Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the Pneumonia Etiology Research for Child Health (PERCH) study experience

被引：5

作者：

Miyakawa, Ryo ^{[1
]}

Zhang, Haijun ^{[2
,3
]}

Brooks, W. Abdullah ^{[4
,5
]}

Prosperi, Christine ^{[2
]}

Baggett, Henry C. ^{[6
,7
]}

Feikin, Daniel R. ^{[2
,8
]}

Hammitt, Laura L. ^{[2
,9
]}

Howie, Stephen R. C. ^{[10
,11
,12
]}

Kotloff, Karen L. ^{[13
]}

Levine, Orin S. ^{[2
]}

Madhi, Shabir A. ^{[14
,15
]}

Murdoch, David R. ^{[16
,17
]}

O'Brien, Katherine L. ^{[2
]}

Scott, J. Anthony G. ^{[9
,18
]}

Thea, Donald M. ^{[19
]}

Antonio, Martin ^{[10
,20
]}

Awori, Juliet O. ^{[9
]}

Bunthi, Charatdao ^{[6
]}

Driscoll, Amanda J. ^{[2
,21
]}

Ebruke, Bernard ^{[10
]}

Fancourt, Nicholas S. ^{[22
,23
]}

Higdon, Melissa M. ^{[2
]}

Karron, Ruth A. ^{[24
]}

Moore, David P. ^{[14
,15
,25
,26
]}

Morpeth, Susan C. ^{[9
,18
,21
]}

Mulindwa, Justin M. ^{[27
]}

Park, Daniel E. ^{[2
,28
]}

Rahman, Mohammed Ziaur ^{[5
]}

Rahman, Mustafizur ^{[5
]}

Salaudeen, Rasheed A. ^{[10
,29
]}

Sawatwong, Pongpun ^{[6
]}

Seidenberg, Phil ^{[19
,30
]}

Sow, Samba O. ^{[31
]}

Tapia, Milagritos D. ^{[13
]}

Knoll, Maria Deloria ^{[2
]}

机构：

[1] Weill Cornell Med, Dept Pediat, New York, NY USA

[2] Johns Hopkins Univ, Int Vaccine Access Ctr, Bloomberg Sch Publ Hlth, Baltimore, MD USA

[3] Peking Univ, Sch Publ Hlth, Dept Hlth Policy & Management, 8 Xueyuan Rd, Beijing 100191, Peoples R China

[4] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA

[5] Bangladesh Icddr B, Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh

[6] Thailand Minist Publ Hlth, US Ctr Dis Control & Prevent Collaborat, Div Global Hlth Protect, Nonthaburi, Thailand

[7] CDCP, Global Hlth Ctr, Div Global Hlth Protect, Atlanta, GA USA

[8] CDCP, Natl Ctr Immunizat & Resp Dis, Div Viral Dis, Atlanta, GA USA

[9] Kenya Govt Med Res Ctr, Wellcome Trust Res Programme, Kilifi, Kenya

[10] London Sch Hyg & Trop Med, Med Res Council Unit, Basse, Gambia

[11] Univ Auckland, Dept Paediat Child & Youth Hlth, Auckland, New Zealand

[12] Fiji Natl Univ, Coll Med, Suva, Fiji

[13] Univ Maryland, Ctr Vaccine Dev & Global Hlth, Dept Pediat, Sch Med,Div Infect Dis & Trop Pediat, Baltimore, MD USA

[14] Univ Witwatersrand, Fac Hlth Sci, South African Med Res Council, Vaccines & Infect Dis Analyt Res Unit, Johannesburg, South Africa

[15] Univ Witwatersrand, Wits Infect Dis & Oncol Res Inst, Johannesburg, South Africa

[16] Univ Otago, Dept Pathol & Biomed Sci, Christchurch, New Zealand

[17] Canterbury Hlth Labs, Microbiol Unit, Christchurch, New Zealand

[18] London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England

[19] Boston Univ, Sch Publ Hlth, Dept Global Hlth, Boston, MA USA

[20] Univ Warwick, London Sch Hyg & Trop Med, Warwick Med Sch, Dept Pathogen Mol Biol,Microbiol & Infect Unit, Coventry, England

[21] Univ Maryland, Ctr Vaccine Dev & Global Hlth, Sch Med, Baltimore, MD USA

[22] Univ Sydney, Childrens Hosp Westmead Clin Sch, Fac Med & Hlth, Sydney, NSW, Australia

[23] Middlemore Hosp, Microbiol Lab, Cty Manukau Dist Hlth Board, Auckland, New Zealand

[24] Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Immunizat Res, Dept Int Hlth, Baltimore, MD USA

[25] Chris Hani Baragwanath Acad Hosp, Dept Paediat & Child Hlth, Johannesburg, South Africa

[26] Univ Witwatersrand, Johannesburg, South Africa

[27] Univ Teaching Hosp, Dept Paediat & Child Hlth, Lusaka, Zambia

[28] George Washington Univ, Milken Inst Sch Publ Hlth, Dept Environm & Occupat Hlth, Washington, DC USA

[29] Lagos Univ, Teaching Hosp, Med Microbiol Dept, Lagos, Nigeria

[30] Univ New Mexico, Dept Emergency Med, Albuquerque, NM USA

[31] Ctr Dev Vaccins CVD Mali, Bamako, Mali

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2025年 / 31卷 / 03期

基金：

比尔及梅琳达.盖茨基金会;

关键词：

Africa; Asia; Human metapneumovirus (hMPV); Paediatric; Severe pneumonia; RESPIRATORY-TRACT INFECTIONS; DIAGNOSIS;

D O I：

10.1016/j.cmi.2024.10.023

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives After respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high-burden settings, which have limited data, by comparing with RSV-positive and other cases. Methods Children aged 1-59 months hospitalized with suspected severe pneumonia and age/season-matched community controls in seven African and Asian countries had nasopharyngeal/oropharyngeal swabs tested by multiplex PCR for 32 respiratory pathogens, among other clinical and lab assessments at admission. Odds ratios adjusted for age and site (adjusted OR [aOR]) were calculated using logistic regression. Aetiologic probability was estimated using Bayesian nested partial latent class analysis. Latent class analysis identified syndromic constellations of clinical characteristics. Results hMPV was detected more frequently among cases (267/3887, 6.9%) than controls (115/4976, 2.3%), among cases with pneumonia chest X-ray findings (8.5%) than without (5.5%), and among controls with respiratory tract illness (3.8%) than without (1.8%; all p <= 0.001). HMPV-positive cases were negatively associated with the detection of other viruses (aOR, 0.18), especially RSV (aOR, 0.11; all p < 0.0001), and positively associated with the detection of bacteria (aORs, 1.77; p 0.03). No single clinical syndrome distinguished hMPV-positive from other cases. Among hMPV-positive cases, 65.2% were aged <1 year and 27.5% had pneumonia danger signs; positive predictive value for hMPV aetiology was 74.5%; mortality was 3.9%, similar to RSV-positive (2.4%) and lower than that among other cases (9.6%). Discussion HMPV-associated severe paediatric pneumonia in high-burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives.

引用

页码：441 / 450

页数：10

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