Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city

Abstract

The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1–5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had significant involvement in coinfections with P values of 0.0001, 0.009 and 0.0001, 0.0001 and 0.001 respectively. Further investigations are required to better understand the clinical roles of the isolated pathogens and their seasonality.

Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital‐based observational study in Niamey, Niger

“…This proportion was similar to that reported in a previous study on the etiology of ARI in children aged younger than 5 years in Niger (78%), although on a limited number of samples . This finding was also consistent with those of other similar studies conducted in Africa (range 55%‐70%) and Asia (range 45%‐65%) …”

Enteric Pathogen Diversity in Infant Foods in Low-income Neighborhoods Of Kisumu, Kenya

“…Addressing the need for information on infant food contamination in LMICs required finding an effective microbial testing method that enabled quantitative and target-specific measuring of a broad array of the most common types of diarrhea pathogens in infant food. Even though qPCR is frequently applied for the quantitative detection of pathogen presence in foodborne outbreak analysis [(38–40)], it has not been widely applied in food samples in LMICs. Our methods are novel in their ability to detect a wide array of pathogens simultaneously.…”

Diagnostic Value of Different Biomarkers to Identify Bacterial Coinfection in Vietnamese Children with Severe Rhinovirus Pneumonia

“…Rhinovirus is a leading cause of respiratory infection in children, accounting for approximately 20 to 50%. [1][2][3][4] Rhinovirusrelated pneumonia may be asymptomatic, but this virus may worsen respiratory infection or cause outbreaks. [5][6][7][8] Rhinovirus infection causes severe consequences for hospitalized children, similar to infection caused by respiratory syncytial virus or influenza viruses.…”