Study of association of respiratory viruses in the etiology of acute lower respiratory tract infections in children and correlation with clinical and laboratory features: role of emerging new viruses
DOI:
https://doi.org/10.18203/2320-6012.ijrms20233993Keywords:
Association, Lower respiratory tract infections, Polymerase chain reaction, VirusesAbstract
Background: Viruses are one of the major causes of childhood pneumonia with the respiratory syncytial virus getting great attention as an important organism for pneumonia.
Methods: This cross-sectional study was conducted in the Department of Paediatrics, Sree Gokulam Medical College and Research Foundation, Thiruvananthapuram, Kerala from May 2022 TO November 2022. 119 children admitted with lower respiratory tract infections were included in this study. Symptoms, signs, and investigation reports including PCR and clinical course in the hospital were recorded.
Results: 25% of children were in the age group less than 1 year, 52% were between 1-5 years and 23% were above 5 years. Viruses were isolated in 82 patients (68.9%). The main viruses were respiratory syncytial virus (23.5%), boca virus (16.14%), influenza A (7.5%), influenza B (4.2%), meta pneumonia virus (3.3%), and para influenza virus (2.5%). Patients with boca virus infections had a more severe clinical course.
Conclusions: Molecular testing with PCR along with clinical and lab parameters will help us to have more insights into the etiology and clinical presentation of respiratory infections in children and help us to do optimum management avoiding unnecessary antibiotic usage.
References
Troeger C, Forouzanfar M, Rao PC, Khalil I, Brown A, Swartz S, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(11):1133-61.
Yadav KK, Awasthi S. Childhood Pneumonia: What’s Unchanged, and What’s New?. Ind J Pediatr. 2023;90(7):1-7.
Hortal M, Russi JC, Arbiza JR, Canepa E, Chiparelli H, Dlarramendi A. Identification of Viruses in a Study of Acute Respiratory lhtct Infection in Children from Uruguay. Revi Infect Dis. 1999;12(Supplement_8):S995-7.
Adegbola RA, Falade AG, Sam BE, Aidoo M, Baldeh I, Hazlett D, et al. The etiology of pneumonia in malnourished and well-nourished Gambian children. Pediat infect dis J. 1994;13(11):975-82.
Simões EA. The burden of respiratory syncytial virus lower respiratory tract disease in infants in the United States: a synthesis. J Infect Dis. 2022;226(Supplement_2):S143-7.
Van den Hoogen BG, de Jong JC, Groen J, Kuiken T, de Groot R, Fouchier RA, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nature Med. 2001;7(6):719-24.
Weber MW, Weber MW, Mulholland EK, Mulholland EK, Greenwood BM. Respiratory syncytial virus infection in tropical and developing countries. Trop Medi Int Heal. 1998;3(4):268-80.
Cherian T, Simoes EA, Steinhoff MC, Chitra K, John M, Raghupathy P, et al. Bronchiolitis in tropical south India. Ame J Dis Child. 1990;144(9):1026-30.
Mathew JL, Singhi S, Ray P, Hagel E, Saghafian–Hedengren S, Bansal A, et al. Etiology of community acquired pneumonia among children in India: prospective, cohort study. Jo Global Heal. 2015;5(2).
Smith DK, Kuckel DP, Recidoro AM. Community-acquired pneumonia in children: rapid evidence review. Am Fam Phys. 2021;104(6):618-25.
Choi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, et al. The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000–2005. Clin Infect Dis. 2006;43(5):585-92.
Hong JY, Lee HJ, Piedra PA, Choi EH, Park KH, Koh YY, et al. Lower respiratory tract infections due to adenovirus in hospitalized Korean children: epidemiology, clinical features, and prognosis. Clin Infect Dis. 2001;32(10):1423-9.
Hindupur A, Dhandapani P, Menon T. Influenza virus among children with acute respiratory infections in Chennai, India. Ind Pediatr. 2019;56(1):74-5.
Priya P, Sheriff AK. Influenza activity among the pediatric age group in Chennai. Indian J Med Res. 2005;70(9):847-53.
Rhedin S, Lindstrand A, Hjelmgren A, Ryd-Rinder M, Öhrmalm L, Tolfvenstam T, et al. Respiratory viruses associated with community-acquired pneumonia in children: matched case–control study. Thorax. 2015;70(9):847-53.
Farshad N, Saffar MJ, Khalilian AR, Saffar H. Respiratory viruses in hospitalized children with acute lower respiratory tract infections, Mazandaran Province, Iran. Ind Pediatr. 2008;45(7):590.
Emhofer J, Ploier R, Popow-Kraupp T, Brunhuber W. Analysis of respiratory syncytial virus diseases in hospitalized children in the district of Steyr 1984/85. Padiatr Padol. 1988;23(1):15-23.
Yun BY, Kim MR, Park JY, Choi EH, Lee HJ, Yun CK. Viral etiology and epidemiology of acute lower respiratory tract infections in Korean children. Pediatr Infect Dis J. 1995;14(12):1054-9.
Kelly MS, Smieja M, Luinstra K, Wirth KE, Goldfarb DM, Steenhoff AP, et al. Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana. PloS one. 2015;10(5):e0126593.
Word Health Organization. Revised WHO classification and treatment of childhood pneumonia at health facilities. Evidence Summaries, 2014. Available at: http://apps.who.int/iris/bitstream/10665/137319/1/9789241507813_eng.pdf. Accessed on 30 August 2023.
Boivin G, De Serres G, Côté S, Gilca R, Abed Y, Rochette L, et al. Human metapneumovirus infections in hospitalized children. Emerg Infect Dis. 2003;9(6):634.
Hall CB, Walsh EE, Schnabel KC, Long CE, McConnochie KM, Hildreth SW, et al. Occurrence of groups A and B of respiratory syncytial virus over 15 years: associated epidemiologic and clinical characteristics in hospitalized and ambulatory children. J Infect Dis. 1990;162(6):1283-90.
Papadopoulos NG, Gourgiotis D, Javadyan A, Bossios A, Kallergi K, Psarras S, et al D. Does respiratory syncytial virus subtype influences the severity of acute bronchiolitis in hospitalized infants?. Resp medi. 2004;98(9):879-82.
Buendía JA, Polack FP, Patiño DG. Clinical manifestations and outcomes of respiratory syncytial virus infection in children less than two years in Colombia. Ind Pediatr. 2021;58(11):1091-2.
Bharaj P, Sullender WM, Kabra SK, Broor S. Human bocavirus infection in children with acute respiratory tract infection in India. J Medi Virol. 2010;82(5):812-6.
Brieu N, Guyon G, Rodière M, Segondy M, Foulongne V. Human bocavirus infection in children with respiratory tract disease. Pediatr Infect Dis J. 2008;27(11):969-73.
von Linstow ML, Høgh M, Høgh B. Clinical and epidemiologic characteristics of human bocavirus in Danish infants: results from a prospective birth cohort study. Pediatr Infect Dis J. 2008;27(10):897-902.
Margaret IP, Nelson EA, Cheuk ES, Leung E, Sung R, Chan PK. Pediatric hospitalization of acute respiratory tract infections with Human Bocavirus in Hong Kong. J Clin Virol. 2008;42(1):72-4.
Gruteke P, Glas AS, Dierdorp M, Vreede WB, Pilon JW, Bruisten SM. Practical implementation of a multiplex PCR for acute respiratory tract infections in children. J Clin Microbiol. 2004;42(12):5596-603.
