Incidence and clinical impact of respiratory viruses in adults with cystic fibrosis
被引:89
作者:
Flight, William G.
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机构:
Univ Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Univ Manchester, Inst Inflammat & Repair, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Flight, William G.
[1
,2
]
Bright-Thomas, Rowland J.
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机构:
Univ Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Univ Manchester, Inst Inflammat & Repair, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Bright-Thomas, Rowland J.
[1
,2
]
Tilston, Peter
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机构:
Cent Manchester Univ Hosp NHS Fdn Trust, Dept Virol, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Tilston, Peter
[3
]
Mutton, Kenneth J.
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h-index: 0
机构:
Univ Manchester, Inst Inflammat & Repair, Manchester, Lancs, England
Cent Manchester Univ Hosp NHS Fdn Trust, Dept Virol, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Mutton, Kenneth J.
[2
,3
]
Guiver, Malcolm
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机构:
Cent Manchester Univ Hosp NHS Fdn Trust, Dept Virol, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Guiver, Malcolm
[3
]
Morris, Julie
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Univ Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Morris, Julie
[1
]
Webb, A. Kevin
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机构:
Univ Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Univ Manchester, Inst Inflammat & Repair, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Webb, A. Kevin
[1
,2
]
Jones, Andrew M.
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机构:
Univ Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Univ Manchester, Inst Inflammat & Repair, Manchester, Lancs, EnglandUniv Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
Jones, Andrew M.
[1
,2
]
机构:
[1] Univ Hosp South Manchester NHS Fdn Trust, Manchester M23 9LT, Lancs, England
[2] Univ Manchester, Inst Inflammat & Repair, Manchester, Lancs, England
[3] Cent Manchester Univ Hosp NHS Fdn Trust, Dept Virol, Manchester, Lancs, England
Background: Viral respiratory infection (VRI) is a common cause of pulmonary exacerbations in children with cystic fibrosis (CF). The importance of VRI in adult CF populations is unclear. Objective: To determine the incidence and clinical impact of VRI among adults with CF. Methods: One hundred adults with CF were followed up prospectively for 12 months. Sputum, nose swabs and throat swabs were collected every 2 months and at onset of pulmonary exacerbation. PCR assays for adenovirus, influenza A&B, human metapneumovirus, parainfluenza 1-3, respiratory syncytial virus and human rhinovirus were performed on each sample. Symptom scores, spirometry and inflammatory markers were measured at each visit. Results: One or more respiratory viruses were detected in 191/626 (30.5%) visits. Human rhinovirus accounted for 72.5% of viruses. Overall incidence of VRI was 1.66 (95% CI 1.39 to 1.92) cases/patient-year. VRI was associated with increased risk of pulmonary exacerbation (OR=2.19; 95% CI 1.56 to 3.08; p<0.001) and prescription of antibiotics (OR=2.26; 95% CI 1.63 to 3.13; p<0.001). Virus-positive visits were associated with higher respiratory symptom scores and greater C-reactive protein levels. Virus-positive exacerbations had a lower acute fall in FEV 1 than virus-negative exacerbations (12.7% vs 15.6%; p=0.040). The incidence of exacerbations, but not VRI, was associated with greater lung function decline over 12 months (-1.79% per pulmonary exacerbation/year; 95% CI -3.4 to -0.23; p=0.025). Conclusion: VRI is common in adults with CF and is associated with substantial morbidity. Respiratory viruses are a potential therapeutic target in CF lung disease.
机构:
Univ Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Seattle Childrens Hosp, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Burns, Jane L.
Emerson, Julia
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Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Emerson, Julia
Kuypers, Jane
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h-index: 0
机构:
Fred Hutchinson Canc Res Ctr, Dept Lab Med, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Kuypers, Jane
Campbell, Angela P.
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h-index: 0
机构:
Univ Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Seattle Childrens Hosp, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Campbell, Angela P.
Gibson, Ronald L.
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机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Gibson, Ronald L.
McNamara, Sharon
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h-index: 0
机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
McNamara, Sharon
Worrell, Kelly
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机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Worrell, Kelly
Englund, Janet A.
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机构:
Univ Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Seattle Childrens Hosp, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Chattoraj, Sangbrita S.
Ganesan, Shyamala
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Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Ganesan, Shyamala
Jones, Andrew M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ S Manchester Hosp, NHS Trust Wythenshawe Hosp, Manchester Adult Cyst Fibrosis Ctr, Manchester M20 8LR, Lancs, EnglandUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Jones, Andrew M.
Helm, Jennifer M.
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h-index: 0
机构:
Univ S Manchester Hosp, NHS Trust Wythenshawe Hosp, Manchester Adult Cyst Fibrosis Ctr, Manchester M20 8LR, Lancs, EnglandUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Helm, Jennifer M.
Comstock, Adam T.
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h-index: 0
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Comstock, Adam T.
Bright-Thomas, Rowland
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Univ S Manchester Hosp, NHS Trust Wythenshawe Hosp, Manchester Adult Cyst Fibrosis Ctr, Manchester M20 8LR, Lancs, EnglandUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Bright-Thomas, Rowland
LiPuma, John J.
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机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
LiPuma, John J.
Hershenson, Marc B.
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机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Univ Michigan, Dept Mol & Integrat Physiol, Ann Arbor, MI USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Hershenson, Marc B.
Sajjan, Umadevi S.
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Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
机构:
Univ Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Seattle Childrens Hosp, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Burns, Jane L.
Emerson, Julia
论文数: 0引用数: 0
h-index: 0
机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Emerson, Julia
Kuypers, Jane
论文数: 0引用数: 0
h-index: 0
机构:
Fred Hutchinson Canc Res Ctr, Dept Lab Med, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Kuypers, Jane
Campbell, Angela P.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Seattle Childrens Hosp, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Campbell, Angela P.
Gibson, Ronald L.
论文数: 0引用数: 0
h-index: 0
机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Gibson, Ronald L.
McNamara, Sharon
论文数: 0引用数: 0
h-index: 0
机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
McNamara, Sharon
Worrell, Kelly
论文数: 0引用数: 0
h-index: 0
机构:
Seattle Childrens Hosp, Seattle, WA USA
Univ Washington, Dept Pediat, Div Pulm & Sleep Med, Seattle, WA 98195 USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Worrell, Kelly
Englund, Janet A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
Seattle Childrens Hosp, Seattle, WA USAUniv Washington, Dept Pediat, Div Infect Dis, Seattle, WA 98195 USA
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Chattoraj, Sangbrita S.
Ganesan, Shyamala
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Ganesan, Shyamala
Jones, Andrew M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ S Manchester Hosp, NHS Trust Wythenshawe Hosp, Manchester Adult Cyst Fibrosis Ctr, Manchester M20 8LR, Lancs, EnglandUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Jones, Andrew M.
Helm, Jennifer M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ S Manchester Hosp, NHS Trust Wythenshawe Hosp, Manchester Adult Cyst Fibrosis Ctr, Manchester M20 8LR, Lancs, EnglandUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Helm, Jennifer M.
Comstock, Adam T.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Comstock, Adam T.
Bright-Thomas, Rowland
论文数: 0引用数: 0
h-index: 0
机构:
Univ S Manchester Hosp, NHS Trust Wythenshawe Hosp, Manchester Adult Cyst Fibrosis Ctr, Manchester M20 8LR, Lancs, EnglandUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Bright-Thomas, Rowland
LiPuma, John J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
LiPuma, John J.
Hershenson, Marc B.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Univ Michigan, Dept Mol & Integrat Physiol, Ann Arbor, MI USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA
Hershenson, Marc B.
Sajjan, Umadevi S.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USAUniv Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI 48109 USA