Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia

Jiang, Wujun; Wu, Min; Zhou, Jing; Wang, Yuqing; Hao, Chuangli; Ji, Wei; Zhang, Xinxing; Gu, Wei; Shao, Xuejun

doi:10.1186/s12879-017-2891-x

Cited by 59 publications

(72 citation statements)

References 31 publications

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“…In our population, the proportion of viral infections in the cases of bronchiolitis and pneumonia was 82.6% and 70.1%, respectively. These results are in agreement with previous reports in which viral pathogens were proven in over 90% of bronchiolitis cases [21][22][23] and in 43-81% of pneumonia cases [24][25][26][27][28]. Not surprisingly, RSV was the most frequently detected etiologic agent of ALRI, identified in 37.5% of the cases (44.5% in patients with bronchiolitis and 25.1% in patients with pneumonia), with a predominance of RSV subgroup B during the three seasons.…”

Section: Discussionsupporting

confidence: 93%

Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria

et al. 2018

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Acute lower respiratory infections (ALRIs) are a leading cause of morbidity and hospital admissions in children. This study aimed to determine the viral etiology of these infections in children aged < 5 years during three successive epidemic seasons in Bulgaria. Nasopharyngeal and throat specimens were collected from children with bronchiolitis and pneumonia during the 2015/ 2016, 2016/2017, and 2017/2018 seasons. The viral etiology was determined by individual real-time PCR assays against 11 respiratory viruses. Of the 515 children examined, 402 (78.1%) were positive for at least one virus. Co-infections with two and three viruses were found in 64 (15.9%) of the infected children. Respiratory syncytial virus (RSV) was the predominant pathogen (37.5%), followed by rhinoviruses (13.8%), metapneumovirus (9.1%), adenoviruses (7%), bocaviruses (7%), influenza A(H1N1)pdm09 (4.9%), A(H3N2) (4.3%), type B (4.1%), and parainfluenza viruses 1/2/3 (2.9%). RSV-B were more prevalent than RSV-A during the three seasons. At least one respiratory virus was identified in 82.6% and 70.1% of the children with bronchiolitis and pneumonia, respectively. Respiratory viruses, especially RSV, are principal pathogens of ALRIs in children aged < 5 years. Diagnostic testing for respiratory viruses using molecular methods may lead to the reduced use of antibiotics and may assist in measures to control infection.

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Section: Discussionsupporting

confidence: 93%

Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria

et al. 2018

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“…In the viral coinfections observed in our study, Rhinovirus/RSV was the most common combination. Jiang et al observed similar results, showing that 48.6% of viral infections were Rhinovirus/RSV codetected infections. Likewise, Asner et al showed that among 77 children with ARI and viral infection, 16.9% (12 of 77) were children with Rhinovirus/RSV codetected.…”

Section: Discussionmentioning

confidence: 64%

High incidence of rhinovirus infection in children with community‐acquired pneumonia from a city in the Brazilian pre‐Amazon region

Ferreira

Costa

Cariolano

et al. 2019

Journal of Medical Virology

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Community‐acquired pneumonia (CAP) is the leading cause of child death worldwide. Viruses are the most common pathogens associated with CAP in children, but their incidence varies greatly. This study investigated the presence of respiratory syncytial virus (RSV), adenovirus, human rhinovirus (HRV), human metapneumovirus (HMPV), human coronavirus (HCoV‐OC43 and HCoV‐NL63), and influenza A virus (FluA) in children with CAP and the contributing risk factors. Here, children with acute respiratory infections were screened by pediatrics; and a total of 150 radiographically‐confirmed CAP patients (aged 3 months to 10 years) from two clinical centers in Sao Luis, Brazil were recruited. Patient's clinical and epidemiological data were recorded. Nasopharyngeal swab and tracheal aspirate samples were collected to extract viral nucleic acid. RSV, adenovirus, rhinovirus, FluA, HMPV, HCoV‐OC43, and HCoV‐NL63 were detected by real‐time polymerase chain reaction. The severe CAP was associated with ages between 3 and 12 months. Viruses were detected in 43% of CAP patients. Rhinovirus infections were the most frequently identified (68%). RSV, adenovirus, FluA, and coinfections were identified in 14%, 14%, 5%, and 15% of children with viral infection, respectively. Rhinovirus was associated with nonsevere CAP (P = .014); RSV, FluA, and coinfections were associated with severe CAP (P < .05). New strategies for prevention and treatment of viral respiratory infections, mainly rhinovirus and RSV infections, are necessary.

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“…A previous study conducted in Taiwan found that RSV was the most common pathogen (41.7%), followed by MPV (27.1%), Boca (6.3%), and EV (6.3%) [33]. Some important studies investigating the epidemiology of respiratory tract infection are summarized in Table 4 [4,6,13,15,23,34,35]. RSV is always the most common pathogen in young children worldwide, but the accompanying pathogens are not always the same [4,5,7,13,36,37].…”

Section: Discussionmentioning

confidence: 99%

Increased Detection of Viruses in Children with Respiratory Tract Infection Using PCR

Lin

Hwang

Chiu

et al. 2020

IJERPH

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Respiratory viruses are a common cause of respiratory tract infection (RTI), particularly in neonates and children. Rapid and accurate diagnosis of viral infections could improve clinical outcomes and reduce the use of antibiotics and treatment sessions. Advances in diagnostic technology contribute to the accurate detection of viruses. We performed a multiplex real-time polymerase chain reaction (PCR) to investigate the viral etiology in pediatric patients and compared the detection rates with those determined using traditional antigen tests and virus cultures. Fifteen respiratory viruses were included in our investigation: respiratory syncytial virus A/B (RSV), influenza virus A (FluA) and influenza virus B (FluB), human metapneumovirus (MPV), enterovirus (EV), human parainfluenza virus (PIV) types 1-4, human rhinovirus (RV), human coronavirus OC43, NL63, and 229E, human adenovirus (ADV), and human bocavirus (Boca). In total, 474 specimens were collected and tested. Respiratory viruses were detected more frequently by PCR (357, 75.3%) than they were by traditional tests (229, 49.3%). The leading pathogens were RSV (113, 23.8%), RV (72, 15.2%), PIV3 (53, 11.2%), FluA (51, 10.8%), and ADV (48, 10.1%). For children younger than 5 years, RSV and RV were most prevalent; for children older than 5 years, FluA and ADV were the most frequently detected. Of the specimens, 25.8% (92/357) were coinfected with two or more viruses. RV, Boca, PIV2, FluB, and PIV4 had higher rates of coinfection; MPV and PIV1 had the lowest rates of coinfection (9.1% and 5.3%). To conclude, the detection power of PCR was better than that of traditional antigen tests and virus cultures when considering the detection of respiratory viruses. RSV and RV were the leading viral pathogens identified in the respiratory specimens. One-quarter of the positive specimens were coinfected with two or more viruses. In the future, further application of PCR may contribute to the rapid and accurate diagnosis of respiratory viruses and could improve patient outcomes.

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Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia

Cited by 59 publications

References 31 publications

Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria

Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria

High incidence of rhinovirus infection in children with community‐acquired pneumonia from a city in the Brazilian pre‐Amazon region

Increased Detection of Viruses in Children with Respiratory Tract Infection Using PCR

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