I-RSV vs. HMPV: Isikhokelo seKliniki sokuchonga ngokuchanekileyo ebantwaneni

Uphononongo lweIphepha loPhando leKlasi

I-Respiratory Syncytial Virus (RSV) kunye ne-Human Metapneumovirus (HMPV) zi-tiintsholongwane ezinxulumene kakhulu ngaphakathiI-Pneumoviridaeusaphoezihlala zibhideka kwiimeko zosulelo olukhawulezileyo lokuphefumla kwabantwana. Nangona iinkcazo zabo zeklinikhi zidibana, idatha yokujonga kwangaphambili (2016–2020) evela kwizibhedlele ezisi-7 zabantwana zase-US—ezibandakanya izigulana ezingama-8,605—ityhila umahluko obalulekileyo kubemi bazo abasengozini enkulu, ubunzima besifo, kunye nolawulo lweklinikhi. Olu phononongo lusebenzise uyilo olusebenzayo nolunokwenzeka olunokuqokelelwa kwe-nasopharyngeal swab kunye novavanyo lweentsholongwane zokuphefumla ezisi-8, nto leyo ebonelela ngothelekiso lokuqala olukhulu, oluyinyani koogqirha babantwana. Ngokuhlalutya amazinga okulaliswa esibhedlele, ukwamkelwa kwi-ICU, ukusetyenziswa komoya woomatshini, kunye nokuhlala ixesha elide esibhedlele (≥iintsuku ezi-3), iseka isiseko esibalulekileyo se-epidemiological ngaphambi kokungenelela kwixesha lokugonywa kwe-RSV entsha (umz., ukugonywa koomama, ii-antibodies ze-monoclonal ezisebenza ixesha elide) kwaye idala isakhelo sophuhliso lwe-HMPV yexesha elizayo.

Isiphumo esiPhambili 1: Iiprofayili eziMngcipheko oPhezulu

-I-RSV ichaphazela kakhulu iintsana ezincinci:Ubudala obuphakathi bokulaliswa esibhedlele yayiziinyanga ezisi-7 kuphela, apho i-29.2% yezigulana ezamkelweyo yayiziintsana ezisandul’ ukuzalwa (iinyanga ezi-0–2). I-RSV yeyona nto iphambili ebangela ukulaliswa esibhedlele kwiintsana ezingaphantsi kweenyanga ezi-6, kwaye ubunzima buhambelana nobudala.

-I-HMPV ijolise kubantwana abadala kunye nabo baneengxaki ezifanayo:Ubudala obuphakathi bokulaliswa esibhedlele yayiziinyanga ezili-16, nto leyo eyayinempembelelo enkulu kubantwana abangaphezu konyaka omnye. Okuphawulekayo kukuba, ukuxhaphaka kweemeko zempilo ezisisiseko (umz., isifo sentliziyo, isifo semithambo-luvo, isifo sokuphefumla) kwakungaphezulu kabini kwizigulane ze-HMPV (26%) xa kuthelekiswa nezigulane ze-RSV (11%), nto leyo ebonisa ukuba basesichengeni esiphezulu.

Umfanekiso 1. Ukusasazwa kweminyaka yokutyelela abantu abane-ED kunye nokulaliswa esibhedleleinxulunyaniswa ne-RSV okanye i-HMPV

kubantwana abangaphantsi kweminyaka eli-18.

Isiphumo esiPhambili sesi-2: Ukwahlulahlula iiNgxelo zeKliniki

-I-RSV ibonakaliswa ziimpawu ezicacileyo zokuphefumla okuphantsi:Inxulunyaniswa kakhulu ne-bronchiolitis (i-76.7% yamatyala asesibhedlele). Iimpawu eziphambili ziqukaukurhoxa kodonga lwesifuba (izigulane ezilaliswe ngaphakathi ezingama-76.9%; 27.5% ED)kwayei-tachypnea (91.8% yezigulane ezilaliswe ngaphakathi; 69.8% ED), zombini ezi zifo zixhaphake kakhulu kunakwi-HMPV.

-I-HMPV ibangela umkhuhlane ophezulu kunye nomngcipheko we-pneumonia:Isifo semiphunga safunyanwa kwi-35.6% yezigulane ze-HMPV ezilaliswe esibhedlele—inani eliphindwe kabini le-RSV.Umkhuhlane wawuyeyona nto iphambili (83.6% yezigulane ezilaliswe esibhedlele; 81% ED)Nangona iimpawu zokuphefumla ezifana nokuphefumla okuncinci kunye ne-tachypnea zisenzeka, zihlala zingekho nzima kangako kunakwi-RSV.

Umfanekiso 2.Iimpawu zokuthelekisa kunye neklinikhiikhosiye-RSV xa kuthelekiswa ne-HMPV kubantwana abangaphantsi kweminyaka eli-18.

Isishwankathelo: I-RSVikakhulu kubangela izifo ezinzulu kwiintsana ezincinci, ezibonakaliswa kukuphazamiseka okukhulu kokuphefumla (ukuphefumla okuncinci, ukurhoxa) kunye ne-bronchiolitis.I-HMPVIxhaphake kakhulu kubantwana abadala abanezinye izifo, ibonakalisa umkhuhlane omkhulu, inomngcipheko ophezulu we-pneumonia, kwaye idla ngokubangela impendulo ebanzi yokudumba komzimba.

Inqaku eliPhambili 3: Iipateni zeXesha Elibalulekileyo

-I-RSV inencopho yokuqala, eqikelelwayo:Umsebenzi wayo ugxile kakhulu, uhlala uphezulu phakathiuNovemba noJanuwari, nto leyo eyenza ukuba ibe sisongelo esiphambili sentsholongwane kwiintsana ekwindla nasebusika.

-I-HMPV ifikelela kwinqanaba eliphezulu kamva ngokuguquguquka okukhulu:Ixesha layo lifika kamva, lidla ngokufika kwincophouMatshi no-Epreli, kwaye ibonisa umahluko omkhulu unyaka nonyaka kunye nowengingqi, odla ngokubonakala “njengegagasi lesibini” emva kokwehla kwe-RSV.

Umfanekiso 3.I-PCR epositive iyonke kunye nendawo ethileeamazinga e-RSV kunye ne-HMPV phakathi kwabantwana abangaphantsi kweminyaka eli-18 abane-ED enxulumene nosulelo oluphezulu lokuphefumla (ARI) kunye nokulaliswa esibhedlele.

Ukuthintela nokuNyamekela: Isicwangciso sokuSebenza esisekelwe kuBungqina

-Ukuthintela i-RSV:Amaqhinga okuthintela ngoku ayafumaneka. Ngo-2023, i-US FDA yavuma i-antibody ye-monoclonal esebenza ixesha elide (i-Nirsevimab), enokukhusela iintsana kwiinyanga zazo zokuqala ezi-5. Ukongeza, ugonyo lwe-RSV lukamama ludlulisela ngempumelelo ii-antibodies zokukhusela kwiintsana ezisandula ukuzalwa.

-Ukuthintela i-HMPV:Okwangoku akukho mayeza okuthintela avunyiweyo. Nangona kunjalo, uninzi lwamayeza okugonya (umz., i-AstraZeneca's RSV/HMPV combination vaccine) akwizilingo zeklinikhi. Abazali bayacetyiswa ukuba bahlale benolwazi malunga nohlaziyo oluvela kwiingcali zempilo yoluntu.

Funa Unyango Olukhawulezileyo Ngeyiphi na “Iimpawu Ezibomvu”:

-Umkhuhlane kwiintsana:Ubushushu obungaphezulu kwama-38°C (100.4°F) kulo naliphi na usana olungaphantsi kweenyanga ezi-3 ubudala.

-Izinga lokuphefumla eliPhakamileyo:Ukuphefumla kudlula ukuphefumla okungama-60 ngomzuzu kwiintsana ezinenyanga e-1 ukuya kwezi-5, okanye ukuphefumla okungama-40 ngomzuzu kubantwana abaneminyaka e-1 ukuya kwemi-5, nto leyo ebonisa ukuba kukho ingxaki yokuphefumla.

-Ukwanda kweoksijini ephantsi:Ukwanda kweoksijini (SpO₂) kuwela ngaphantsi kwe-90%, uphawu olubalulekileyo lokugula kakhulu olubonwe kwi-30% ye-RSV kunye ne-32.1% yeemeko ze-HMPV ezilaliswe esibhedlele kolu phando.

-Ubunzima bokudinwa okanye bokutya:Ukudinwa okuphawulekayo okanye ukuncipha kokusetyenziswa kobisi ngaphezulu kwesinye kwisithathu kwiiyure ezingama-24, nto leyo enokuba negalelo ekuphelelweni ngamanzi emzimbeni.

Nangona kwahlukile kwi-epidemiology nakwimbonakalo yeklinikhi, ukwahlula ngokuchanekileyo phakathi kwe-RSV kunye ne-HMPV kwindawo yokhathalelo kusengumngeni. Ngaphezu koko, ingozi yeklinikhi idlulela ngaphaya kwezi ntsholongwane zimbini, kunye nezifo ezifana ne-influenza A kunye nezinye izifo ezibangelwa yintsholongwane kunye neentsholongwane ezisongela impilo yoluntu ngaxeshanye. Ukuxilongwa ngexesha elifanelekileyo nangokuchanekileyo kubalulekile ukuze kulawulwe ngokufanelekileyo inkxaso, ukwahlulwa okusebenzayo, kunye nokwabiwa kwezixhobo ngengqiqo.

Ukwazisa i-AIO800 + 14-Pathogen Combined Detection Kit (i-Fluorescence PCR)(NMPA, CE, FDA, SFDA ivunyiwe)

Ukuze kuhlangatyezwane nale mfuno,Inkqubo yokuFumanisa i-Nucleic Acid ye-Eudemon™ AIO800 ezenzekelayo ngokupheleleyo, idityaniswe neIphaneli yokuphefumla ene-pathogen eli-14, inika isisombululo esiguqulayo — inika inyani"Isampuli ngena, phendula"ukuxilongwa kwimizuzu engama-30 kuphela.

Olu vavanyo lokuphefumla olupheleleyo lufumanisazombini iintsholongwane kunye neebhaktheriyaukusuka kwisampulu enye, evumela ababoneleli beenkonzo zempilo abaphambili ukuba benze izigqibo zonyango eziqinisekileyo, ezifike ngexesha, nezijolise kubo.

Iimpawu eziphambili zeNkqubo ezibalulekileyo kubathengi bakho

 Ukuhamba komsebenzi ozenzekelayo ngokupheleleyo
Ixesha lokusebenza ngezandla lingaphantsi kwemizuzu emi-5. Akukho mfuneko yabasebenzi abanobuchule beemolekyuli.

- Iziphumo ezikhawulezayo
Ixesha lokutshintsha kwempilo lemizuzu engama-30 lixhasa iimeko zeklinikhi ezingxamisekileyo.

- 14Ukufunyanwa kwePathogen Multiplex
Ukuchonga ngaxeshanye:

Iintsholongwane:I-COVID-19, umkhuhlane A & B,RSV,Adv,hMPV,Rhv,Parainfluenza iindidi I-IV, HBoV,EV,CoV

Iintsholongwane:MP,Cpn,SP

-IiReagents eziLungileyo eziZinzileyo kwiqondo lobushushu begumbi (2–30°C)
Yenza kube lula ukugcina nokuthutha, isusa ukuxhomekeka kwi-cold-chain.

Inkqubo Yokuthintela Ungcoliseko Eqinileyo
Amanyathelo okulwa nongcoliseko aneeleya ezili-11 kuquka ukubulala iintsholongwane kwi-UV, ukuhluza i-HEPA, kunye nokuhamba komsebenzi we-cartridge evaliweyo, njl.

Ukuchonga i-pathogen ngokukhawuleza nangokupheleleyo sisiseko solawulo lwanamhlanje lwezifo zokuphefumla kwabantwana. Inkqubo ye-AIO800, enephaneli yayo ye-multiplex PCR esebenza ngokuzenzekelayo, yemizuzu engama-30, ibonelela ngesisombululo esisebenzayo kwiindawo ezingaphambili. Ngokuvumela ukufunyanwa kwangoko nangokuchanekileyo kwe-RSV, i-HMPV, kunye nezinye izifo eziphambili, inika amandla oogqirha ukuba benze izigqibo zonyango ezijolise kubo, baphucule ukusetyenziswa kwamayeza okubulala iintsholongwane, kwaye basebenzise ulawulo olusebenzayo losulelo—ekugqibeleni baphucule ukhathalelo lwezigulane kunye nokusebenza kakuhle kwezempilo.

#RSV #HMPV #Ikhawuleza #Ukuchonga #Ukuphefumla #Isifo sephepha #Umzekelo-ukuphendula#Uvavanyo lweMacroMicro