Abstract
BackgroundMolecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques.MethodsA nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus, respiratory syncytial virus (RSV), parainfluenza (1–4), rhinovirus, adenovirus (A—F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children with acute respiratory infection prospectively admitted to any of the GENDRES network hospitals between 2011–2013. The results were corroborated in an independent cohort collected in the UK.ResultsA total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and 36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12–24 months age group. The most frequently observed co-infection patterns were RSV—Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV—bocavirus / bocavirus—influenza (5 patients, 5.2%, UK cohort).ConclusionThe presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is very frequent and seems to peak at 12–24 months of age. The clinical significance of these findings is unclear but should warrant further analysis.
Highlights
Lower tract acute respiratory infections (LT-ARI) are estimated to cause 75% of all acute illnesses and are the leading cause of hospitalization for infants and young children worldwide [1,2]
We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques
Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12–24 months age group
Summary
Lower tract acute respiratory infections (LT-ARI) are estimated to cause 75% of all acute illnesses and are the leading cause of hospitalization for infants and young children worldwide [1,2]. Several new respiratory viruses, including human metapneumovirus (hMPV) [5], new subtypes of human coronaviruses (hCoV) [1] and bocavirus (hBoV) [6], have been associated with LT-ARI, though their clinical importance requires clarification. The importance of viral co-infections in the pathogenesis of LT-ARI is unclear; the possible impact of age on viral co-infection prevalence is, to the best of our knowledge, unknown. Molecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with lower tract acute respiratory infection (LT-ARI), using molecular techniques
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