Abstract
BackgroundAcute respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. Many studies have described the frequency of viruses in hospitalized patients, but studies describing the prevalence of viruses in the community setting are limited, particularly in developing countries, where most of the deaths from serious respiratory diseases occur. The aim of this study was to evaluate the diversity of respiratory viruses in the community setting using molecular diagnostic tools, as well as the clinical characteristics of respiratory viral infections in the general pediatric practice in Mexico.MethodsChildren with respiratory tract infections attending private pediatric practices during a 10-month period in five cities of the state of Veracruz were included. Nasal swabs were taken and processed by a multiplex detection kit for 15 respiratory viruses.Results525 children were included from July 2011 to May 2012; 44% were female, mean age was 45 months. The 3 most frequent clinical diagnosis were: rhinopharyngitis 68%, pharyngitis 18%, and 3.3% influenza-like illness. 71.5% of the samples were positive for virus. The five most frequent pathogens were respiratory syncycitial virus in 18.3% of the children, rhinovirus in 17.5%, influenza A 9.1%, adenovirus 7.2%, and enterovirus 3.4%, although all 15 viruses were detected; there were viral coinfections in 14.1%, and 28.5% of the samples were negative.ConclusionsA large proportion of respiratory infections in the community setting in Mexico was associated to viruses. Although testing for common respiratory pathogens in children with acute respiratory tract infections may lead to a better understanding of the role of viral pathogens in, and eventually to improvement in the management of, individual patients, additional prospective studies are required to study the need of routinely using such tests in general pediatric practices in resource-limited countries.
Highlights
Acute respiratory tract infections are the leading cause of morbidity and mortality in children world‐ wide
There were statistically significant differences among the municipalities (Table 1): the oldest children were from Poza Rica and Minatitlán
We found differences in the pathogens detected among single viral infections according to the clinical diagnosis
Summary
Acute respiratory tract infections are the leading cause of morbidity and mortality in children world‐ wide. Many studies have described the frequency of viruses in hospitalized patients, but studies describing the prevalence of viruses in the community setting are limited, in developing countries. Previous reports in Mexico have evaluated the presence of at most seven viruses in a single study using different methods, such as viral culture, immunofluorescence, or single PCR. The majority of these studies have been carried out in hospital settings, which limits the available information about the pathogens causing respiratory infections in the community. The multiplex PCR assays are more sensitive than any other diagnostic method, including virus isolation in cell culture and antigen detection, and are being used around the world for the past few years [3]. These technological advances have changed the landscape of virus detection and provide the opportunity to better understand the epidemiology of respiratory viruses
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