Rhinovirus and acute bronchiolitis in young infants

Pitrez, Paulo Márcio; Stein, Renato T.; Stuermer, Larissa; Macedo, Izolete Santos; Schmitt, Virgínia M.; Jones, Marcus Herbert; Arruda, Eurico

doi:10.2223/jped.1394

Cited by 23 publications

(11 citation statements)

References 23 publications

(36 reference statements)

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“…After Papadopoulos et al 22 demonstrated that rhinovirus can directly infect the lower airway (i.e., it is not limited to the upper airway as once thought), many epidemiologic studies have shown that rhinovirus is an important causative pathogen of lower respiratory infection in children. [4][5][6][7][8][9][10][11][12][13][14][15] This virus can indeed cause all sorts of lower respiratory illnesses; such as bronchiolitis, pneumonia and asthma exacerbation. 23 As assessed by molecular methods, the prevalence of rhinovirus causing acute lower respiratory infection among young children <3 years of age varies between 17 and 35%.…”

Section: Discussionmentioning

confidence: 99%

“…Other pathogens-such as human metapneumovirus (hMPV), influenza virus, parainfluenza virus, adenovirus as well as Mycoplasma pneumoniae-also cause wheezing in children. [2][3][4][5] Recently, rhinovirus was reported as frequently as RSV among children hospitalized with wheezing illnesses [6][7][8][9][10][11] and a number of studies have shown that it is a significant risk factor for subsequent wheezing and/or development of asthma. [12][13][14][15][16] Epidemiologic studies on the prevalence of the causative pathogens in young children suffering from an acute wheezing episode and their impact on subsequent respiratory illnesses in Thailand are limited.…”

Section: Introductionmentioning

confidence: 99%

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Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies

Teeratakulpisarn

Pientong²,

Ekalaksananan³

et al. 2014

Asian Pac J Allergy Immunol

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Rhinovirus ranked second after RSV as the cause of hospitalizations of children with acute bronchiolitis. More than half of these children had recurrent wheezing which mostly disappeared before the age of 6. Nearly half were subsequently diagnosed with asthma at the 5th year of follow-up. The specific pathogens did not account for a statistically significant difference in subsequent wheezing or asthma development.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies

Teeratakulpisarn

Pientong²,

Ekalaksananan³

et al. 2014

Asian Pac J Allergy Immunol

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“…Infants and toddlers younger than three years of age, with a diagnosis of LRTI, admitted to the emergency room (ER) or pediatric wards of a tertiary hospital in Porto Alegre, southern Brazil, were recruited for this study, during the months of greatest prevalence for acute pediatric respiratory viral illnesses (i.e., from April to November) in 2007 [4,15]. The great majority of patients seen in this particular setting come from low-income families, with health coverage provided by the Brazilian free-access public health system.…”

Section: Subjects and Study Designmentioning

confidence: 99%

“…Although RSV is well recognized as the main agent associated with severe LRTIs, recent data indicate that other viruses may play a significant role in these clinical outcomes. Human rhinovirus (HRV) seems to be of particular interest, as the most prevalent virus in respiratory illnesses even in the first years of life [4,5], being associated with severe acute bronchiolitis, especially among children of atopic parents [6]. Moreover, a recent study showed that, in a population of preterm infants, HRV was the most prevalent agent associated with severe bronchiolitis [7].…”

Section: Introductionmentioning

confidence: 99%

Severe lower respiratory tract infection in infants and toddlers from a non-affluent population: viral etiology and co-detection as risk factors

et al. 2013

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BackgroundLower respiratory tract infection (LRTI) is a major cause of pediatric morbidity and mortality, especially among non-affluent communities. In this study we determine the impact of respiratory viruses and how viral co-detections/infections can affect clinical LRTI severity in children in a hospital setting.MethodsPatients younger than 3 years of age admitted to a tertiary hospital in Brazil during the months of high prevalence of respiratory viruses had samples collected from nasopharyngeal aspiration. These samples were tested for 13 different respiratory viruses through real-time PCR (rt-PCR). Patients were followed during hospitalization, and clinical data and population characteristics were collected during that period and at discharge to evaluate severity markers, especially length of hospital stay and oxygen use. Univariate regression analyses identified potential risk factors and multivariate logistic regressions were used to determine the impact of specific viral detections as well as viral co-detections in relation to clinical outcomes.ResultsWe analyzed 260 episodes of LRTI with a viral detection rate of 85% (n = 222). Co-detection was observed in 65% of all virus-positive episodes. The most prevalent virus was Respiratory Syncytial Virus (RSV) (54%), followed by Human Metapneumovirus (hMPV) (32%) and Human Rhinovirus (HRV) (21%). In the multivariate models, infants with co-detection of HRV + RSV stayed 4.5 extra days (p = 0.004), when compared to infants without the co-detection. The same trends were observed for the outcome of days of supplemental oxygen use.ConclusionsAlthough RSV remains as the main cause of LRTI in infants our study indicates an increase in the length of hospital stay and oxygen use in infants with HRV detected by RT-PCR compared to those without HRV. Moreover, one can speculate that when HRV is detected simultaneously with RSV there is an additive effect that may be reflected in more severe clinical outcome. Also, our study identified a significant number of children infected by recently identified viruses, such as hMPV and Human Bocavirus (HBov), and this is a novel finding for poor communities from developing countries.

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“…15 The impact of these and other newly discovered viruses in the epidemiology of CAP in developing countries is yet to be completely elucidated but recent data suggest it is unlikely that the distribution is much different from that found in developed countries. 16,17 Other viruses like influenza B, parainfluenza 1 and 2, and cytomegalovirus are often implicated in the etiology of CAP in children and have to be accounted for. 1,4,18 Streptococcus pneumoniae is the main bacterium causing pneumonia in children under the age of 5.…”

Section: Etiologymentioning

confidence: 99%

Community‐Acquired pneumonia: A review and recent advances

Stein

Maróstica

2007

Pediatric Pulmonology

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In the beginning of this 21st century, community-acquired pneumonias (CAP) are still responsible for a significant number of deaths among young children in many developing countries. Public health initiatives such as those proposed by the World Health Organization (WHO) for the management of CAP by means of identifying highly predictable signs and symptoms have had great positive impact in some communities. Still, this approach induces an overdiagnosis and overtreatment of CAP in children below the age of 5 years due to the misclassification of pneumonia in children with fast breathing associated with viral bronchiolitis. Even among children of developed countries, CAP is an important public health problem and many aspects of current diagnostic and management measures are discussed here. In this article, we review the epidemiology and basic concepts of CAP and update current information on clinical evaluation and management of the disease.

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Rhinovirus and acute bronchiolitis in young infants

Abstract: Rhinovirus was the second most common agent detected in nasal secretions from young infants hospitalized with acute bronchiolitis.

Cited by 23 publications

References 23 publications

Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies

Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies

Severe lower respiratory tract infection in infants and toddlers from a non-affluent population: viral etiology and co-detection as risk factors

Community‐Acquired pneumonia: A review and recent advances

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