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Comparing the Etiology of Viral Acute Respiratory Illnesses Between Children Who Do and Do Not Attend Childcare. Pediatr Infect Dis J 2023; 42:443-448. [PMID: 36854108 DOI: 10.1097/inf.0000000000003884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND AND OBJECTIVE Childcare attendance is a common risk factor for acute respiratory illness (ARI) in young children. Our goal was to better understand the specific respiratory viruses that predominate in childcare, which may support the development of tailored illness prevention and intervention strategies in childcare settings. METHODS Using data from a prospective household cohort of ARI surveillance, we assessed specimen from 1418 ARIs reported by 359 childcare-aged children over 6 study seasons (2012/2013 through 2017/2018). Respiratory swabs were tested by polymerase chain reaction for 9 respiratory viruses. A mixed-effect logistic regression model was used to compare odds of various viral detection outcomes. The Shannon's Diversity index was used to compare the richness (ie, number of species) and diversity (ie, relative species abundance) associated with respiratory viruses detected in both groups. RESULTS At least 1 virus was detected in 75.5% of childcare-associated ARIs and in 80.1% of homecare ARIs. Compared with illnesses among homecare children, childcare illnesses were associated with significantly higher odds of detected adenovirus (odds ratio = 1.86, 95% confidence interval = 1.05-3.28) and human metapneumovirus (odds ratio = 1.76, 95% confidence interval = 1.03-3.0). The pool of viruses associated with childcare ARI was found to be significantly richer and more diverse than that of viruses associated with homecare ARI (P < 0.0001). CONCLUSIONS Children attending childcare experience a higher risk of adenovirus and human metapneumovirus infection and are regularly exposed to a rich and diverse pool of respiratory viruses in childcare environments. Our results underscore the necessity of thorough and multifaceted viral prevention strategies in childcare settings.
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Probst V, Spieker AJ, Stopczynski T, Stewart LS, Haddadin Z, Selvarangan R, Harrison CJ, Schuster JE, Staat MA, McNeal M, Weinberg GA, Szilagyi PG, Boom JA, Sahni LC, Piedra PA, Englund JA, Klein EJ, Michaels MG, Williams JV, Campbell AP, Patel M, Gerber SI, Halasa NB. Clinical Presentation and Severity of Adenovirus Detection Alone vs Adenovirus Co-detection With Other Respiratory Viruses in US Children With Acute Respiratory Illness from 2016 to 2018. J Pediatric Infect Dis Soc 2022; 11:430-439. [PMID: 35849119 DOI: 10.1093/jpids/piac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/28/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Human adenovirus (HAdV) is commonly associated with acute respiratory illnesses (ARI) in children and is also frequently co-detected with other viral pathogens. We compared clinical presentation and outcomes in young children with HAdV detected alone vs co-detected with other respiratory viruses. METHODS We used data from a multicenter, prospective, viral surveillance study of children seen in the emergency department and inpatient pediatric settings at seven US sites. Children less than 18 years old with fever and/or respiratory symptoms were enrolled between 12/1/16 and 10/31/18 and tested by molecular methods for HAdV, human rhinovirus/enterovirus (HRV/EV), respiratory syncytial virus (RSV), parainfluenza (PIV, types 1-4), influenza (flu, types A-C), and human metapneumovirus (HMPV). Our primary measure of illness severity was hospitalization; among hospitalized children, secondary severity outcomes included oxygen support and length of stay (LOS). RESULTS Of the 18,603 children enrolled, HAdV was detected in 1,136 (6.1%), among whom 646 (56.9%) had co-detection with at least one other respiratory virus. HRV/EV (n = 293, 45.3%) and RSV (n = 123, 19.0%) were the most frequent co-detections. Children with HRV/EV (aOR = 1.61; 95% CI = [1.11-2.34]), RSV (aOR = 4.48; 95% CI = [2.81-7.14]), HMPV (aOR = 3.39; 95% CI = [1.69-6.77]), or ≥ 2 co-detections (aOR = 1.95; 95% CI = [1.14-3.36]) had higher odds of hospitalization compared to children with HAdV alone. Among hospitalized children, HAdV co-detection with RSV or HMPV was each associated with higher odds of oxygen support, while co-detection with PIV or influenza viruses was each associated with higher mean LOS. CONCLUSIONS HAdV co-detection with other respiratory viruses was associated with greater disease severity among children with ARI compared to HAdV detection alone.
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Affiliation(s)
- Varvara Probst
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Tess Stopczynski
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura S Stewart
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Zaid Haddadin
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, University of Missouri-Kansas City and Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Christopher J Harrison
- Department of Pathology and Laboratory Medicine, University of Missouri-Kansas City and Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Jennifer E Schuster
- Department of Pediatrics, University of Missouri-Kansas City and Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Mary A Staat
- Department of Pediatrics, College of Medicine, University of Cincinnati and Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Monica McNeal
- Department of Pediatrics, College of Medicine, University of Cincinnati and Division of Infectious Diseases, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Geoffrey A Weinberg
- Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Peter G Szilagyi
- Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
- Department of Pediatrics, University of California at Los Angeles Mattel Children's Hospital and University of California at Los Angeles, Los Angeles, California, USA
| | - Julie A Boom
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, Texas Children's Hospital, Houston, Texas, USA
| | - Leila C Sahni
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, Texas Children's Hospital, Houston, Texas, USA
| | - Pedro A Piedra
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, Texas Children's Hospital, Houston, Texas, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas. Texas Children's Hospital, Houston, Texas, USA
| | - Janet A Englund
- Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA
| | - Eileen J Klein
- Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA
| | - Marian G Michaels
- Department of Pediatrics, School of Medicine, University of Pittsburgh and University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John V Williams
- Department of Pediatrics, School of Medicine, University of Pittsburgh and University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Angela P Campbell
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish Patel
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan I Gerber
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natasha B Halasa
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee, USA
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Wang X, Tan X, Li Q. Difference in clinical features and prognosis of severe adenoviral pneumonia in children with different ages. J Med Virol 2022; 94:3303-3311. [PMID: 35218046 DOI: 10.1002/jmv.27680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/08/2022] [Accepted: 02/23/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aims to analyze the difference in clinical features and prognosis of severe adenovirus pneumonia (SAP) in children of different ages, and analyze the risk factors for poor prognosis in children with SAP. METHODS A retrospective observational study was performed to describe the clinical features and analyze the risk factors for death and post-infectious bronchiolitis obliterans (PIBO) in 303 children hospitalized with SAP from January 2015 through to January 2020. The participants were divided into 4 age groups: < 6 months (n = 25, 8.3%); 6-12 months (n = 98, 32.3%); 12-36 months (n = 118, 38.9%); and > 36 months (n = 62, 20.5%). RESULTS Fever rate, peak, and duration were the lowest in the < 6 months group, while no significant difference was found among other age groups. Serum levels of lactate dehydrogenase (LDH) and the load of adenovirus were the lowest in the < 6 months group, and the highest in the 6-12 months and 12-36 months groups, respectively. A total of 80.9% of patients recovered, 3.3% of patients died, and 15.8% of patients were diagnosed PIBO. The mortality rate showed no significance between age groups. The > 36 months group had the highest recovery rate and the lowest incidence of PIBO, while the 6-12 months group had the lowest recovery rate and the highest incidence of PIBO. Independent risk factors for PIBO among all participants from the 4 groups were invasive mechanical ventilation, administration of intravenous steroids, duration of fever, and male gender. Independent risk factors for death among all participants from the 4 groups were hypercapnia, low albumin levels, and invasive mechanical ventilation. Risk factor analysis of different ages was not possible due to the limited sample size. CONCLUSIONS The morbidity, clinical features, and prognosis of SAP are affected by children's ages. Pediatric patients with a longer duration of fever, hypercapnia, low serum albumin levels, invasive mechanical ventilation, and intravenous steroids use are more likely to develop a poor prognosis in SAP, especially if the patient is male. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xia Wang
- Department of Pediatrics, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Xiangsheng Tan
- The First Hospital Affiliated to Army Medical University, Chongqing, 400038, China
| | - Qubei Li
- Department of the Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.,National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
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Xu XH, Fan HF, Shi TT, Yang DY, Huang L, Jiang WH, Lu G. Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: a comparative study. BMC Pulm Med 2021; 21:363. [PMID: 34763680 PMCID: PMC8582151 DOI: 10.1186/s12890-021-01708-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/26/2021] [Indexed: 12/03/2022] Open
Abstract
Background Adenovirus pneumonia is prone to severe clinical and imaging manifestations in children. Bronchoscopic alveolar lavage (BAL) is an important adjunctive therapy for patients with severe imaging findings. The study aimed to evaluate the effect of the timing on the efficacy of bronchoalveolar lavage in children with adenovirus pneumonia. Methods This study included 134 patients with adenovirus pneumonia treated with BAL at Guangzhou Women and Children's Medical Center from January 2019 to January 2020.They were classified into the severe and mild groups. Based on the timing of BAL, each group was divided into the early BAL layer (received BAL within 1–9 days of the illness course) and the late BAL layer (received BAL within 10–14 days of the illness course). The clinical data of patients with different BAL timings were analyzed in two groups. Results Among the 134 patients, 70 were categorized into the mild group and 64 were categorized into the severe group. Of the 134 patients, 42 patients received BAL early (mild group: n = 21 and severe group: n = 21) and 92 patients received BAL later (mild group: n = 49 and severe group: n = 43). In the mild group, the fever and hospital duration were shorter in patients who received BAL early than in those who received BAL later (p < 0.05). However, in the severe group, there were no statistically significant differences in the fever and hospital duration between patients who received BAL early and those who received BAL later. However, the need for mechanical ventilation and the incidence of BAL complications, such as new need for oxygen, were higher in patients who received BAL early than in those who received BAL later in the severe group (p < 0.05). Conclusion For mild adenovirus pneumonia, early BAL may shorten the fever and hospital duration. However, early BAL in severe cases might not shorten the course of the disease or improve prognosis and may even increase the risks of mechanical ventilation and BAL complications.
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Affiliation(s)
- Xue-Hua Xu
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Hui-Feng Fan
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Ting-Ting Shi
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Di-Yuan Yang
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Li Huang
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wen-Hui Jiang
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Gen Lu
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
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Schjelderup Nilsen HJ, Nordbø SA, Krokstad S, Døllner H, Christensen A. Human adenovirus in nasopharyngeal and blood samples from children with and without respiratory tract infections. J Clin Virol 2018; 111:19-23. [PMID: 30594701 PMCID: PMC7106418 DOI: 10.1016/j.jcv.2018.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/22/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022]
Abstract
Positive HAdV culture and high levels of HAdV DNA >106 copies/mL in NPAs were strongly associated with RTI in hospitalized children. Co-detection of other viruses was a very common phenomenon in children with HAdV DNA positive NPAs. Qualitative PCR detection of HAdV DNA in NPAs was not useful for diagnostic purposes.
Background Human adenovirus (HAdV) is a double-stranded DNA virus associated with respiratory tract infections (RTI) in children. Using polymerase chain reaction (PCR) tests, HAdV often is detected together with other virus species, even in healthy controls. Objectives The aim of this study was to compare molecular detection of HAdV with culture, and to examine the associations of various methods to RTI. Study design Nasopharyngeal aspirates (NPA) were collected from 4319 children admitted with RTI and from 361 controls. The NPAs were examined for 23 viral and bacterial pathogens, using inhouse real-time PCR-assays based on TaqMan probes, in addition to bacterial and viral culture. HAdV concentration was evaluated semi-quantitatively from the Ct-value and quantitatively by use of ADENOVIRUS R-gene®. Results HAdV-DNA was detected in 6.1% patient samples and in 10.5% controls (p< 0.001). Compared to controls, patients had an OR of 3.8 (95% CI 1.4–10.3) for mono-detection of HAdV DNA, and an OR of 5.1 (95% CI 2.0–13.4) for HAdV-positive samples grew adenovirus by culture. HAdV DNA loads from children with RTI consisted of two clusters: one cluster with high viral loads (Ct < 30 and >106 copies/ml) and one cluster with low viral loads, whereas among the controls, nearly all had low viral loads (OR 7.8, 95% CI 2.2–27.1). In 61 available plasma samples, 16.4% were positive for HAdV DNA, all were from patients. Conclusion The detection of HAdV DNA per se by qualitative PCR is not useful as a diagnostic test. Detection of HAdV by use of viral culture and a high viral HAdV DNA load are the two methods most strongly associated with RTI in children.
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Affiliation(s)
| | - Svein Arne Nordbø
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Norway
| | - Sidsel Krokstad
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Henrik Døllner
- Children's Department, St. Olavs Hospital, Trondheim University Hospital, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Norway
| | - Andreas Christensen
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Norway
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Xie L, Zhang B, Xiao N, Zhang F, Zhao X, Liu Q, Xie Z, Gao H, Duan Z, Zhong L. Epidemiology of human adenovirus infection in children hospitalized with lower respiratory tract infections in Hunan, China. J Med Virol 2018; 91:392-400. [PMID: 30286268 PMCID: PMC7159165 DOI: 10.1002/jmv.25333] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/02/2018] [Indexed: 12/18/2022]
Abstract
To investigate the current genotypes of circulating human adenovirus (HAdV) strains, we molecularly genotyped HAdV in the nasopharyngeal aspirates (NPAs) of patients with acute lower respiratory tract infections (ALRTIs) and attempted to determine their associations with clinical symptoms. A total of 4751 NPA samples were collected from 4751 patients admitted to Hunan Provincial People's Hospital from September 2007 to March 2014, of which 447 (9.4%) samples were HAdV positive. Fourteen different HAdV types were identified; HAdV types 1 to 7 (HAdV 1‐7) were identified in 95.7% of the 447 NPA samples with HAdV‐7 and HAdV‐3 being the most prevalent. In addition, 93.3% (417 of 447) of patients were younger than 5 years. The incidence of HAdV infection peaked in summer. Different HAdV types showed a predilection for different age groups and different seasonal distribution patterns. Coinfection of HAdVs and other respiratory viruses was detected in 63.3% (283 of 447) of the HAdV‐positive samples. The most common clinical diagnosis was pneumonia and the most common symptoms were fever and cough. In comparison with children infected with HAdV‐3 alone, those infected with HAdV‐7 alone had an increased frequency of severe pneumonia involvement (11.6% vs 32.4%; P = 0.031), higher intensive care unit admission rates (7.0% vs 26.5%; P = 0.019), and a longer length of hospital stay (P = 0.03). Mixed infections in younger children were associated with a longer hospital stay (P = 0.023). Our results demonstrate the recent changes in the trends of circulating HAdV genotypes associated with ALRTIs in Hunan China.
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Affiliation(s)
- Leyun Xie
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Bing Zhang
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Niguang Xiao
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Fei Zhang
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Xin Zhao
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Qin Liu
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
| | - Zhiping Xie
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Hanchun Gao
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Zhaojun Duan
- Key Laboratory for Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Lili Zhong
- Hunan Provincial People's Hospital, Children's Medical Center, Changsha, China
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Kim JH, Kang HR, Kim SY, Ban JE. Discrimination of Kawasaki disease with concomitant adenoviral detection differentiating from isolated adenoviral infection. KOREAN JOURNAL OF PEDIATRICS 2018; 61:43-48. [PMID: 29563943 PMCID: PMC5854841 DOI: 10.3345/kjp.2018.61.2.43] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/09/2017] [Accepted: 09/17/2017] [Indexed: 11/27/2022]
Abstract
Purpose Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection. Methods A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain reaction. In addition, 11 patients having KD with adenovirus, who were treated with intravenous immunoglobulin therapy during the acute phase of KD were also evaluated. Results Compared with the adenoviral infection group, the KD with adenovirus group was significantly associated with frequent lip and tongue changes, skin rash and changes in the extremities. In the laboratory parameters, higher C-reactive protein (CRP) level and presence of hypoalbuminemia and sterile pyuria were significantly associated with the KD group. In the multivariate analysis, lip and tongue changes (odds ratio [OR], 1.416; 95% confidence interval [CI], 1.151–1.741; P=0.001), high CRP level (OR, 1.039; 95% CI 1.743–1.454; P= 0.021) and sterile pyuria (OR 1.052; 95% CI 0.861–1.286; P=0.041) were the significant predictive factors of KD. In addition, the cutoff CRP level related to KD with adenoviral detection was 56 mg/L, with a sensitivity of 81.8% and a specificity of 75.9%. Conclusion Lip and tongue changes, higher serum CRP level and sterile pyuria were significantly correlated with adenovirus-positive KD.
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Affiliation(s)
- Jong Han Kim
- Department of Pediatrics, Hallym University Medical Center, Seoul, Korea
| | - Hye Ree Kang
- Department of Pediatrics, Hallym University Medical Center, Seoul, Korea
| | - Su Yeong Kim
- Department of Pediatrics, Hallym University Medical Center, Seoul, Korea
| | - Ji-Eun Ban
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
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Sun HQ, Zhang XX, Kuang XN, Gu WJ, Chen ZR, Yan YD, Wang YQ, Zhu CH, Dong HT, Zhang XL, Ji W. [Epidemiological analysis of 440 cases of respiratory adenovirus infections in children from the Suzhou area between 2006 and 2015]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:34-38. [PMID: 28100319 PMCID: PMC7390133 DOI: 10.7499/j.issn.1008-8830.2017.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 09/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To study the epidemiological characteristics of respiratory adenovirus (ADV) infections in children from the Suzhou area, China. METHODS The clinical data of ADV-positive children out of 35 529 children with respiratory tract infections who were hospitalized in the Children's Hospital of Soochow University between January 2006 and December 2015 were retrospectively studied. RESULTS Of the 35 529 children with respiratory tract infections, 440 (1.24%) were ADV-positive. There was no significant difference in the rate of ADV infections between boys and girls (1.18% vs 1.34%). The ADV infection rates of children at the age of <1 year old, 1-3 years old, 3-7 years old and 7-14 years old were 0.39% (71/18 002), 1.12% (103/9 191), 3.14% (201/6 398), and 3.35%( 65/1 938) respectively and the rate increased with age (P<0.01). The ADV infection rates in spring [1.85%(60/8 658)] and summer [2.20%(189/8 606)] were significantly higher than in autumn [0.30%(27/8 952)] and winter [0.69%(64/9 313)] (P<0.01). CONCLUSIONS The ADV infection rate is increased with age in the children from the Suzhou area, but it is not associated with gender. ADV infections are more common in spring and summer.
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Affiliation(s)
- Hui-Quan Sun
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, China.
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Lee HJ, Seo YE, Han SB, Jeong DC, Kang JH. Clinical Impact of Mixed Respiratory Viral Infection in Children with Adenoviral Infection. Infect Chemother 2016; 48:309-316. [PMID: 27883373 PMCID: PMC5204010 DOI: 10.3947/ic.2016.48.4.309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/25/2016] [Indexed: 01/24/2023] Open
Abstract
Background Although adenovirus (ADV) infection occurs steadily all year round in Korea and the identification of respiratory viral coinfections has been increasing following the introduction of multiplex real-time polymerase chain reaction tests, the clinical impact of viral coinfection in children with ADV infection has rarely been reported. Materials and Methods Medical records of children diagnosed with ADV infection were retrospectively reviewed. The enrolled children were divided into two groups based on the identified respiratory viruses: ADV group and coinfection group. Clinical and laboratory parameters were compared between the two groups. Results In total, 105 children (60 males and 45 females) with a median age of 29 months (range: 0-131 months) diagnosed with an ADV infection were enrolled. Fever (99.0%) was by far the most frequent symptom, followed by respiratory (82.9%), and gastrointestinal (22.9%) symptoms. Upper and lower respiratory tract infections were diagnosed in 56 (53.3%), and 32 (30.5%) children, respectively. Five (4.8%) children received oxygen therapy, and no child died due to ADV infection. Coinfection was diagnosed in 32 (30.5%) children, with rhinovirus (46.9%), and respiratory syncytial virus (21.9%) being the most frequent. The proportions of children younger than 24 months (P <0.001), with underlying medical conditions (P = 0.020), and diagnosed with lower respiratory tract infection (P = 0.011) were significantly higher in the coinfection group than in the ADV group. In a multivariate analysis, only the younger age was significantly associated with coinfection (P <0.001). Although more children in the coinfection group received oxygen therapy (P = 0.029), the duration of fever and hospitalization was not significantly different between the two groups. Conclusion Respiratory viral coinfection with ADV occurred more frequently in children younger than 24 months of age compared with children aged 24 months or older. Respiratory viral coinfection may increase the severity of ADV infection, however, appropriate therapy prevented prolonged hospitalization and poor prognosis due to coinfection.
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Affiliation(s)
- Hyun Jun Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Eun Seo
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Dae Chul Jeong
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Immunocompromised Children with Severe Adenoviral Respiratory Infection. Crit Care Res Pract 2016; 2016:9458230. [PMID: 27242924 PMCID: PMC4875965 DOI: 10.1155/2016/9458230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/18/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children's hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58%) did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (p = 0.015), multiple organ dysfunction syndrome (p = 0.001), requirement of renal replacement therapy (p = 0.01), ICU admission severity of illness score (p = 0.011), and treatment with cidofovir (p = 0.005). Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (p = 0.01), require renal replacement therapy (p = 0.02), and not survive to hospital discharge (p = 0.004). One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children.
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Cheng JL, Peng CC, Chiu NC, Weng LC, Chiu YY, Chang L, Huang DTN, Huang FY, Liu CP, Chi H. Risk factor analysis and molecular epidemiology of respiratory adenovirus infections among children in northern Taiwan, 2009-2013. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 50:418-426. [PMID: 26454422 DOI: 10.1016/j.jmii.2015.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND/PURPOSE Respiratory infections caused by human adenoviruses (HAdV) are worldwide, and have significantly increased recently in Taiwan. This study aimed to clarify the molecular epidemiology and risk factors of HAdV severe infections and pneumonia among Taiwanese children. METHODS Patients with HAdV infections and hospitalized in a medical center between 2009 and 2013 were divided into severe or nonsevere HAdV infections based on whether or not they received intensive care. HAdV pneumonia was identified for comparison. The HAdV genotype was determined by sequencing the partial hexon and fiber genes. The nucleotide sequences were compared by phylogenetic analysis. RESULTS The 176 patients (97 boys, 79 girls) had a median age of 3.7 years. The HAdV infections circulated year-round. HAdV B3 (54.5%) was the most common genotype, followed by HAdV C2 (21%), HAdV E4 (8%), and HAdV B7 (6.8%). Thirty-two patients needed intensive care. In multivariate analysis, the risk factors for severe HAdV infections were underlying neurologic diseases [odds ratio (OR): 164.9; p < 0.001], prematurity (OR: 10.9; p = 0.042), and HAdV B7 (OR: 39.5; p = 0.011). Twenty-nine patients had HAdV pneumonia. Patients with underlying neurologic diseases (OR 76.8; p < 0.001), airway anomaly (OR 15.1; p = 0.033), chronic lung diseases (OR 12.5; p = 0.047), weight < 3rd percentile (OR 5.5; p = 0.027), and HAdV B7 (OR 4.2; p = 0.002) had higher incidences of pneumonia. Four with underlying neurologic diseases died of acute respiratory distress syndrome. CONCLUSION HAdV infections circulate all year-round. HAdV B7 is strongly related to severe infections and pneumonia. Underlying neurologic diseases and prematurity are risk factors for severe HAdV infections.
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Affiliation(s)
- Jia Lu Cheng
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan
| | - Chun-Chih Peng
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan
| | - Li-Chuan Weng
- Section of Microbiology, Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Ying Chiu
- Department of Clinical Virology of Laboratory Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Lung Chang
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan
| | | | - Fu-Yuan Huang
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan
| | - Chang-Pan Liu
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Section of Microbiology, Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hsin Chi
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan; Section of Microbiology, Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan.
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Kim TH, Yim CH, Ahn SY, Kang KJ, Choi YM, Ko JH, Choi KE, Lee JH, Lee WW. Clinical features of respiratory adenovirus infections in pediatric inpatients in a single medical center. ALLERGY ASTHMA & RESPIRATORY DISEASE 2015. [DOI: 10.4168/aard.2015.3.6.402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tae Hyun Kim
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Chung Hyuk Yim
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Sung Yoon Ahn
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Kook Jin Kang
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Yu Mi Choi
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Jeong Hee Ko
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Kyong Eun Choi
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Jung Hyun Lee
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
| | - Won Wook Lee
- Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
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