High Incidence of Multiple Viral Infections Identified in Upper Respiratory Tract Infected Children under Three Years of Age in Shanghai, China

Zhang, Guocui; Hu, Yunwen; Wang, Hongping; Zhang, Lu; Bao, Yixi; Zhou, Xiaoming

doi:10.1371/journal.pone.0044568

Cited by 58 publications

(75 citation statements)

References 20 publications

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“…In conclusion, based on the present findings, there is no difference between the outcomes of a single adenovirus infection and co-infection with other mentioned 4 Arch Pediatr Infect Dis. 2017; 5(1):e36953.…”

Section: Discussionsupporting

confidence: 53%

“…Co-infection with two or more viruses cannot be distinguished on the basis of clinical presentation (4). In such cases, the treatment goal should be management and control of all the co-infective agents (26).…”

Section: Discussionmentioning

confidence: 99%

“…Respiratory tract infections are caused by a broad range of microorganisms. Viral infections in particular seem to be responsible for 80% of the cases (3,4). The major causative pathogens are influenza A and B viruses, respiratory syncytial virus (RSV), human parainfluenza virus (HPIV) and human adenovirus (HAdV), which account for 35% to 87% of ARTIs in children (5,6).…”

Section: Introductionmentioning

confidence: 99%

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Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Malekshahi

Shafiei-Jandaghi

Yavarian

et al. 2016

Arch Pediatr Infect Dis

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Background: Acute respiratory tract infection is associated with significant morbidity, mortality, and economic loss worldwide. Viral infections seem to be responsible for 80% of the cases. There are several reports on the influence of dual or multiple respiratory viral infections on the severity of disease in childhood. Objectives: A limited number of studies have been conducted on co-infection of Adenovirus (AdV) with coxsackievirus, human bocavirus (HBoV) and Mycoplasma pneumoniae (MP) in Iran. To address this, the present article focuses on both the etiology and epidemiology of multiple microbial respiratory infections (coxsackievirus, HBoV, MP and influenza virus) and their clinical significance in young Iranian children with confirmed AdV infection. Patients and Methods: Molecular detection of HBoV, coxsackievirus, MP and influenza virus was performed by conventional PCR in 71 respiratory adenovirus-positive samples obtained from children younger than 5 years of age. Results: Among the 71 adenovirus-positive samples, 6 (8.4%) were co-infected, three were co-infected with MP and three of which were co-infected with influenza A/H3N2. Of the six patients with co-infection, four were male and two were female; three patients were less than 1 year of age and the remaining were 2, 3 and 4 years of age. Moreover, there were two inpatients and four outpatients. Conclusions: Although several studies have investigated viral respiratory co-infection, no study has evaluated the rate of respiratory co-infections in adenovirus-positive samples from children younger than 5 years. However, this study has filled this gap, the the number of co-infections were too small to draw any definite conclusions. Therefore, large-scale studies using bigger samples are required to understand the clinical significance of polymicrobial acute respiratory infections.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Malekshahi

Shafiei-Jandaghi

Yavarian

et al. 2016

Arch Pediatr Infect Dis

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“…Co-infection has been reported to be common in children with an RTI. 3,20,30 RSV and MP were also found commonly in children with an RTI. 1.…”

Section: Discussionmentioning

confidence: 95%

Parallel pathogens in the upper and lower respiratory tracts in children with a respiratory tract infection, as revealed by the Filmarray assay

Lin

Liang

Miao

et al. 2017

Frontiers in Laboratory Medicine

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a b s t r a c tBackground: Respiratory tract infection (RTI) is a common disease among children of all ages that causes high hospitalization and mortality rates. Infection with more than one pathogen has been reported in RTI; however, the association of the pathogen spectrum in upper and lower respiratory tract infections remains unclear. Methods: A prospective study was conducted during February to October 2016. Fifty-five nasopharyngeal swabs (NPS) and 30 bronchoalveolar lavage fluid (BALF) samples from 55 hospitalized children aged less than 14 years (mean age 40 months) and diagnosed with an RTI were collected. All samples were detected for 18 respiratory pathogens using the Filmarray assay, real-time PCR, or nested PCR methods. Detection results and clinical characteristics of all cases were analyzed using chi-square and t tests.Results: Forty-one of 55 (74.5%) NPS obtained from children were positive for at least one pathogen by the Filmarray assay. Of these cases, 53.7% (22/41) were co-infected. The most commonly detected pathogen was rhinovirus (RV), followed by Mycoplasma pneumoniae (MP) and respiratory syncytial virus (RSV). Infection by both RV and MP was the most frequently observed pattern of co-infection. Similar results were observed using real-time PCR. The pathogens in the NPS from 76.6% of cases detected by Filmarray and 80.0% of cases by real-time PCR included all the pathogens detected in the BALF sample from the same individual. The Filmarray assay showed an 80% concordance rate with real-time PCR and had a turnaround time of less than 1.2 h. No significant differences were observed between the association of single-infection and co-infection with clinical characteristics, neither by Filmarray nor realtime PCR. Conclusion: The spectrum of pathogens is mostly concordant in the upper and lower respiratory tract. Collecting NPS for detection can be a non-invasive and more convenient option compared with BALF. Although co-infection is common in children with an RTI, the clinical significance of co-infection remains unclear and warrants further analysis.

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“…63 Despite coinfection rates as high as 30%, the significance of these infections remains Integration of Technology Into Clinical Practice unclear. 63,64 The US Acute Gastroenteritis Etiology Study Team recently surveyed the cause of acute gastroenteritis in adults and found that nearly 10% of patients had mixed infections, many of which were mixed viral/bacterial infections. 65 Third, a high percentage of stool cultures submitted for diagnostic testing are not accompanied by orders for viral pathogens.…”

Section: Assessing Multiplex Panels and Their Possible Impact On The mentioning

confidence: 99%

Integration of Technology Into Clinical Practice

Doern

2013

Clinics in Laboratory Medicine

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High Incidence of Multiple Viral Infections Identified in Upper Respiratory Tract Infected Children under Three Years of Age in Shanghai, China

Cited by 58 publications

References 20 publications

Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Parallel pathogens in the upper and lower respiratory tracts in children with a respiratory tract infection, as revealed by the Filmarray assay

Integration of Technology Into Clinical Practice

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