Viral Lower Respiratory Tract Infections

Green, Robin J.; Zar, Heather J.; White, Debbie A; Madhi, Shabir А.

doi:10.1007/978-3-319-54093-1_2

Cited by 6 publications

(11 citation statements)

References 111 publications

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“…As expected, viruses and P. jiroveci (atypical pathogens) were the predominant causes of pneumonia in HIV-infected children. Emerging evidence shows that pneumonia is frequently caused by coinfections with bacterial and viral pathogens, regardless of HIV status [64,65]. Antemortem diagnosis of pneumonia largely relies on clinical presentation and radiological findings, whereby it is often impossible to distinguish viral from bacterial disease.…”

Section: Discussionmentioning

confidence: 99%

Causes of death in HIV-infected and HIV-uninfected children aged under-five years in western Kenya

Onyango

Akelo

Sande

et al. 2021

Aids

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Objectives: Describe the causes of death among infants and children less than 5 years stratified by HIV status.Design: Cross-sectional analysis of causes of death ascertained through minimally invasive tissue sampling (MITS) in the Kenya Child Health and Mortality Prevention Surveillance site. Methods:We included decedents aged 28 days to less than 5 years, whose death was reported within 36 h, underwent MITS, and had HIV test results and causes of death determined. MITS specimens were tested using Taqman Array Cards, culture, cytology, histopathology and immunohistochemistry and HIV PCR. A panel evaluated epidemiologic, clinical, verbal autopsy and laboratory data to assign causes of death using ICD-10 guidelines. Causes of death and etiological agents were stratified by HIV status.Results: Of 176 included decedents, 14% (n ¼ 25) were HIV-infected, median viral load was 112 205 copies/ml [interquartile range (IQR) ¼ 9349-2 670 143). HIV-disease (96%; n ¼ 24) and malnutrition (23%; n ¼ 34) were the leading underlying causes of death in HIV-infected and HIV-uninfected decedents, respectively. Malnutrition was more frequent in the causal chain of HIV-infected (56%; n ¼ 14) than HIV-uninfected decedents (31%; n ¼ 49) (P value ¼ 0.03). Viral pneumonia was twice as common in HIV-infected (50%; n ¼ 9) than HIV-uninfected decedents (22%; n ¼ 7) (P value ¼ 0.04). Conclusion:Nearly all HIV-infected decedents' underlying cause of death was HIV disease, which was associated with malnutrition. Our findings underscore the need for strengthening early identification and management of HIV-infected children. Prevention, early diagnosis and treatment of malnutrition could be instrumental in improving the survival of HIV-infected and HIV-uninfected children.

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Section: Discussionmentioning

confidence: 99%

Causes of death in HIV-infected and HIV-uninfected children aged under-five years in western Kenya

Onyango

Akelo

Sande

et al. 2021

Aids

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“…7 Withholding and early stopping of antibiotics in cases of nonbacterial etiology infections, especially in absence of clinical suspicion of bacterial sepsis, strengthens the antibiotic stewardship policy in neonatal care. 8 Therefore, assessment of etiology of late onset ALRTI is need of the hour against the dogmatic belief that bacteria always cause such pneumonia, especially for <2-month-old children. In the Indian context, there is a paucity of data regarding etiological agents of community acquired ALRTI in neonates.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Cohort Study on Spectrum of Community Acquired Late Onset Neonatal Pneumonia: An Eye Opener for Neonatal Care

Munian

Roy

Poddar

et al. 2023

Journal of Neonatology

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Background Acute lower respiratory tract infections (ALRTIs) are a leading cause of morbidity and mortality in infants in low- and middle-income countries. We emphasize the differences in presentation and outcome between viral and bacterial origin community acquired ALRTI in late neonatal period. Methods All consecutively admitted neonates, aged 7 days or older, with features of ALRTI were included in the study, other than babies referred with prior hospital stay, congenital airway malformations and heart disease. Relevant investigations including nasopharyngeal swab polymerase chain reaction (PCR) and blood culture were done for etiological diagnosis. The predisposing factors, presenting features and short-term outcomes were compared between viral and bacterial etiology cohorts. Results Half of the 89 babies had primary viral infections, respiratory syncytial virus (RSV) being predominant (n = 21, 23.6%); 27 (30.3%) had bacterial infections, while no organisms were identified in 18% cases. Ten babies (11.2%) had COVID-19 and 4 (4.5%) had pertussis. Small for date (n = 15, 55.5%, p < .001) and history of past sick neonatal care unit admission were significantly higher (n = 20, 74.1%, p = .009) in babies with bacterial isolates. Median age of presentation was day 10 (interquartile range [IQR] 8-12). Bacterial ALRTI was more severe with significantly high respiratory score ( p < .001), need for invasive ventilation ( p < .001), systemic complications, and mortality ( p = .012), while viral ALRTI group required longer respiratory support and hospital stay ( p < .001). Conclusions PCR based methods are important in etiological diagnosis of community acquired late onset neonatal pneumonia. Such ALRTI is mostly of viral origin, and this is less likely to be fatal but require longer hospital stay than bacterial pneumonia.

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“…Infections of the lower respiratory tract are troublesome, especially in children under 5 years of age (1). Pneumonia and acute viral bronchiolitis are the main causes of hospitalization in regions with a high socioeconomic standard and are one of the leading causes of death in children under 5 years of age in developing countries (2).…”

Section: Introductionmentioning

confidence: 99%

The frequency of respiratory viruses in lower respiratory tract infections in children

Crnogorac,

Knežević

2023

Medicinski podmladak

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Introduction: Acute viral infections of the lower respiratory tract are of great importance for mortality in children worldwide. The most common causative agents include human respiratory syncytial virus (HRSV), human metapneumovirus, parainfluenza virus, influenza virus and adenoviruses. The application of molecular methods has significantly contributed to the identification and determination of the frequency of respiratory viruses in these infections. Aim: The aim of this study was to determine the frequency of different viruses that cause lower respiratory tract infections in the pediatric population using panel PCR test from bronchoalveolar lavage samples. Material and methods: Eighteen samples of bronchoalveolar lavage of children younger than 5 years with a diagnosis of pneumonia and antigenic confirmation of the presence of HRSV were analyzed. Virus detection was performed by real-time chain polymerization using the commercial FTlyoTM Respiratory Pathogens 21 kit (Fast Track Diagnostics, Luxembourg) to simultaneously detect the genomes of 18 different viruses and 1 bacterium. Results: Respiratory viruses were detected in all 18 samples, with HRSV identified in all samples, human bocavirus (HBoV) in 7 and human rhinovirus (HRV) in one sample. Coinfections were detected in 38.9% of samples. The HRSV and HBoV co-infection was proven in 33.33% of samples, while the presence of all three viruses in only one sample. Conclusion: The results of this study show the presence of HRSV, HBoV and HRV in bronchoalveolar lavage using multiplex RT-PCR method. Both HRSV and HBoV were the most common viral coinfections. Additional research is needed to more accurately estimate the frequency and distribution of respiratory viruses in children.

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Viral Lower Respiratory Tract Infections

Cited by 6 publications

References 111 publications

Causes of death in HIV-infected and HIV-uninfected children aged under-five years in western Kenya

Causes of death in HIV-infected and HIV-uninfected children aged under-five years in western Kenya

A Prospective Cohort Study on Spectrum of Community Acquired Late Onset Neonatal Pneumonia: An Eye Opener for Neonatal Care

The frequency of respiratory viruses in lower respiratory tract infections in children

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