte de recém-nascidos, entre dezembro/2002 a setembro/2005, foi de 9,84/1000 criança-mês.Um total de 316 amostras de lavado de nasofaringe, foram processadas por três diferentes técnicas (isolamento viral, imunofluorescência direta e PCR) para detecção de vírus respiratório sincicial humano (VSRH). Destas, 36 (11,4 por cento) foram positivas para o VSRH. A PCR foi à técnica mais sensível, sendo positiva em 35 (11,1 por cento) das amostras, seguido da imunofluorescência direta (25/316, 7,9 por cento) e isolamento viral (20/315, 6,3 por cento) (p<0,001). Os dados do presente estudo sugerem que o conceito de isolamento viral como “padrão ouro” no diagnóstico do VSRH seja revisto / The incidence of respiratory illnesses caused by the human respiratory syncytial virus (HRSV) in a cohort of neonates between December 2002 and September 2005 was 9.84/1000 children/month. A total of 316 samples of nasopharyngeal lavage were processed using three different techniques (viral isolation, direct immunofluorescence and PCR) to detect the human respiratory syncytial virus (HRSV). Of these, 36 (11.4 per cent) were positive for HRSV. PCR was the most sensitive technique. It was positive in 35 (11.1 per cent) of the samples, followed by direct immunofluorescence (25/316, 7.9 per cent) and viral isolation (20/315, 6.3 per cent) (p<0.001). The findings of this study suggest that the view that viral isolation is the “gold standard” for diagnosis of HRSV should be reconsidered...

Características do lactente hospitalizado com infecção do aparelho respiratório inferior por vírus sincicial respiratório: tipos e genótipos do vírus e anticorpos séricos específicos / Characteristics of infants hospitalized with lower respiratory tract infection due to respiratory syncytial virus: types and genotypes of the virus and specific serum antibodies

As doenças do aparelho respiratório inferior (DARI) são responsáveis por altos índices de morbi-mortalidade em crianças em todo o mundo. O principal agente causador de DARI em lactentes é o vírus sincicial respiratório (VSR), que acomete, principalmente os lactentes no primeiro ano de vida. O perfil dos tipos e genotipos de VSR causadores de DARI e o papel dos anticorpos séricos do lactente ainda estão indefinidos. Este conhecimento é importante para o desenvolvimento de medidas terapêuticas e profiláticas eficazes.Throughout the world, lower respiratory tract infection (LRTI) is responsible for high mortality rates among children. The main etiological agent of LRTI in infants is respiratory syncytial virus (RSV) that mainly involves infants in the first year of life. The profile of the types and genotypes of RSV that cause LRTI and the role of the infant's serum antibodies have yet to be fully clarified. This knowledge is important for the development of effective therapeutic and prophylactic measures...

Seroprevalence of anti-RSV IgG in Thai children aged 6 months to 5 years.

Respiratory syncytial virus (RSV) is the single most important cause of lower respiratory tract infection during infancy and early childhood worldwide including Thailand. The magnitude as well as the intensity of both infection and host response to the RSV infection determine the severity of disease. To determine the presence of anti-RSV IgG in children of different age groups, 124 serum samples were randomly collected from healthy children aged 6 months to 5 years. All of them were assayed for anti-RSV IgG using a commercial ELISA kit. The mean prevalence rate was found to be 68.91%. The prevalence increased with age: from 6 to 11 months, 11.76%; from 12 to 17 months, 41.67%; from 18 to 23 months, 60.87%; from 24 to 29 months, 88.24%; from 30 to 35 months, 78.57%; from 36 to 41 months, 94.44% and from 42 to 60 months, 100%. The amount of anti-RSV IgG among the groups was significantly different (p = 0.006). No sexual preponderance was found. RSV infection commonly occurred in children aged 12 to 29 months. All children older than 5 years had experienced a RSV infection.

Variabilidad antigénica de cepas de virus sincitial respiratorio aisladas en ciudad de la Habana mediante ELISA utilizando anticuerpos monoclonales / Antigenic variance of strains of the espiratory sincitial virus isolated in Habana city by eans of ELISA using antibodies

Se realizó el estudio de caracterización y análisis de la variabilidad antigénica con un panel de 10 anticuerpos monoclonales que reconocen a epítopes lineales de la protéina G, a 15 cepas de Virus Sincitial Respiratorio aisladas en dos brotes ocurridos en Ciudad Habana entre los meses de octubre a enero (1994-1995) y octubre (1996), respectivamente. Para ello se utilizaron dos cepas de referencia: la Cepa Long y la Cepa A/Mon/3/88. El ELISA fue el método empleado para los ensayos. Los resultados mostraron la variabilidad de la proteína G entre los aislamientos y su relación antigénica con la cepa prototipo Long, además de confirmar que todas las cepas que habían circulado en estos períodos correspondían antigénicamente al Subgrupo A

Evaluación de un ultramicroELISA para la detección de la infección por el virus sincitial respiratorio / Evaluation of an ultramicroELISA assay for the detection of infection by the respiratory syncytial virus

Objetivo. El presente trabajo tuvo como objetivo la evaluación de un ensayo de ultramicroELISA (UME) de doble anticuerpo para la detección rápida de anticuerpos IgG al Virus Sincitial Respiratorio (VSR) en monosueros y muestras de sueros pareados. Materiales y métodos. Se evaluaron 1567 muestras de suero por las técnicas de UME y Fijación de Complemento (FC), de ellas 619 eran monosueros de niños menores de 15 años y 474 pares pertenecientes al Programa Nacional de Vigilancia Seroepidemiológica de las Infecciones Respiratorias Agudas. En el UME de doble anticuerpo se utilizó un anticuerpo monoclonal específico a la proteína F del VSR. Resultados. Para los monosueros el UME con respecto a la FC mostró una sensibilidad de 98.9 por ciento, una especificidad de 56.05 por ciento y una coincidencia de 63.9 por ciento. Para los sueros pares la sensibilidad fue de 92.7 porciento, mientras que la especificidad y la coincidencia aumentaron aun 79.3 por ciento y 80.1 por ciento respectivamente. Conclusiones. La utilización del anticuerpo monoclonal permitió la inclusión de preparaciones antigénicas crudas en lugar de fracciones purificadas, disminuyendo notablemente la reactividad obtenida con el control de antígeno. Los resultados obtenidos respaldan la utilización de este método como una herramienta complementaria en estudios seroepidemiológico a gran escala y con fines diagnósticos