Abstract
ObjectiveFew comprehensive studies have searched for viruses in infants and young children with community-acquired pneumonia (CAP) in China. The aim of this study was to investigate the roles of human herpes viruses (HHVs) and other respiratory viruses in CAP not caused by typical bacterial infection and to determine their prevalence and clinical significance.MethodsInduced sputum (IS) samples were collected from 354 hospitalised patients (infants, n = 205; children, n = 149) with respiratory illness (CAP or non-CAP) admitted to Wenling Hospital of China. We tested for HHVs and respiratory viruses using PCR-based assays. The epidemiological profiles were also analysed.ResultsHigh rate of virus detection (more than 98%) and co-infection (more than 80%) were found among IS samples from 354 hospitalised infants and children with respiratory illness in this study. Of 273 CAP samples tested, CMV (91.6%), HHV-6 (50.9%), RSV (37.4%), EBV (35.5%), HBoV (28.2%), HHV-7 (18.3%) and rhinovirus (17.2%) were the most commonly detected viruses. Of 81 non- CAP samples tested, CMV (63%), RSV (49.4%), HHV-6 (42%), EBV (24.7%), HHV-7 (13.6%) and HBoV (8.6%) were the dominant viruses detected. The prevalence of several viral agents (rhinovirus, bocavirus, adenovirus and CMV) among IS samples of CAP were significantly higher than that of non-CAP control group. We also found the prevalence of RSV coinfection with HHVs was also higher among CAP group than that of non-CAP control.ConclusionsWith sensitive molecular detection techniques and IS samples, high rates of viral identification were achieved in infants and young children with respiratory illness in a rural area of China. The clinical significance of rhinovirus, bocavirus, adenovirus and HHV (especially CMV) infections should receive greater attention in future treatment and prevention studies of CAP in infants and children.
Highlights
Lower respiratory tract infections are the leading cause of death worldwide in infants and children [1,2]
Two hundred and seventy-three samples were preselected from hospitalised children patients who diagnosed as non typical bacterial community-acquired pneumonia (CAP) within 48 hrs of admission, while 81 samples from hospitalized children patients were set as a control group, whom were clinical diagnosis as non-CAP patients based on chest X-ray and other respiratory signs at admission
Characteristics of the Study Population All induced sputum (IS) samples were collected from hospitalised patients with severe CAP (n = 273) and non-CAP (n = 81) in Wenling area between September 2007 and April 2008
Summary
Lower respiratory tract infections (primarily pneumonia) are the leading cause of death worldwide in infants and children [1,2]. There are approximately 150 million cases of childhood community-acquired pneumonia (CAP) each year [1,3]. CAP is a major cause of morbidity and mortality among children in developing countries, which is 10–50 times more common than in developed countries [1,3]. Bacteria as the principal cause of CAP in children has been widely investigated [3,4,5]. The appropriate sample from infants and young children is critical for the aetiologic diagnosis of CAP. Lung itself is rarely sampled directly, and sputum, representing lower-airway secretions, can rarely be obtained from children [11,14,15]
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