High Frequency of Viral Co-Detections in Acute Bronchiolitis.

Hortense Petat,Astrid Vabret,Jacques Brouard,Meriadeg Ar Gouilh,Vincent Gajdos,Christophe Marguet,François Angoulvant,Pierre-Olivier Vidalain,Sandrine Corbet

doi:10.3390/v13060990

Abstract

Over two years (2012–2014), 719 nasopharyngeal samples were collected from 6-week- to 12-month-old infants presenting at the emergency department with moderate to severe acute bronchiolitis. Viral testing was performed, and we found that 98% of samples were positive, including 90% for respiratory syncytial virus, 34% for human rhino virus, and 55% for viral co-detections, with a predominance of RSV/HRV co-infections (30%). Interestingly, we found that the risk of being infected by HRV is higher in the absence of RSV, suggesting interferences or exclusion mechanisms between these two viruses. Conversely, coronavirus infection had no impact on the likelihood of co-infection involving HRV and RSV. Bronchiolitis is the leading cause of hospitalizations in infants before 12 months of age, and many questions about its role in later chronic respiratory diseases (asthma and chronic obstructive pulmonary disease) exist. The role of virus detection and the burden of viral codetections need to be further explored, in order to understand the physiopathology of chronic respiratory diseases, a major public health issue.

Highlights

Acute bronchiolitis is the most common respiratory disease in infants under 12 months of age, and the leading cause of hospitalization in infants [1]
Multicenter, double-blinded, randomized prospective study called GUERANDE, which aimed to test the efficacy of 3% hypertonic saline nebulization in acute viral bronchiolitis, respiratory samples were collected from 719 patients [8]
Patients’ median age was 3 months (IQR 2-5), and 719 samples were collected in the study

Summary

Introduction

Acute bronchiolitis is the most common respiratory disease in infants under 12 months of age, and the leading cause of hospitalization in infants [1]. RSV is responsible for 34 million new cases of lower respiratory tract infections, and 2.4 million hospitalizations of infants all over the world, with 199,000 deaths per year, mostly in developing countries [4]. PCR methods and multivalent techniques in particular have become instrumental in detecting viruses associated with acute respiratory infections. Many studies evaluated the virus-dependent risk of outcomes, and the impact of viral etiology on severity and length of stay has been established [2,3,5,6]. Viral co-infections remain poorly investigated and available studies are scarce [2,7]. The aim of this study was to evaluate the burden of viral co-detections in infants with acute bronchiolitis

Objectives

Methods

Results

Conclusion