Epidemiologic and clinical characteristics of human bocavirus infection in infants and young children suffering with community acquired pneumonia in Ningxia, China

Abstract

Background Pneumonia has a high incidence rate and is a major cause of mortality in children, mostly community-acquired pneumonia (CAP). Human bocavirus (HBoV), since it first identified in 2005, has been repeatedly associated with respiratory tract infections. Nevertheless, the role and related information of HBoV as a pathogen of CAP has not been fulfilled. Here our study is to assess the epidemiological and clinical features in HBoV-positive children with CAP. Methods A total of 878 secretions of lower respiratory samples were obtained, multiplex PCR was used to detect HBoV and other respiratory viruses. Results Of all cases, HBoV was detected in 10.0%, with a peak incidence of infection among children < 2 year old, and predominantly noted in autumn and winter. Only 8 patients were HBoV single infection. Co-infection with other respiratory viruses was observed in 86.4%. Moreover, co-infection with bacteria occurred in 27.3% and with Mycoplasma pneumoniae (MP) in 33.0% of HBoV-positive patients. Among all HBoV-positive samples co-infected with bacteria, 87.5% are gram negative bacteria. Compared with HBoV-negative group, age (P = 0.048), wheezing (P = 0.015), tachypnea (P = 0.016), lactate dehydrogenase (P = 0.026) and severe pneumonia (P = 0.023) were statistically significant in HBoV-positive patients. Furthermore, HBoV-positive patients less than 1 year old were more likely to have co-infection with bacteria (P = 0.007). Conclusions HBoV can be detected alone in respiratory samples of children with CAP, maybe it is one of the causes of CAP in infants. The high incidence of severe pneumonia was found in HBoV-positive patients compared with HBoV-negative cases may indicate a relationship between severe pneumonia and HBoV.

Epidemiologic and clinical characteristics of human bocavirus infection in children hospitalized for acute respiratory tract infection in Qingdao, China

“…The differences observed between the pathogen etiology and clinical characteristics of HBoV-positive and HBoV-negative patients are presented below. HBoV, RSV, and HRV were detected in high frequencies in both groups, which is in agreement with previous studies (Madi and Al-Adwani, 2020 ; Ji et al, 2021 ; Nantachit et al, 2021 ). As indicated in the results, HBoV infection was more common in children ≥ 5 years old as opposed to most studies at this stage where HBoV1 is more prevalent in children under 2 years of age.…”

“…This suggests that children ≥5 years old should be considered a priority study group, since this group has relatively higher immunity than children under 2 years old, which might help identify more risk factors for HBoV1 infection in different immune populations. In patients with HBoV infection, respiratory symptoms, such as cough, rales, or wheezing, remain the most common symptoms, which are consistent with previous reports (Ji et al, 2021 ; Zhang et al, 2021 ). In HBoV-positive patients, AST, LDH, URE, CK-MB, and Mg levels were significantly different from those in HBoV-negative patients.…”

“…The number of mixed infections of HBoV with bacteria is not widely studied. However, in this study, bacteria were detected in 69.6% of HBoV-positive children with upper respiratory infections, and the bacterial infection rate was also higher than that observed in previous studies (Cia et al, 2021 ; Ji et al, 2021 ). We tried to explain this phenomenon in terms of the difference in detection methods and the ability to achieve screening for more target pathogens with the assays selected for this study.…”

“…In this study, the mixed infection rate of HBoV with other viruses was 25%, which is much lower than the mixed viral infection rate of HBoV in most studies of nasopharyngeal swab samples at this stage, including Moreno et al ( 2016 ) (54.5%) in Panama, Lekana-Douki et al ( 2018 ) (84.4%) in Gabon, and Calvo et al ( 2016 ) (75%) in Spain. Notably, the single viral infection rate in this study is much higher than that in similar studies (Abdel-Moneim et al, 2018 ; Abozahra et al, 2020 ; Madi and Al-Adwani, 2020 ; Ji et al, 2021 ). In the absence of serological confirmation and lack of evidence of viremia or HBoV mRNA in peripheral blood cells, we still cannot rule out the possibility that the high detection rate of HBoV monoinfection was caused by a recent HBoV infection or persistent HBoV1 viral shedding in the upper respiratory tract of the Qingdao hospitalized children enrolled in this study.…”

Pathogenic changes of community-acquired pneumonia in a children’s hospital in Beijing, China before and after COVID-19 onset: a retrospective study

“…The experiment also showed that Gram-positive bacteria were the main strain detected before and after pandemic onset, and the top three bacteria were Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus , which was in accordance with the results of Nathan et al [ 15 ] and Mathew [ 16 ] but was inconsistent with the results of Ji et al [ 17 ] and Liu et al [ 18 ], who reported that Gram-negative bacteria were the most common agents. Klebsiella pneumoniae was the most common bacteria.…”