Comparison of the prevalence of respiratory viruses in patients with acute respiratory infections at different hospital settings in North China, 2012–2015

Abstract

BackgroundAcute respiratory infections (ARIs) are a great public health challenge globally. The prevalence of respiratory viruses in patients with ARIs attending at different hospital settings is fully undetermined.MethodsLaboratory-based surveillance for ARIs was conducted at inpatient and outpatient settings of 11 hospitals in North China. The first 2–5 patients with ARIs were recruited in each hospital weekly from 2012 through 2015. The presence of respiratory viruses was screened by PCR assays. The prevalence of respiratory viruses was determined and compared between patients at different hospital settings.ResultsA total of 3487 hospitalized cases and 6437 outpatients/Emergency Department (ED) patients were enrolled. The most commonly detected viruses in the hospitalized cases were respiratory syncytial virus (RSV, 33.3%) in children less than two years old, adenoviruses (13.0%) in patients 15–34 years old, and influenza viruses (IFVs, 9.6%) in patients ≥65 years. IFVs were the most common virus in outpatient/ED patients across all age groups (22.7%). After controlling for the confounders caused by other viruses and covariates, adenoviruses (adjusted odds ratio [aOR]: 3.97, 99% confidence interval [99% CI]: 2.19–7.20) and RSV (aOR: 2.04, 99% CI: 1.34–3.11) were independently associated with increased hospitalization in children, as well as adenoviruses in adults (aOR: 2.14, 99% CI: 1.19–3.85). Additionally, co-infection of RSV with IFVs was associated with increased hospitalization in children (aOR: 12.20, 99% CI: 2.65–56.18).ConclusionsA substantial proportion of ARIs was associated with respiratory viruses in North China. RSV, adenoviruses, and co-infection of RSV and IFVs were more frequent in hospitalized children (or adenoviruses in adults), which might predict the severity of ARIs. Attending clinicians should be more vigilant of these infections.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-2982-3) contains supplementary material, which is available to authorized users.

Comparison of viral and epidemiological profiles of hospitalized children with severe acute respiratory infection in Beijing and Shanghai, China

“…1 Detection frequencies of respiratory viruses in Beijing and Shanghai according to matched age groups. We considered P < 0.05 to be significant (marked as an asterisk) for all analyses between two cities frequent during the summer months in Beijing and more common during autumn in Shanghai, which is consistent with previous findings [15,19,25]. Moreover, our findings that RSV and HMPV were prevalent in the spring and winter and that Flu A/B peaked in winter are consistent with those of previous studies [15,25,32,33].…”

“…Our study is the first to compare respiratory viral infections and their epidemiology in hospitalized children with SARI in Beijing and Shanghai. Of the 700 patients included in the study, 78.1% tested positive for at least one virus; this rate was higher than that reported by previous studies (range, 34.6-70.3%) [18][19][20][21][22][23][24][25]. This finding may be mainly explained by some differences in the SARI case inclusion criteria, since additional criteria in our study were a normal or low leukocyte count or indrawing of the lower chest wall.…”

“…Either the total or age groupmatched positive rates of RSV, HCoV, and HMPV significantly differed in Beijing and Shanghai (P < 0.05). In addition, a comparison of our data with those from other studies collected during the same period in the same locations revealed that our infection rates differed from those of the other studies [15,19,25]. Differences in detection methods and primers, sample collection, and subject populations may account for this disparity.…”

“…This finding may be mainly explained by some differences in the SARI case inclusion criteria, since additional criteria in our study were a normal or low leukocyte count or indrawing of the lower chest wall. In addition, several factors may account for this disparity, including true differences in the overall burden or differences in study populations or methodologies [18,[23][24][25]. Moreover, infection rates vary with geographical location and season [22,26,27].…”

Influenza-associated paediatric respiratory hospitalizations in China, 1996–2012: a systematic analysis

“…Influenza not only contributes to respiratory hospitalization among children aged < 18 years, it also contributes to a significant percentage of outpatient visits. One study conducted in two northern provinces of China during 2012–2015 found that influenza was the most commonly detected virus in ambulatory patients across all age groups, ( 29 ) though this study used ARI for patient screening.…”