Abstract
Both viral and bacterial infections can be associated with wheezing episodes in children; however, information regarding combined infections with both viral and bacterial pathogens in full term neonates is limited. We sought to investigate the effects of viral–bacterial codetection on pneumonia severity and recurrent wheezing. A retrospective cohort study was conducted on neonates admitted to our hospital with pneumonia from 2009 to 2015. Of 606 total cases, 341 were diagnosed with RSV only, and 265 were diagnosed with both RSV and a potential bacterial pathogen. The leading four species of bacteria codetected with RSV were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Enterobacter cloacae. Neonates with RSV and a potential bacterial pathogen were significantly more likely to have worse symptoms, higher C-reactive protein values and more abnormal chest x-ray manifestations with Bonferroni correction for multiple comparisons (P < 0.01). On Cox regression analysis, an increased risk of recurrent wheezing was found for neonates positive for RSV–Staphylococcus aureus and RSV–Klebsiella pneumoniae. Our findings indicate that the combination of bacteria and RSV in the neonatal airway is associated with more serious clinical characteristics. The presence of RSV and Staphylococcus aureus or Klebsiella pneumoniae may provide predictive markers for wheeze.
Highlights
Pneumonia is the primary infectious cause of death worldwide in children under five years of age
In this study, we investigated the effect of viral–bacterial codetection on pneumonia severity in full term neonates, and sought to determine if codetection increases the risk of recurrent wheezing, rhinitis and eczema
8128 (29.9%) had nasopharyngeal aspirates collected to check for respiratory viruses within 24 hours of admission
Summary
Pneumonia is the primary infectious cause of death worldwide in children under five years of age. Some studies have reported increasing detection rates for mixed viral–bacterial infections in children with community-acquired pneumonia[4,5] and have found an interplay between viruses and bacteria. Other research has focused primarily on children with low birth weights[13], whereas the interaction of pulmonary viruses and bacteria are relatively unclear in full term neonates. It has been hypothesized that adverse exposures in early postnatal life might influence lung growth and development, and lead to www.nature.com/scientificreports/. Persistently smaller airways and impaired lung function. In this study, we investigated the effect of viral–bacterial codetection on pneumonia severity in full term neonates, and sought to determine if codetection increases the risk of recurrent wheezing, rhinitis and eczema
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