Prospective Detection of Respiratory Pathogens in Symptomatic Children With Cancer

Abstract

Background The data on human rhinovirus (HRV), coronavirus (hCoV), bocavirus (hBoV), metapneumovirus (hMPV), Chlamydophila pneumoniae, Mycoplasma pneumoniae and Bordetella pertussis infections in children with cancer is limited. Methods We sought to determine prospectively the prevalence of respiratory pathogens in these children, using multiplexed-PCR. Results We enrolled 253 children with upper, or lower respiratory tract infection (URTI/LRTI) during a one year period. A respiratory virus was detected in 193 (76%) patients; 156 (81%) patients had URTI. Human rhinovirus was the most common virus detected in 97 (62%) and 24 (65%) patients with URTI and LRTI, respectively. Leukemia or lymphoma (LL) was the most common underlying diagnosis in 95 (49%) patients followed by solid tumor 47 (24%), post-hematopoietic stem cell transplant (HCT) 28 (15%), and brain tumor in 23 (12%) patients. By multiple logistic regression analysis hBoV was the most commonly detected respiratory virus in patients with LRTI (P = 0.008; odds ratio, 4.52; 95% confidence interval, 1.48-13.79). Co-infection with more than 1 virus was present in 47 (24%) patients, and did not increase the risk for LRTI. Two (0.7%) patients succumbed to LRTI from parainfluenza virus (PIV)-3 and respiratory syncytial virus/HRV infection, respectively. C.pneumoniae and M.pneumoniae were detected in 4 and 3 patients, respectively. Conclusions HRV was the most common virus detected in children with cancer and post-HCT hospitalized with an acute respiratory illness, and was not associated with increased morbidity. Prospective studies with viral load determination and asymptomatic controls are needed to study the association of these emerging respiratory viruses with LRTI in children with cancer and post-HCT.

Characteristics and Outcomes of Coronavirus Infection in Children: The Role of Viral Factors and an Immunocompromised State

“…Recent data suggested a significant association between HCoV-related LRTD and a need for respiratory support and increased risk of death in immunocompromised adults [12]. Previous pediatric studies of HCoV infection have included small numbers of immunocompromised children [10,24,25]; few data from studies that focused specifically on this high-risk population exist. In our study, an immunocompromised state was associated with a higher risk of severe LRTD after we adjusted for clinical and virologic covariates.…”

Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy

“…Os achados deste estudo estão de acordo com os encontrados na literatura, quando comparados com pesquisas que utilizaram o mesmo método laboratorial pela técnica da qPCR. Koskenvuo et al 4 documentaram a presença de infecção respiratória em 44% dos casos analisados de crianças e adolescentes com leucemia e febre, e Srinivasan et al 15 75% em outro estudo.…”

Long‐term morbidity of respiratory viral infections during chemotherapy in children with leukaemia

“…However, respiratory infections are also a significant cause of pulmonary morbidity during treatment . In particular, recent studies using polymerase chain reaction (PCR) diagnostics have found respiratory viral infections (RVI) cause up to 57% of febrile episodes, and that children undergoing chemotherapy are at risk of more severe RVIs with a prolonged clinical course and higher viral loads …”