Prevalence of respiratory syncytial virus infection among children hospitalized with acute lower respiratory tract infections in Southern India

Abstract

BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of lower respiratory infections among children. AIM To investigate the proportion of RSV and non-RSV respiratory viral infections among hospitalized children ≤ 5 years. METHODS Hospitalized children aged < 5 years, with a diagnosis of acute lower respiratory infections (ALRI), admitted between August 2011-August 2013, were included. Cases were defined as laboratory-confirmed RSV and non-RSV respiratory viruses by direct fluorescence assay from the nasopharyngeal wash. RESULTS Of 383 1-59 mo old children hospitalized with an acute lower respiratory infection, 33.9% (130/383) had evidence of viral infection, and RSV was detected in 24.5% (94/383). Co-infections with RSV and other respiratory viruses (influenza A or B, adenovirus, para influenza 1, 2 or 3) were seen in children 5.5% (21/383). Over 90% of the RSV-positive children were under 2 years of age. RSV was detected throughout the year with peaks seen after the monsoon season. Children hospitalized with RSV infection were more likely to have been exposed to a shorter duration of breastfeeding of less than 3 mo. RSV positive children had a shorter hospital stay, although there were significant complications requiring intensive care. Use of antibiotics was high among those with RSV and non-RSV viral infections. CONCLUSION Our study provides evidence of a high proportion of RSV and other virus-associated ALRI among hospitalized children in India. RSV infection was associated with fewer days of hospital stay compared to other causes of lower respiratory infections. A high level of antibiotic use was seen among all respiratory virus-associated hospitalizations. These results suggest the need for implementing routine diagnostics for respiratory pathogens in order to minimize the use of unnecessary antibiotics and plan prevention strategies among pediatric populations.

Viral and Atypical Pathogens Epidemiology of a Large Cohort of Patients with Acute Respiratory Tract Infections in Shaanxi Province, Northwest China

“…19 Although viral infection is the dominant cause of ARIs, the proportion of infections with atypical pathogens is increasing due to the abuse of antibiotics and the development of detection technology. [9][10][11] At present, several studies on the epidemiology and etiology of respiratory pathogens of children in different areas have been reported, 7,16,[20][21][22][23] The result of this study shows that the top three most prevalent pathogens were MP (18.12%, 2816/5597),Flu B (11.65%, 1811/5597) and CP (7.00%, 1088/5597). The total positive detection rate is 36.01% (5597/15443) in Xi'an, which was similar with the previous study in Turkey (33.4 ) and Shandong province in China (35.75 ), 12,18 and signi cantly higher than that reported in Beijing (5.64%), Shenzhen (14.55%), Suzhou (13.6%) and Gansu province in China (29.2%), [13][14][15][16] but lower than that reported in north China (39.3%).…”

“…3 Respiratory syncytial virus (RSV), in uenza virus A (Flu A), in uenza virus B (Flu B), parain uenza virus (PIV) and adenovirus (ADV) are considered to be the common pathogens of most ARIs. 5 RSV is the leading cause of severe lower respiratory tract infection (LRTIs) in infants and young children, 6,7 while in uenza virus (IFVs) is the main pathogen causing LRTIs in hospitalized adults. 8 In addition, with the increase of antibiotic resistance rate and the development of pathogen detection technology, the research on mycoplasma (MP), chlamydia (CP), legionella (LP) and other atypical pathogens has been gradually deepened, and their role in respiratory tract infections has aroused people's attention.…”

Disease Burden Due to Respiratory Syncytial Virus in Indian Pediatric Population: A Literature Review

“…A smaller peak was also noted during December, January, and February. 23,24,27,47,48 Few Indian studies conducted in North India reported that RSV mainly peaks in winter (November to February) and observed some correlation with low temperature. 44,49 While few studies reported negative co-relation between RSV cases with temperature and rainfall however a, positive correlation (25%-40%) was observed with cool, dry months (December-February).…”

“…Studies conducted in Indian children from various regions indicated strongest association between RSV and acute lower respiratory infections (ALRI), acute respiratory infection (ARI), upper respiratory infection (URI), lower respiratory tract infection (LRTI) and influenza. 8 , 19 , 23 , 24 , 39 , 40 , 45 , 48 , 49 A study from north India reported 90% and 86% of the RSV–associated hospitalization rates in children with ARI aged <2 years and <5 years, respectively. 36 Outcome of the study conducted by Saxena et al 37 reported simultaneous diagnosis of RSV with influenza in pediatric population which shows that patients with influenza can be considered as high-risk group for RSV infection.…”

Application of next generation sequencing-based rapid detection platform for microbiological diagnosis and drug resistance prediction in acute lower respiratory infection

“…Acute lower respiratory infections (ALRIs) are common diseases worldwide, and have a high mortality rate, especially in children, where they account for approximately 30% of child deaths (1)(2)(3). Generally, ALRIs are caused by microbial organisms such as bacteria, viruses, mycoplasma, chlamydia, and legionella.…”