Abstract
BackgroundBronchiolitis is a clinical syndrome commonly encountered in practice, particularly among infants and young children. To investigate the prevalence of pathogens in hospitalized children with bronchiolitis and study the clinical characteristics of bronchiolitis with or without coinfections.MethodsWe investigated the respiratory specimens and clinical data of 1012 children with bronchiolitis who were treated at the Children’s Hospital of Soochow University between November 2011 and December 2018. The nasopharyngeal aspirates were examined to detect viruses by direct immunofluorescence assay or polymerase chain reaction (PCR). Mycoplasma pneumoniae (MP) was tested by PCR and enzyme-linked immunosorbent assay.ResultsOf the 1134 children less than 2 years with bronchiolitis, 122 were excluded by exclusion criteria. Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). Coinfection was identified in 13.5% (137 of 1012) of the patients. Coinfection included mixed virus infection and virus infection with MP infection. Children with single virus infection had a higher rate of oxygen therapy compared with single MP infection.ConclusionsThe most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia.
Highlights
Bronchiolitis is a clinical syndrome commonly encountered in practice, among infants and young children
Respiratory syncytial virus (RSV) is the most common viral pathogen identified in children with globally, acute lower respiratory infection (ALRI); about 45% of hospital admissions and in-hospital deaths due to respiratory syncytial virus (RSV)-ALRI occur in children younger than 6 months [6, 7].RSV is the most common pathogen identified in bronchiolitis, followed by parainfluenza virus (PIV) and adenovirus (ADV) [8, 9]
We sought to evaluate the distribution of pathogens responsible for bronchiolitis in children ≤2 years of age and analyze the differences in the clinical features of bronchiolitis caused by different pathogenic agents, and explore the difference between simple infection and coinfection
Summary
Subjects We conducted a retrospective analysis of the data of 1012 children who were admitted to the Children’s Hospital of Soochow University for the management of bronchiolitis between November 2011 and December 2018. Microbe detection A quantitative diagnostic kit (provided by Sun Yat-sen University Daan Gene Co., Ltd.) for MP DNA was performed to identify the 16 s rRNA gene of MP extracted from nasopharyngeal specimens [13]. Data collection The medical records of the patients were reviewed and data regarding the following parameters were recorded: (1) demographic and clinical characteristics, including age, gender, and duration of symptoms prior to admission; (2) results of viral diagnostic tests performed in nasopharyngeal aspirates; (3) results of blood tests for inflammatory indices, including white blood cell (WBC) count, percentage of neutrophils, serum C-reactive protein (CRP) levels. P value of < 0.05 was considered to indicate statistical significance
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