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儿童呼吸道合胞病毒感染诊断、治疗和预防专家共识。

Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children.

机构信息

Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China.

Clinical Research Unit, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

World J Pediatr. 2024 Jan;20(1):11-25. doi: 10.1007/s12519-023-00777-9. Epub 2023 Dec 8.

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years, representing a major global healthcare burden. There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life. A multidisciplinary consensus development group comprising experts in epidemiology, infectious diseases, respiratory medicine, and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.

DATA SOURCES

The evidence searches and reviews were conducted using electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, using variations in terms for "respiratory syncytial virus", "RSV", "lower respiratory tract infection", "bronchiolitis", "acute", "viral pneumonia", "neonatal", "infant" "children", and "pediatric".

RESULTS

Evidence-based recommendations regarding diagnosis, treatment, and prevention were proposed with a high degree of consensus. Although supportive care remains the cornerstone for the management of RSV infections, new monoclonal antibodies, vaccines, drug therapies, and viral surveillance techniques are being rolled out.

CONCLUSIONS

This consensus, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections. Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.

摘要

背景

呼吸道合胞病毒(RSV)是全球主要的呼吸道感染病原体,每年导致 5 岁以下儿童 300 多万人住院,1 万多人死亡,是全球主要的医疗保健负担。因此,迫切需要新的药物和通用策略来预防生命早期的 RSV 感染。一个由流行病学、传染病学、呼吸医学和方法学专家组成的多学科共识发展小组旨在制定当前的共识,以解决儿童 RSV 感染的临床问题。

资料来源

使用电子数据库(包括 PubMed、Embase、Web of Science 和 Cochrane Library)进行证据检索和综述,使用了“呼吸道合胞病毒”、“RSV”、“下呼吸道感染”、“细支气管炎”、“急性”、“病毒性肺炎”、“新生儿”、“婴儿”、“儿童”和“儿科”等术语的变体。

结果

提出了具有高度共识的基于证据的诊断、治疗和预防建议。尽管支持性护理仍然是 RSV 感染管理的基石,但新的单克隆抗体、疫苗、药物治疗和病毒监测技术正在推出。

结论

本共识基于国际和国家科学证据,强化了当前的建议,并整合了最近的进展,以实现 RSV 感染的最佳护理和预防。进一步改善 RSV 感染的管理将需要通过设计严谨、具有较小偏倚和足够能力识别有临床意义终点的研究来生成最高质量的证据。

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