BACKGROUND Viral respiratory tract infections are common during early childhood. How they impact cystic fibrosis lung disease history in young children is poorly known. The principal aim of our study was to determinate respiratory tract infections frequency in this cystic fibrosis young population. Secondary outcomes were nature of viral agents recovered and impact of such infections. METHODS We conducted a prospective cohort study of 25 children affected by cystic fibrosis and aged less than 2 years. Nasal samplings were taken systematically monthly or bimonthly with additional samples taken during respiratory tract infections episodes. Ten pathogens were tested by a combination of five duplex RT-PCRs or PCRs: influenza A and B, respiratory syncytial virus (RSV), metapneumovirus (MPV), rhinovirus/enterovirus (RV/EV)), coronavirus (HKU1, NL63, 229E and OC43), parainfluenza virus (1-4), adenovirus and bocavirus (Respiratory Multi-Well System MWS r-gene®, BioMérieux, Marcy l'Étoile, France). Cycle thresholds (CTs) were reported for all positive samples and considered positive for values below 40. Quantitative variables were compared using a nonparametric statistical test (Wilcoxon signed rank for paired comparisons). Pearson's correlation coefficient (r) was used to assess relationships between two variables. Statistical analyses were performed using SAS v9.4 (SAS Institute, Cary, NC, USA) or GraphPad Prism V6.00 (GraphPad Software, La Jolla, CA, USA). The significance level was set at 0.05. RESULTS The mean age at inclusion was 9.6 ± 6.7 months. The patients had 3.4 ± 1.7 respiratory tract infections episodes per child per year. Forty-four respiratory tract infections (69%) were associated with virus: rhinovirus and enterovirus (RV/EV) were implied in 61% of them and respiratory syncytial virus (RSV) in 14%. Only one patient required hospitalization for lower respiratory tract infections. 86% of the patients were treated by antibiotics for a mean of 13.8 ± 6.2 days. RSV infections (n = 6) were usually of mild severity. CONCLUSIONS Respiratory tract infections in young children with cystic fibrosis were of mild severity, rarely requiring hospitalization. Unsurprisingly, RV/EV were the most frequent agents. RSV-related morbidity seems low in this population. This raises the question of the usefulness of RSV preventive medication in this young population.

中文翻译：

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患有囊性纤维化的幼儿病毒性呼吸道感染：一项前瞻性的全年季节性研究。

背景技术病毒性呼吸道感染在幼儿时期很常见。它们如何影响幼儿的囊性纤维化肺部疾病史尚不清楚。我们研究的主要目的是确定这个囊性纤维化年轻人群的呼吸道感染频率。次要结果是病毒制剂的性质和这种感染的影响。方法我们对25名年龄小于2岁的受囊性纤维化影响的儿童进行了一项前瞻性队列研究。每月或每两个月系统地进行一次鼻采样，并在呼吸道感染发作期间进行额外采样。通过五种双重RT-PCR或PCR的组合测试了十种病原体：甲型和乙型流感，呼吸道合胞病毒（RSV），间质肺病毒（MPV），鼻病毒/肠病毒（RV / EV），冠状病毒（HKU1，NL63，229E和OC43），副流感病毒（1-4），腺病毒和博卡病毒（呼吸多井系统MWSr-gene®，BioMérieux，法国马西勒图勒）。报告所有阳性样品的循环阈值（CT），对于低于40的值视为阳性。使用非参数统计检验（定量比较采用Wilcoxon符号等级）比较定量变量。皮尔逊相关系数（r）用于评估两个变量之间的关系。使用SAS v9.4（美国北卡罗来纳州卡里市的SAS研究所）或GraphPad Prism V6.00（美国加利福尼亚州拉荷亚的GraphPad软件）进行统计分析。显着性水平设定为0.05。结果纳入的平均年龄为9.6±6.7个月。每个孩子每年患者有3.4±1.7例呼吸道感染发作。其中有44例呼吸道感染（69％）与病毒有关：其中61％隐含鼻病毒和肠病毒（RV / EV），14％隐含呼吸道合胞病毒（RSV）。只有一名患者因下呼吸道感染需要住院治疗。86％的患者平均接受了13.8±6.2天的抗生素治疗。RSV感染（n = 6）通常是轻度的。结论患有囊性纤维化的幼儿呼吸道感染轻度，很少需要住院。毫不奇怪，RV / EV是最常见的代理商。在该人群中，与RSV相关的发病率似乎较低。这就提出了在年轻人中使用RSV预防药物的有效性的问题。其中61％隐含鼻病毒和肠病毒（RV / EV），14％隐含呼吸道合胞病毒（RSV）。只有一名患者因下呼吸道感染需要住院治疗。86％的患者平均接受了13.8±6.2天的抗生素治疗。RSV感染（n = 6）通常是轻度的。结论患有囊性纤维化的幼儿呼吸道感染轻度，很少需要住院。毫不奇怪，RV / EV是最常见的代理商。在该人群中，与RSV相关的发病率似乎较低。这就提出了在年轻人中使用RSV预防药物的有效性的问题。其中61％隐含鼻病毒和肠病毒（RV / EV），14％隐含呼吸道合胞病毒（RSV）。只有一名患者因下呼吸道感染需要住院治疗。86％的患者平均接受了13.8±6.2天的抗生素治疗。RSV感染（n = 6）通常是轻度的。结论患有囊性纤维化的幼儿呼吸道感染轻度，很少需要住院。毫不奇怪，RV / EV是最常见的代理商。在该人群中，与RSV相关的发病率似乎较低。这就提出了在年轻人中使用RSV预防药物的有效性的问题。RSV感染（n = 6）通常是轻度的。结论患有囊性纤维化的幼儿呼吸道感染轻度，很少需要住院。毫不奇怪，RV / EV是最常见的代理商。在该人群中，与RSV相关的发病率似乎较低。这就提出了在年轻人中使用RSV预防药物的有效性的问题。RSV感染（n = 6）通常是轻度的。结论患有囊性纤维化的幼儿呼吸道感染轻度，很少需要住院。毫不奇怪，RV / EV是最常见的代理商。在该人群中，与RSV相关的发病率似乎较低。这就提出了在年轻人中使用RSV预防药物的有效性的问题。