1
|
Lee JK, Song SH, Ahn B, Yun KW, Choi EH. Etiology and Epidemiology of Croup before and throughout the COVID-19 Pandemic, 2018-2022, South Korea. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101542. [PMID: 36291478 PMCID: PMC9599993 DOI: 10.3390/children9101542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/27/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022]
Abstract
Omicron, a recent variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently globally dominating. We reviewed the etiology and epidemiology of croup over an approximately 5-year period, with an emphasis on the recent dominance of the Omicron variant. Children less than 5 years of age seen in the emergency department with diagnosis of croup from two large national tertiary hospitals were collected for the period from January 2018 through March 2022. Viral etiologies of the patients were compared with national surveillance data upon circulating respiratory viruses in the community. A total number of 879 croup cases were recognized during the study period. The most common pathogen was SARS-CoV-2 (26.9%), followed by HRV (23.8%), PIV1 (14.6%), PIV3 (13.1%), and CoV NL63 (13.1%), among seventeen respiratory viral pathogens tested by polymerase chain reaction. The viral identification rate was significantly higher in the Omicron period, with most of the pathogens identified as SARS-CoV-2. In the Omicron period, with the exponential increase in the number of COVID-19 cases in the community, croup associated with SARS-CoV-2 significantly increased, with a high detection rate of 97.2% (35 of 36) among croup cases with pathogen identified. The etiologic and epidemiologic data before and throughout the COVID-19 pandemic indicate that the association between croup and infection with the SARS-CoV-2 Omicron variant is highly plausible.
Collapse
Affiliation(s)
- Joon Kee Lee
- Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Korea
| | - Seung Ha Song
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, Korea
| | - Bin Ahn
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence:
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul 03080, Korea
| |
Collapse
|
2
|
Galindo-Fraga A, Guerra de Blas PDC, Ortega-Villa AM, Mateja A, Ruiz Quiñones JA, Cervantes PR, Barrientos FL, Ortiz-Hernández AA, Llamosas-Gallardo B, Ramírez-Venegas A, Vázquez RV, Chepitel DN, Moreno-Espinosa S, Powers JH, Lourdes Guerrero M, Ruiz-Palacios GM, Beigel J. DIFFERENT CLINICAL PRESENTATIONS OF HUMAN RHINOVIRUS (HRV) SPECIES INFECTION IN CHILDREN AND ADULTS IN MEXICO. Open Forum Infect Dis 2022; 9:ofac303. [PMID: 35891697 PMCID: PMC9308452 DOI: 10.1093/ofid/ofac303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background Human rhinoviruses (HRVs) are a common cause of influenza-like illness, with the ability to infect the upper and lower respiratory tracts. In this study we aim to describe the clinical and molecular features of HRV infection in Mexican children and adults. Methods We performed a hospital-based, 4-year multicenter prospective observational cohort study of patients with influenza-like illness. Participants who tested positive for HRV were included. We described demographic, clinical, and laboratory characteristics and the association between HRV types, illness severity, and clinical outcomes. Results Of the 5662 subjects recruited, 1473 (26%) had HRV; of those, 988 (67.1%) were adults (≥18 years) and 485 (32.9%) were children. One hundred sixty-seven (11.33%) samples were sequenced; 101 (60.5%) were rhinovirus species A (HRV-A), 22 (13.2%) were rhinovirus species B (HRV-B), and 44 (26.3%) were rhinovirus species C (HRV-C). Among children and adults, 30.5% and 23.5%, respectively, were hospitalized (non–intensive care unit [ICU]). The odds of HRV-C are higher than HRV-A for participants in the ICU (compared to outpatient) and when platelets, lymphocytes, white blood cells, and lactate dehydrogenase are increased. The odds of HRV-C are higher than HRV-A and HRV-B with shortness of breath. The odds of HRV-A are higher than HRV-B, and the odds of HRV-B are higher than HRV-C, when mild symptoms like muscle ache and headache occur. Conclusions Rhinoviruses are a common cause of influenza-like illness. It is necessary to improve the surveillance, testing, and species identification for these viruses to understand different clinical presentations and risk factors associated with worse outcomes. Clinical Trials Registration. NCT01418287.
Collapse
Affiliation(s)
- Arturo Galindo-Fraga
- Departamento de Epidemiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | | | - Ana M Ortega-Villa
- National Institute of Allergy and Infectious Diseases , Bethesda, MD , USA
| | - Allyson Mateja
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research , Frederick, Maryland , United States of America
| | - Jesus Arturo Ruiz Quiñones
- Departamento de Epidemiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Pilar Ramos Cervantes
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Fernando Ledesma Barrientos
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Ana A Ortiz-Hernández
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría Mexico City , Mexico
| | - Beatriz Llamosas-Gallardo
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría Mexico City , Mexico
| | - Alejandra Ramírez-Venegas
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” , Mexico City , Mexico
| | - Rafael Valdéz Vázquez
- Departamento de Infectología, Hospital General “Dr. Manuel Gea González” , Mexico City , Mexico
| | - Daniel Noyola Chepitel
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luís Potosí , San Luis Potosí , Mexico
| | - Sarbelio Moreno-Espinosa
- Departamento de Infectología, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud , Mexico City , Mexico
| | - John H Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick , Maryland , United States of America
| | - M Lourdes Guerrero
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Guillermo M Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - John Beigel
- National Institute of Allergy and Infectious Diseases , Bethesda, MD , USA
| | | |
Collapse
|
3
|
Laya BF, Concepcion NDP, Garcia-Peña P, Naidoo J, Kritsaneepaiboon S, Lee EY. Pediatric Lower Respiratory Tract Infections: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:15-40. [PMID: 34836562 DOI: 10.1016/j.rcl.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Lower respiratory tract infection (LRTI) remains a major cause of morbidity and mortality in children. Various organisms cause LRTI, including viruses, bacteria, fungi, and parasites, among others. Infections caused by 2 or more organisms also occur, sometimes enhancing the severity of the infection. Medical imaging helps confirm a diagnosis but also plays a role in the evaluation of acute and chronic sequelae. Medical imaging tests help evaluate underlying pathology in pediatric patients with recurrent or long-standing symptoms as well as the immunocompromised.
Collapse
Affiliation(s)
- Bernard F Laya
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines.
| | - Nathan David P Concepcion
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines
| | - Pilar Garcia-Peña
- Autonomous University of Barcelona (AUB), University Hospital Materno-Infantil Vall d'Hebron, Pso. Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jaishree Naidoo
- Paeds Diagnostic Imaging and Envisionit Deep AI, 2nd Floor, One-on Jameson Building, 1 Jameson Avenue, Melrose Estate, Johannesburg, 2196, South Africa
| | - Supika Kritsaneepaiboon
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Kanjanavanich Road, Hat Yai, 90110, Thailand
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| |
Collapse
|
4
|
Viral Loads and Disease Severity in Children with Rhinovirus-Associated Illnesses. Viruses 2021; 13:v13020295. [PMID: 33668603 PMCID: PMC7918889 DOI: 10.3390/v13020295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/23/2022] Open
Abstract
The role of rhinoviruses (RVs) in children with clinical syndromes not classically associated with RV infections is not well understood. We analyzed a cohort of children ≤21 years old who were PCR+ for RV at a large Pediatric Hospital from 2011 to 2013. Using univariate and multivariable logistic regression, we analyzed the associations between demographic, clinical characteristics, microbiology data, and clinical outcomes in children with compatible symptoms and incidental RV detection. Of the 2473 children (inpatients and outpatients) with an RV+ PCR, 2382 (96%) had compatible symptoms, and 91 (4%) did not. The overall median age was 14 months and 78% had underlying comorbidities. No differences in RV viral loads were found according to the presence of compatible symptoms, while in children with classic RV symptoms, RV viral loads were higher in single RV infections versus RV viral co-infections. Bacterial co-infections were more common in RV incidental detection (7.6%) than in children with compatible symptoms (1.9%, p < 0.001). The presence of compatible symptoms independently increased the odds ratio (OR, 95% CI) of hospitalization 4.8 (3.1-7.4), prolonged hospital stays 1.9 (1.1-3.1), need for oxygen 12 (5.8-25.0) and pediatric intensive care unit (PICU) admission 4.13 (2.0-8.2). Thus, despite comparable RV loads, disease severity was significantly worse in children with compatible symptoms.
Collapse
|
5
|
Matsuno AK, Gagliardi TB, Paula FE, Luna LKS, Jesus BLS, Stein RT, Aragon DC, Carlotti APCP, Arruda E. Human coronavirus alone or in co-infection with rhinovirus C is a risk factor for severe respiratory disease and admission to the pediatric intensive care unit: A one-year study in Southeast Brazil. PLoS One 2019; 14:e0217744. [PMID: 31158256 PMCID: PMC6546210 DOI: 10.1371/journal.pone.0217744] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 05/19/2019] [Indexed: 12/16/2022] Open
Abstract
Objective We aimed to assess the profile of respiratory viruses in young children hospitalized for acute lower respiratory tract infection (ALRI) and its association with disease severity, defined as need for pediatric intensive care unit (PICU) admission. Design Prospective observational cohort study. Setting A tertiary-care university hospital in Brazil. Patients Children younger than three years attending the pediatric emergency room with ALRI who were admitted to the hospital. Interventions None. Measurements and main results Nasopharyngeal aspirates were collected from patients from June 1st, 2008 to May 31st, 2009within the first 48 hours of hospitalization. Nasopharyngeal aspirates were tested for 17humanrespiratory viruses by molecular and immunofluorescence based assays. Simple and multiple log-binomial regression models were constructed to assess associations of virus type with a need for PICU admission. Age, prematurity, the presence of an underlying disease and congenital heart disease were covariates. Nasopharyngeal aspirates were positive for at least one virus in 236 patients. Rhinoviruses were detected in 85.6% of samples, with a preponderance of rhinovirus C (RV-C) (61.9%). Respiratory syncytial virus was detected in 59.8% and human coronavirus (HCoV) in 11% of the samples. Co-detections of two to five viruses were found in 78% of the patients. The detection of HCoV alone (adjusted relative risk (RR) 2.18; 95% CI 1.15–4.15) or in co-infection with RV-C (adjusted RR 2.37; 95% CI 1.23–4.58) was independently associated with PICU admission. Conclusions The detection of HCoV alone or in co-infection with RV-C was independently associated with PICU admission in young children hospitalized for ALRI.
Collapse
Affiliation(s)
- Alessandra K. Matsuno
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- * E-mail:
| | - Talita B. Gagliardi
- Department of Cell Biology and Virology Research Center, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Flavia E. Paula
- Department of Cell Biology and Virology Research Center, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Luciano K. S. Luna
- Department of Cell Biology and Virology Research Center, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Bruna L. S. Jesus
- Department of Cell Biology and Virology Research Center, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - Renato T. Stein
- Department of Pediatrics,Pontifícia Universidade Católica do Rio Grande do Sul School of Medicine, Porto Alegre, Brazil
| | - Davi C. Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana P. C. P. Carlotti
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Eurico Arruda
- Department of Cell Biology and Virology Research Center, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| |
Collapse
|
6
|
Andrés C, Peremiquel-Trillas P, Gimferrer L, Isern A, Piñana M, Rodrigo-Pendás JÁ, Codina MG, Martín MDC, Fuentes F, Rubio S, Campins-Martí M, Pumarola T, Antón A. Genetic diversity of rhinoviruses detected at a tertiary hospital in Catalonia (Spain) during the 2014-2017 seasons. Future Microbiol 2018; 13:1565-1573. [PMID: 30417657 DOI: 10.2217/fmb-2018-0151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AIM To describe the genetic diversity of rhinovirus (RV) from patients attended at a tertiary hospital in Barcelona (Spain) from October 2014 to May 2017. METHODS RV detection was performed by real-time multiplex RT-PCR. A specific real-time quantitive retrotranscription PCR (qRT-PCR) was carried out to select those samples (Ct < 35) for molecular characterization based on partial VP4/2 protein. RESULTS Phylogenetic characterization revealed proportions of 63% RV-A, 6% RV-B and 31% RV-C (119 different types). RV-A circulated throughout all the study period, with a minor circulation during winter, just when RV-C prevailed. Differences between age medians by RV-specie were reported. CONCLUSION The large genetic diversity of RV detected in our area is described here. The variable cocirculation of multiple RV types is also reported, showing differences by age.
Collapse
Affiliation(s)
- Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Preventive Medicine & Epidemiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Vall Hebron Research Institute, Barcelona, Spain
| | - Laura Gimferrer
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Isern
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Piñana
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Ángel Rodrigo-Pendás
- Preventive Medicine & Epidemiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Vall Hebron Research Institute, Barcelona, Spain
| | - Maria Gema Codina
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Del Carmen Martín
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco Fuentes
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Rubio
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Magda Campins-Martí
- Preventive Medicine & Epidemiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Vall Hebron Research Institute, Barcelona, Spain
| | - Tomàs Pumarola
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
7
|
Savage TJ, Kuypers J, Chu HY, Bradford MC, Buccat AM, Qin X, Klein EJ, Jerome KR, Englund JA, Waghmare A. Enterovirus D-68 in children presenting for acute care in the hospital setting. Influenza Other Respir Viruses 2018; 12:522-528. [PMID: 29498483 PMCID: PMC6005627 DOI: 10.1111/irv.12551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Severe respiratory disease associated with enterovirus D68 (EV-D68) has been reported in hospitalized pediatric patients. Virologic and clinical characteristics of EV-D68 infections exclusively in patients presenting to a hospital Emergency Department (ED) or urgent care have not been well defined. METHODS Mid-nasal swabs from pediatric patients with respiratory symptoms presenting to the ED or urgent care were evaluated using a commercial multiplex PCR platform. Specimens positive for rhinovirus/enterovirus (HRV/EV) were subsequently tested using real-time reverse-transcriptase PCR for EV-D68. The PCR cycle threshold (CT) was used as a viral load proxy. Clinical outcomes were compared between patients with EV-D68 and patients without EV-D68 who tested positive for HRV/EV. RESULTS From August to December 2014, 511 swabs from patients with HRV/EV were available. EV-D68 was detected in 170 (33%) HRV/EV-positive samples. In multivariable models adjusted for age and underlying asthma, patients with EV-D68 were more likely to require hospitalization for respiratory reasons (odds ratio (OR): 3.11, CI: 1.85-5.25), require respiratory support (OR: 1.69, CI: 1.09-2.62), have confirmed/probable lower respiratory tract infection (LRTI; OR: 3.78, CI: 2.03-7.04), and require continuous albuterol or steroids (OR: 3.91, CI: 2.22-6.88 and OR: 4.73, CI: 2.65-8.46, respectively). Higher EV-D68 viral load was associated with need for respiratory support and LRTI in multivariate models. CONCLUSIONS Among pediatric patients presenting to the ED or urgent care, EV-D68 causes more severe disease than non-EV-D68 HRV/EV independent of underlying asthma. High viral load was associated with worse clinical outcomes. Rapid and quantitative viral testing may help identify and risk stratify patients.
Collapse
Affiliation(s)
- Timothy J. Savage
- Seattle Children's HospitalSeattleWAUSA
- University of WashingtonSeattleWAUSA
| | | | | | | | | | - Xuan Qin
- Seattle Children's HospitalSeattleWAUSA
| | - Eileen J. Klein
- Seattle Children's HospitalSeattleWAUSA
- University of WashingtonSeattleWAUSA
- Seattle Children's Research InstituteSeattleWAUSA
| | - Keith R. Jerome
- University of WashingtonSeattleWAUSA
- Fred Hutchinson Cancer Research CenterSeattleWAUSA
| | - Janet A. Englund
- Seattle Children's HospitalSeattleWAUSA
- University of WashingtonSeattleWAUSA
- Seattle Children's Research InstituteSeattleWAUSA
| | - Alpana Waghmare
- Seattle Children's HospitalSeattleWAUSA
- University of WashingtonSeattleWAUSA
- Seattle Children's Research InstituteSeattleWAUSA
- Fred Hutchinson Cancer Research CenterSeattleWAUSA
| |
Collapse
|
8
|
Tsagarakis NJ, Sideri A, Makridis P, Triantafyllou A, Stamoulakatou A, Papadogeorgaki E. Age-related prevalence of common upper respiratory pathogens, based on the application of the FilmArray Respiratory panel in a tertiary hospital in Greece. Medicine (Baltimore) 2018; 97:e10903. [PMID: 29851817 PMCID: PMC6392546 DOI: 10.1097/md.0000000000010903] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The FilmArray Respiratory Panel (FA-RP) is an FDA certified multiplex PCR that can detect 17 viruses and 3 bacteria responsible for upper respiratory tract infections, thus it is potentially useful to the assessment of the age-related prevalence of these pathogens.In this observational study, we retrospectively analyzed the results of all the respiratory samples, which had been processed during 1 year-period (November 2015 to November 2016) with the FA-RP, in the Central Laboratories of Hygeia & Mitera General Hospitals of Athens, Greece. In order to have an age-related distribution, the following age groups were implemented: (<2), (≥2, <5), (≥5, <10), (≥10, <18), (≥18, <45), (≥45, <65), and (≥65) years old.Among 656 respiratory samples tested, 362 (55%) were from male and 294 (45%) from female patients, while 356 (54.3%) were positive and 300 (45.7%) negative. In the first age-group (<2), 41/121 samples (33.9%) revealed human rhinovirus/enterovirus (HRV) and 16 (13.2%) adenovirus (Adv), followed by respiratory syncytial virus (RSV), coronavirus, human metapneumovirus (Hmpv), and parainfluenza viruses (PIV). In the age-group (≥2, <5), Adv predominated with 37/147 samples (25.2%), followed by HRV, RSV, coronavirus (all types), and influenza, Hmpv and PIV. In the age-group (≥5, <10), HRV was identified in 25/80 samples (31.3%), Adv in 18 (22.5%), influenza in 11 (13.8%), and Hmpv in 6 (7.5%). Influenza predominated in the age-group (≥10, <18), with 4/22 samples (18.2%), while in the remaining age-groups (≥18), HRV was the commonest isolated pathogen, 33/286 (11.5%), followed by influenza with 20 (7%) (influenza A H1-2009, 11/20).In our patient series, HRV seemed to prevail in most age-groups, followed by Adv, although Influenza was the second most frequent pathogen isolated in the age-groups (≥18). Moreover, increasing age corresponded to increasing possibility of having a negative sample, indicating that FilmArray may be more useful before adolescence.
Collapse
|
9
|
Rodrigues CMC, Groves H. Community-Acquired Pneumonia in Children: the Challenges of Microbiological Diagnosis. J Clin Microbiol 2018; 56:e01318-17. [PMID: 29237789 PMCID: PMC5824044 DOI: 10.1128/jcm.01318-17] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Community-acquired pneumonia (CAP) is the leading cause of mortality in children under 5 years of age globally. To improve the management of CAP, we must distinguish CAP from other common pediatric conditions and develop better diagnostic methods to detect the causative organism, so as to best direct appropriate resources in both industrialized and developing countries. Here, we review the diagnostic modalities available for identifying viruses and bacteria in the upper and lower respiratory tract of children, with a discussion of their utility and limitations in diagnosing CAP in children.
Collapse
Affiliation(s)
- C M C Rodrigues
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- Department of Paediatric Infectious Diseases and Immunology, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - H Groves
- Centre for Experimental Medicine, Queens University, Belfast, United Kingdom
- Department of Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| |
Collapse
|
10
|
Ogimi C, Englund JA, Bradford MC, Qin X, Boeckh M, Waghmare A. Characteristics and Outcomes of Coronavirus Infection in Children: The Role of Viral Factors and an Immunocompromised State. J Pediatric Infect Dis Soc 2018; 8:21-28. [PMID: 29447395 PMCID: PMC6437838 DOI: 10.1093/jpids/pix093] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 01/23/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Immunocompromised children might be predisposed to serious infections from human coronaviruses (HCoVs), including strains OC43, NL63, HKU1, and 229E; however, the virologic and clinical features of HCoV infection in immunocompromised children have not been compared to those in nonimmunocompromised children. METHODS We retrospectively analyzed a cohort of children who presented to Seattle Children's Hospital and in whom HCoV was detected by a multiplex respiratory polymerase chain reaction assay of a nasal sample between October 2012 and March 2016. Lower respiratory tract disease (LRTD) was defined as possible or definite infiltrate seen in chest imaging, need for oxygen, or abnormal lung examination in conjunction with a physician diagnosis of LRTD. We used logistic regression modeling to evaluate risk factors for LRTD and LRTD that necessitated oxygen use (severe LRTD), including an immunocompromised state, in children with HCoV infection. RESULTS The median ages of 85 immunocompromised and 1152 nonimmunocompromised children with HCoV infection were 6.3 and 1.6 years, respectively. The prevalence of LRTD and of severe LRTD did not differ greatly between the immunocompromised and nonimmunocompromised patients (22% vs 26% [LRTD] and 15% vs 11% [severe LRTD], respectively); however, in a multivariable model, an immunocompromised state was associated with an increased likelihood of severe LRTD (adjusted odds ratio, 2.5 [95% confidence interval, 1.2-4.9]; P = .01). Younger age, having an underlying pulmonary disorder, and the presence of respiratory syncytial virus were also associated with LRTD or severe LRTD in multivariable models. The risks of LRTD or severe LRTD did not differ among the children with different HCoV strains. CONCLUSIONS The presence of a copathogen and host factors, including an immunocompromised state, were associated with increased risk for severe LRTD. Recognizing risk factors for severe respiratory illness might assist in risk stratification.
Collapse
Affiliation(s)
- Chikara Ogimi
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle,Pediatric Infectious Diseases Division, Seattle Children’s Hospital, Washington
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle,Pediatric Infectious Diseases Division, Seattle Children’s Hospital, Washington
| | - Miranda C Bradford
- Children’s Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Washington
| | - Xuan Qin
- Department of Laboratory Medicine, University of Washington, Seattle,Microbiology Laboratory, Seattle Children’s Hospital, Washington
| | - Michael Boeckh
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Medicine, University of Washington, Seattle,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Alpana Waghmare
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle,Pediatric Infectious Diseases Division, Seattle Children’s Hospital, Washington,Correspondence: A. Waghmare, MD, Pediatric Infectious Diseases Division, Seattle Children’s Hospital, 4800 Sand Point Way NE, MA 7.226, Seattle, WA 98105 ()
| |
Collapse
|
11
|
Barlow-Anacker A, Bochkov Y, Gern J, Seroogy CM. Neonatal immune response to rhinovirus A16 has diminished dendritic cell function and increased B cell activation. PLoS One 2017; 12:e0180664. [PMID: 29045416 PMCID: PMC5646756 DOI: 10.1371/journal.pone.0180664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 06/19/2017] [Indexed: 02/02/2023] Open
Abstract
Background Rhinovirus infections during infancy account for the majority of respiratory illness health care utilization and are an associated risk factor for subsequent development of allergic asthma. Neonatal type I interferon production is diminished compared to adults after stimulation with TLR agonists. However, broad profiling of immune cell responses to infectious rhinovirus has not been undertaken and we hypothesized that additional immune differences can be identified in neonates. In this study, we undertook a comparative analysis of neonatal and adult blood immune cell responses after in vitro incubation with infectious RV-A16 for 6 and 24 hours. Methods Intracellular proinflammatory and type I interferon cytokines along with expression of surface co-stimulatory and maturation markers were measured using multi-parameter flow cytometry. Results Both circulating myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) frequency were lower in cord blood. Qualitative and quantitative plasmacytoid dendritic cell IFN-alpha + TNF- alpha responses to rhinovirus were significantly lower in cord pDCs. In cord blood samples, the majority of responsive pDCs were single-positive TNF-alpha producing cells, whereas in adult samples rhinovirus increased double-positive TNF-alpha+IFN-alpha+ pDCs. Rhinovirus upregulated activation and maturation markers on monocytes, mDCs, pDCs, and B cells, but CD40+CD86+ monocytes, mDCs, and pDCs cells were significantly higher in adult samples compared to cord samples. Surprisingly, rhinovirus increased CD40+CD86+ B cells to a significantly greater extent in cord samples compared to adults. Conclusions These findings define a number of cell-specific differences in neonatal responses to rhinovirus. This differential age-related immune response to RV may have implications for the immune correlates of protection to viral respiratory illness burden and determination of potential biomarkers for asthma risk.
Collapse
Affiliation(s)
- Amanda Barlow-Anacker
- Department of Pediatrics, Division of Allergy, Immunology, & Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Yury Bochkov
- Department of Pediatrics, Division of Allergy, Immunology, & Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - James Gern
- Department of Pediatrics, Division of Allergy, Immunology, & Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Christine M. Seroogy
- Department of Pediatrics, Division of Allergy, Immunology, & Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
- * E-mail:
| |
Collapse
|
12
|
Stenberg-Hammar K, Hedlin G, Söderhäll C. Rhinovirus and preschool wheeze. Pediatr Allergy Immunol 2017; 28:513-520. [PMID: 28599066 DOI: 10.1111/pai.12740] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 12/16/2022]
Abstract
Rhinovirus (RV) known as the common cold virus generally only causes a mild upper respiratory infection, but severe lower respiratory symptoms have been associated with RV infections especially in asthmatic individuals. Wheezing is a symptom of airway obstruction, and preschool children wheezing with RV have been associated with increased risk of asthma at school age. There are, however, conflicting opinions as to whether there are differences in response to RV infection or whether wheezing with RV reveals a preexisting impairment that promotes asthma mainly in predisposed children. The advent of molecular diagnostics to detect respiratory viruses has led to new insights into the role of RV infections. This review will discuss recent information concerning the role of RV as an important respiratory pathogen related to early onset wheeze and exacerbation of established asthma in preschool children.
Collapse
Affiliation(s)
- Katarina Stenberg-Hammar
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Centre of Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Centre of Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Centre of Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
13
|
Philpott EK, Englund JA, Katz J, Tielsch J, Khatry S, LeClerq SC, Shrestha L, Kuypers J, Magaret AS, Steinhoff MC, Chu HY. Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight in Nepal. Open Forum Infect Dis 2017; 4:ofx073. [PMID: 28584855 PMCID: PMC5450902 DOI: 10.1093/ofid/ofx073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/03/2017] [Indexed: 12/14/2022] Open
Abstract
Background Adverse birth outcomes, including low birth weight (LBW), defined as <2500 grams, small-for-gestational-age (SGA), and prematurity, contribute to 60%–80% of infant mortality worldwide and may be related to infections during pregnancy. The aim of this study was to assess whether febrile human rhinovirus (HRV) illness is associated with adverse birth outcomes. Methods Active household-based weekly surveillance was performed for respiratory illness episodes in pregnant women as part of a community-based, prospective, randomized trial of maternal influenza immunization in rural Nepal. Rhinovirus (HRV) febrile illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia with HRV detected on mid-nasal swab. Multivariate regression analysis evaluated the association between febrile HRV respiratory illness and adverse birth outcomes. Results Overall, 96 (3%) of 3693 pregnant women had HRV-positive febrile respiratory illnesses. Infants born to pregnant women with HRV febrile illness had a 1.6-fold increased risk of being LBW compared with those with non-HRV febrile illness (28 of 96 [38%] vs 109 of 458 [24%]; relative risk [RR], 1.6; 95% confidence interval [CI], 1.1–2.3). No difference in risk of LBW was observed between infants born to mothers with non-HRV febrile respiratory illness and those without respiratory illness during pregnancy (109 of 458 [24%] vs 552 of 2220 [25%], respectively; RR, 1.0; 95% CI, 0.8–1.2). Conclusions Febrile illness due to rhinovirus during pregnancy was associated with increased risk of LBW in a rural South Asian population. Interventions to reduce the burden of febrile respiratory illness due to rhinovirus during pregnancy may have a significant impact on LBW and subsequent infant mortality.
Collapse
Affiliation(s)
| | - Janet A Englund
- Pediatrics.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Washington
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - James Tielsch
- Department of Global Healthy, George Washington University, Washington DC
| | | | | | - Laxman Shrestha
- Department of Pediatrics, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal; and
| | | | | | - Mark C Steinhoff
- Department of Global Health, Cincinnati Children's Hospital Medical Center, Ohio
| | | |
Collapse
|