机构：[1]Xuanwu Hospital of Capital Medical University首都医科大学宣武医院[2]Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases[3]Department of Respiratory Medicine, Capital Medical University[4]Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing[5]Department of Respiratory, Emergency and Critical Care Medicine, First Affiliated Hospital of Soochow University[6]Fifth People’s Hospital of Suzhou[7]Intensive Care Unit, Suzhou Municipal Hospital, Soochow[8]Intensive Care Unit, Wuxi People’s Hospital, Wuxi[9]Intensive Care Unit, Taizhou People’s Hospital, Taizhou[10]First Affiliated Hospital of Nanchang University, Nanchang[11]Department of Critical Care Medicine, Third Affiliated Hospital of Soochow University, First People’s Hospital of Changzhou,Changzhou[12]Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Wenzhou Medical University, Wenzhou[13]Infectious Diseases Department, Shenzhen Third People’s Hospital, Shenzhen深圳市康宁医院深圳医学信息中心[14]Intensive Care Unit, Wuhan Medical Treatment Center Hospital, Wuhan[15]Department of Respiratory Medicine, Second Affiliated Hospital of Anhui Medical University[16]Intensive Care Unit, Anhui No. 2 Province People’s Hospital[17]Intensive Care Unit, Binhu Hospital of Hefei[18]Department of Critical Care Medicine,Second People’s Hospital of Hefei, Hefei[19]Infectious Diseases Department, Henan Provincial People’s Hospital, Zhengzhou[20]Center for Respiratory Diseases, Suining Central Hospital, Suining[21]Department of Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing[22]Intensive Care Unit, Affiliated Hospital of Nantong University, Nantong[23]Department of Pulmonary and Critical Care Medicine, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an[24]Intensive Care Unit, Jieyang People’s Hospital,Jieyang[25]Lishui Municipal Central Hospital[26]Department of Respiratory Medicine, Suichang County People’s Hospital, Lishui[27]Intensive Care Unit, Guangzhou No. 8 People’s Hospital, Guangzhou[28]Yancheng First People’s Hospital, Yancheng[29]Intensive Care Unit, Dongguan People’s Hospital, Dongguan[30]Intensive Care Unit, First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Wuhu[31]Department of Respiratory Medicine, Anqing Municipal Hospital, Anqing[32]Department of Pulmonary and Critical Care Medicine, Second Xiangya Hospital of Central South University, Changsha[33]Infectious Diseases Department, First Hospital of China Medical University, Shenyang[34]Department of Pulmonary and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou[35]Bozhou People’s Hospital, Bozhou[36]Infectious Diseases Department, General Hospital of Wanbei Coal-Electric Group, Suzhou[37]Infectious Diseases Department, Zhaoqing First People’s Hospital, Zhaoqing[38]Department of Critical Care Medicine, Xiaolan People’s Hospital of Zhongshan, Zhongshan[39]Infectious Diseases Department, Putian Municipal Hospital, Putian[40]Intensive Care Unit, First People’s Hospital of Xiangtan City, Xiangtan[41]Infectious Diseases Department, Lu’an People’s Hospital, Lu’an[42]Yunnan Provincial Infectious Disease Hospital, Kunming[43]Department of Critical Care Center, Yueqing First People’s Hospital, Wenzhou Medical University, Yueqing[44]Department of Respiratory Medicine, Beilun District People’s Hospital[45]Department of Respiratory Medicine,Ningbo First Hospital, Ningbo[46]Third Affiliated Hospital of Wenzhou Medical University, Rui’an[47]Department of Respiratory Medicine, Huzhou Central Hospital, Huzhou, China[48]Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Background. Data are limited on the impact of neuraminidase inhibitor (NAI) treatment on avian influenza A(H7N9) virus RNA shedding. Methods. In this multicenter, retrospective study, data were collected from adults hospitalized with A(H7N9) infection during 2013-2017 in China. We compared clinical features and A(H7N9) shedding among patients with different NAI doses and combination therapies and evaluated factors associated with A(H7N9) shedding, using Cox proportional hazards regression. Results. Among 478 patients, the median age was 56 years, 71% were male, and 37% died. The median time from illness onset to NAI treatment initiation was 8 days (interquartile range [IQR], 6-10 days), and the median duration of A(H7N9) RNA detection from onset was 15.5 days (IQR, 12-20 days). A(H7N9) RNA shedding was shorter in survivors than in patients who died (P < .001). Corticosteroid administration (hazard ratio [HR], 0.62 [95% confidence interval {CI},.50-.77]) and delayed NAI treatment (HR, 0.90 [95% CI,.91-.96]) were independent risk factors for prolonged A(H7N9) shedding. There was no significant difference in A(H7N9) shedding duration between NAI combination treatment and monotherapy (P = .65) or between standard-dose and double-dose oseltamivir treatment (P = .70). Conclusions. Corticosteroid therapy and delayed NAI treatment were associated with prolonged A(H7N9) RNA shedding. NAI combination therapy and double-dose oseltamivir treatment were not associated with a reduced A(H7N9) shedding duration as compared to standard-dose oseltamivir.
基金：
National Science Fund for Distinguished Young ScholarsNational Natural Science Foundation of ChinaNational Science Fund for Distinguished Young Scholars [81425001/H0104]; National Science and Technology Emergency Project [10600100000015001206]; National Key Technology Support Program from Ministry of Science and Technology [2015BAI12B11]
第一作者机构：[1]Xuanwu Hospital of Capital Medical University[2]Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases[3]Department of Respiratory Medicine, Capital Medical University
通讯机构：[*1]Department of Pulmonary and Critical Care Medicine, ChinaJapan Friendship Hospital, National Clinical Research Center for Respiratory Diseases. Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Yeming Wang,Qiang Guo,Zheng Yan,et al.Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection[J].JOURNAL OF INFECTIOUS DISEASES.2018,217(11):1708-1717.doi:10.1093/infdis/jiy115.
APA：
Yeming Wang,Qiang Guo,Zheng Yan,Daming Zhou,Wei Zhang...&the CAP-China Network.(2018).Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection.JOURNAL OF INFECTIOUS DISEASES,217,(11)
MLA：
Yeming Wang,et al."Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection".JOURNAL OF INFECTIOUS DISEASES 217..11(2018):1708-1717
医学