Comparison of the prevalence of respiratory viruses in patients with acute respiratory infections at different hospital settings in North China, 2012\u20132015

Jianxing Yu,Zhengde Xie,Donghong Yang,Jinxiang Han,Fang Huang,Thomas Bénet,Zhancheng Gao,Tiegang Zhang,Philippe Vanhems,Kunling Shen,Hongwei Fan,Lili Ren,Yanqin Lu,Jianwei Wang,Taisheng Li

doi:10.1186/s12879-018-2982-3

Abstract

BackgroundAcute respiratory infections (ARIs) are a great public health challenge globally. The prevalence of respiratory viruses in patients with ARIs attending at different hospital settings is fully undetermined.MethodsLaboratory-based surveillance for ARIs was conducted at inpatient and outpatient settings of 11 hospitals in North China. The first 2–5 patients with ARIs were recruited in each hospital weekly from 2012 through 2015. The presence of respiratory viruses was screened by PCR assays. The prevalence of respiratory viruses was determined and compared between patients at different hospital settings.ResultsA total of 3487 hospitalized cases and 6437 outpatients/Emergency Department (ED) patients were enrolled. The most commonly detected viruses in the hospitalized cases were respiratory syncytial virus (RSV, 33.3%) in children less than two years old, adenoviruses (13.0%) in patients 15–34 years old, and influenza viruses (IFVs, 9.6%) in patients ≥65 years. IFVs were the most common virus in outpatient/ED patients across all age groups (22.7%). After controlling for the confounders caused by other viruses and covariates, adenoviruses (adjusted odds ratio [aOR]: 3.97, 99% confidence interval [99% CI]: 2.19–7.20) and RSV (aOR: 2.04, 99% CI: 1.34–3.11) were independently associated with increased hospitalization in children, as well as adenoviruses in adults (aOR: 2.14, 99% CI: 1.19–3.85). Additionally, co-infection of RSV with IFVs was associated with increased hospitalization in children (aOR: 12.20, 99% CI: 2.65–56.18).ConclusionsA substantial proportion of ARIs was associated with respiratory viruses in North China. RSV, adenoviruses, and co-infection of RSV and IFVs were more frequent in hospitalized children (or adenoviruses in adults), which might predict the severity of ARIs. Attending clinicians should be more vigilant of these infections.

Highlights

Acute respiratory infections (ARIs) are a great public health challenge globally
These studies are very helpful for characterizing the prevalence and burden of specific respiratory viruses (RVs) in pre-vaccine Chinese populations
In conclusion, a substantial proportion of ARIs are associated with the infection or co-infection of RVs in North China

Summary

Introduction

Acute respiratory infections (ARIs) are a great public health challenge globally. The prevalence of respiratory viruses in patients with ARIs attending at different hospital settings is fully undetermined. After the SARS events in 2002 [9], regional and nationwide laboratory-based surveillance studies for ARIs were conducted in China to help clarify the epidemiological feature of RVs by employing the highly sensitive modern molecular techniques, such as polymerase chain reaction (PCR) [10,11,12,13,14,15,16] These studies are very helpful for characterizing the prevalence and burden of specific RVs in pre-vaccine Chinese populations (i.e., vaccines against Streptococcus pneumoniae, Haemophilus influenzae type b, and influenza viruses are currently not incorporated into the national immunization program [17]). It is very important to clarify the most common viral agents causing ARIs and their relationship with the severe disease presentation for clinicians who treated their patients with ARIs at different hospital settings

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