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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2012

Open Access 01-12-2012 | Research article

Respiratory viruses from hospitalized children with severe pneumonia in the Philippines

Authors: Akira Suzuki, Socorro Lupisan, Yuki Furuse, Naoko Fuji, Mariko Saito, Raita Tamaki, Hazel Galang, Lydia Sombrero, Melisa Mondoy, Rapunzel Aniceto, Remigio Olveda, Hitoshi Oshitani

Published in: BMC Infectious Diseases | Issue 1/2012

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Abstract

Background

Pneumonia remains a leading cause of child death in developing countries. The viruses in severe pneumonia remain poorly defined.

Methods

The study was conducted at the Eastern Visayas Regional Medical Center in Tacloban City, Philippines from May 2008 to May 2009. Patients aged 8 days to 13 years old who were admitted to the Department of Pediatrics with severe pneumonia were enrolled for the study. Upon admission, polymerase chain reaction was performed using nasopharyngeal swabs and blood cultures to detect respiratory viruses and bacteria, respectively.

Result

Among the 819 patients enrolled, at least one virus was detected in 501 cases (61.2%). In addition, 423 cases were positive for a single virus while bacteria were detected in the blood culture sample of 31 cases. The most commonly detected viruses were human rhinoviruses (n = 189), including types A (n = 103), B (n = 17), and C (n = 69), and respiratory syncytial virus (RSV) (n = 165). Novel viruses such as human metapneumovirus, human coronavirus NL63, human bocavirus, and human polyomaviruses WU and KI were also detected. There were 70 deaths, and one or more viruses were detected in 35 (50%) of these cases. Positivity only for influenza A virus (OR = 4.3, 95% CI = 1.3-14.6) was significantly associated with fatal outcome. From the blood culture, Burkholderia cepacia group (n = 9), Streptococcus pneumoniae (n = 4), Staphylococcus aureus (n = 4), Haemophilus influenzae (n = 1), and Salmonella C1 (n = 1) were also isolated.

Conclusion

Viruses were commonly detected in children with severe pneumonia in the Philippines. Hence, viral etiologies should be considered while developing better effective strategies to reduce child pneumonia-related deaths in developing countries.
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Literature
1.
You D, Wardlaw T, Salama P, Jones G: Levels and trends in under-5 mortality, 1990–2008. Lancet. 2010, 375 (9709): 100-103.CrossRefPubMed
2.
Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R, et al: Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010, 375 (9730): 1969-1987.CrossRefPubMed
3.
UNICEF/WHO: Pneumonia: The forgotten killer of children. 2006
4.
Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H: Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008, 86 (5): 408-416.CrossRefPubMedPubMedCentral
5.
Arifeen SE, Hoque DM, Akter T, Rahman M, Hoque ME, Begum K, Chowdhury EK, Khan R, Blum LS, Ahmed S, et al: Effect of the integrated management of childhood illness strategy on childhood mortality and nutrition in a rural area in Bangladesh: a cluster randomised trial. Lancet. 2009, 374 (9687): 393-403.CrossRefPubMed
6.
van den Hoogen BG, de Jong JC, Groen J, Kuiken T, de Groot R, Fouchier RA, Osterhaus AD: A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001, 7 (6): 719-724.CrossRefPubMed
7.
van der Hoek L, Pyrc K, Jebbink MF, Vermeulen-Oost W, Berkhout RJ, Wolthers KC, Wertheim-van Dillen PM, Kaandorp J, Spaargaren J, Berkhout B: Identification of a new human coronavirus. Nat Med. 2004, 10 (4): 368-373.CrossRefPubMed
8.
Esper F, Weibel C, Ferguson D, Landry ML, Kahn JS: Evidence of a novel human coronavirus that is associated with respiratory tract disease in infants and young children. J Infect Dis. 2005, 191 (4): 492-498.CrossRefPubMed
9.
Woo PC, Lau SK, Chu CM, Chan KH, Tsoi HW, Huang Y, Wong BH, Poon RW, Cai JJ, Luk WK, et al: Characterization and complete genome sequence of a novel coronavirus, coronavirus HKU1, from patients with pneumonia. J Virol. 2005, 79 (2): 884-895.CrossRefPubMedPubMedCentral
10.
Lamson D, Renwick N, Kapoor V, Liu Z, Palacios G, Ju J, Dean A, George K, Briese T, Lipkin WI: MassTag polymerase-chain-reaction detection of respiratory pathogens, including a new rhinovirus genotype, that caused influenza-like illness in New York State during 2004–2005. J Infect Dis. 2006, 194 (10): 1398-1402.CrossRefPubMed
11.
Allander T, Tammi MT, Eriksson M, Bjerkner A, Tiveljung-Lindell A, Andersson B: Cloning of a human parvovirus by molecular screening of respiratory tract samples. Proc Natl Acad Sci U S A. 2005, 102 (36): 12891-12896.CrossRefPubMedPubMedCentral
12.
Allander T, Andreasson K, Gupta S, Bjerkner A, Bogdanovic G, Persson MA, Dalianis T, Ramqvist T, Andersson B: Identification of a third human polyomavirus. J Virol. 2007, 81 (8): 4130-4136.CrossRefPubMedPubMedCentral
13.
Gaynor AM, Nissen MD, Whiley DM, Mackay IM, Lambert SB, Wu G, Brennan DC, Storch GA, Sloots TP, Wang D: Identification of a novel polyomavirus from patients with acute respiratory tract infections. PLoS Pathog. 2007, 3 (5): e64-CrossRefPubMedPubMedCentral
14.
Furuse Y, Suzuki A, Kishi M, Galang HO, Lupisan SP, Olveda RM, Oshitani H: Detection of novel respiratory viruses from influenza-like illness in the Philippines. J Med Virol. 2010, 82 (6): 1071-1074.CrossRefPubMed
15.
16.
17.
WHO/UNICEF: Model IMCI handbook: Integrated management of childhood illness. 2005
18.
Clinical Practice Guidelines In The Evaluation and Management of Pediatric Community Acquired Pneumonia. 2008
19.
Gove S: Integrated management of childhood illness by outpatient health workers: technical basis and overview. The WHO working group on guidelines for integrated management of the sick child. Bull World Health Organ. 1997, 75 (Suppl 1): 7-24.PubMedPubMedCentral
20.
Quiambao BP, Ruutu PJ, Ladesma EA, Gozum LS, Inobaya MT, Lupisan SP, Sombrero LT, Romano V, Simoes EA: Pneumonia among young infants in rural Southeast Asia (Bohol Island, Philippines). Trop Med Int Health. 2009, 14 (12): 1457-1466.CrossRefPubMed
21.
Lupisan SP, Ruutu P, Erma Abucejo-Ladesma P, Quiambao BP, Gozum L, Sombrero LT, Romano V, Herva E, Riley I, Simoes EA: Predictors of death from severe pneumonia among children 2–59 months old hospitalized in Bohol, Philippines: implications for referral criteria at a first-level health facility. Trop Med Int Health. 2007, 12 (8): 962-971.CrossRefPubMed
22.
Lupisan SP, Herva E, Sombrero LT, Quiambao BP, Capeding MR, Abucejo PE, Esparar G, Arcay J, Ruutu P: Invasive bacterial infections of children in a rural province in the central Philippines. Am J Trop Med Hyg. 2000, 62 (3): 341-346.PubMed
23.
Lupisan SP, Ruutu P, Abucejo-Ladesma PE, Quiambao BP, Gozum L, Sombrero LT, Romano V, Riley I, Simoes EA: Central nervous system infection is an important cause of death in underfives hospitalised with World Health Organization (WHO) defined severe and very severe pneumonia. Vaccine. 2007, 25 (13): 2437-2444.CrossRefPubMed
24.
Bellau-Pujol S, Vabret A, Legrand L, Dina J, Gouarin S, Petitjean-Lecherbonnier J, Pozzetto B, Ginevra C, Freymuth F: Development of three multiplex RT-PCR assays for the detection of 12 respiratory RNA viruses. J Virol Methods. 2005, 126 (1–2): 53-63.CrossRefPubMed
25.
Kiang D, Yagi S, Kantardjieff KA, Kim EJ, Louie JK, Schnurr DP: Molecular characterization of a variant rhinovirus from an outbreak associated with uncommonly high mortality. J Clin Virol. 2007, 38 (3): 227-237.CrossRefPubMed
26.
Kiang D, Kalra I, Yagi S, Louie JK, Boushey H, Boothby J, Schnurr DP: Assay for 5' noncoding region analysis of all human rhinovirus prototype strains. J Clin Microbiol. 2008, 46 (11): 3736-3745.CrossRefPubMedPubMedCentral
27.
Peret TC, Hall CB, Hammond GW, Piedra PA, Storch GA, Sullender WM, Tsou C, Anderson LJ: Circulation patterns of group A and B human respiratory syncytial virus genotypes in 5 communities in North America. J Infect Dis. 2000, 181 (6): 1891-1896.CrossRefPubMed
28.
Savolainen C, Blomqvist S, Mulders MN, Hovi T: Genetic clustering of all 102 human rhinovirus prototype strains: serotype 87 is close to human enterovirus 70. J Gen Virol. 2002, 83 (Pt 2): 333-340.CrossRefPubMed
29.
Casas I, Avellon A, Mosquera M, Jabado O, Echevarria JE, Campos RH, Rewers M, Perez-Brena P, Lipkin WI, Palacios G: Molecular identification of adenoviruses in clinical samples by analyzing a partial hexon genomic region. J Clin Microbiol. 2005, 43 (12): 6176-6182.CrossRefPubMedPubMedCentral
30.
Tamura K, Dudley J, Nei M, Kumar S: MEGA4: Molecular Evolutionary Genetics Analysis (MEGA) software version 4.0. Mol Biol Evol. 2007, 24 (8): 1596-1599.CrossRefPubMed
31.
32.
Ruutu P, Halonen P, Meurman O, Torres C, Paladin F, Yamaoka K, Tupasi TE: Viral lower respiratory tract infections in Filipino children. J Infect Dis. 1990, 161 (2): 175-179.CrossRefPubMed
33.
Tupasi TE, Lucero MG, Magdangal DM, Mangubat NV, Sunico ME, Torres CU, de Leon LE, Paladin JF, Baes L, Javato MC: Etiology of acute lower respiratory tract infection in children from Alabang, Metro Manila. Rev Infect Dis. 1990, 12 (Suppl 8): S929-939.CrossRefPubMed
34.
Tupasi TE, de Leon LE, Lupisan S, Torres CU, Leonor ZA, Sunico ES, Mangubat NV, Miguel CA, Medalla F, Tan ST, et al: Patterns of acute respiratory tract infection in children: a longitudinal study in a depressed community in Metro Manila. Rev Infect Dis. 1990, 12 (Suppl 8): S940-949.CrossRefPubMed
35.
Yoshida LM, Suzuki M, Yamamoto T, Nguyen HA, Nguyen CD, Nguyen AT, Oishi K, Vu TD, Le TH, Le MQ, et al: Viral pathogens associated with acute respiratory infections in central vietnamese children. Pediatr Infect Dis J. 2009, 27: 75-77.
36.
Berkley JA, Munywoki P, Ngama M, Kazungu S, Abwao J, Bett A, Lassauniere R, Kresfelder T, Cane PA, Venter M, et al: Viral etiology of severe pneumonia among Kenyan infants and children. JAMA. 2010, 303 (20): 2051-2057.CrossRefPubMedPubMedCentral
37.
Power UF: Respiratory syncytial virus (RSV) vaccines–two steps back for one leap forward. J Clin Virol. 2008, 41 (1): 38-44.CrossRefPubMed
38.
Fitzgerald DA: Preventing RSV bronchiolitis in vulnerable infants: the role of palivizumab. Paediatr Respir Rev. 2009, 10 (3): 143-147.CrossRefPubMed
39.
Oshitani H, Kamigaki T, Suzuki A: Major issues and challenges of influenza pandemic preparedness in developing countries. Emerg Infect Dis. 2008, 14 (6): 875-880.CrossRefPubMedPubMedCentral
40.
Duke T, Wandi F, Jonathan M, Matai S, Kaupa M, Saavu M, Subhi R, Peel D: Improved oxygen systems for childhood pneumonia: a multihospital effectiveness study in Papua New Guinea. Lancet. 2008, 372 (9646): 1328-1333.CrossRefPubMed
41.
Lau SK, Yip CC, Lin AW, Lee RA, So LY, Lau YL, Chan KH, Woo PC, Yuen KY: Clinical and molecular epidemiology of human rhinovirus C in children and adults in Hong Kong reveals a possible distinct human rhinovirus C subgroup. J Infect Dis. 2009, 200 (7): 1096-1103.CrossRefPubMed
42.
Calvo C, Casas I, Garcia-Garcia ML, Pozo F, Reyes N, Cruz N, Garcia-Cuenllas L, Perez-Brena P: Role of rhinovirus c respiratory infections in sick and healthy children in Spain. Pediatr Infect Dis J. 2010, 29: 717-720.CrossRefPubMed
43.
Xiang Z, Gonzalez R, Xie Z, Xiao Y, Liu J, Chen L, Liu C, Zhang J, Ren L, Vernet G, et al: Human rhinovirus C infections mirror those of human rhinovirus A in children with community-acquired pneumonia. J Clin Virol. 2010, 49 (2): 94-99.CrossRefPubMed
44.
van den Hoogen BG, Osterhaus DM, Fouchier RA: Clinical impact and diagnosis of human metapneumovirus infection. Pediatr Infect Dis J. 2004, 23 (1 Suppl): S25-32.CrossRefPubMed
45.
Mathisen M, Strand TA, Sharma BN, Chandyo RK, Valentiner-Branth P, Basnet S, Adhikari RK, Hvidsten D, Shrestha PS, Sommerfelt H: RNA viruses in community-acquired childhood pneumonia in semi-urban Nepal; a cross-sectional study. BMC Med. 2009, 7: 35-CrossRefPubMedPubMedCentral
46.
Capeding MR, Sombrero LT, Paladin FJ, Suzuki H, Numazaki Y, Saniel MC: Etiology of acute lower respiratory infection in Filipino children under five years. Southeast Asian J Trop Med Public Health. 1994, 25 (4): 684-687.PubMed
47.
Berkley JA, Versteeg AC, Mwangi I, Lowe BS, Newton CR: Indicators of acute bacterial meningitis in children at a rural Kenyan district hospital. Pediatrics. 2004, 114 (6): e713-719.CrossRefPubMed
48.
Reiche J, Schweiger B: Genetic variability of group A human respiratory syncytial virus strains circulating in Germany from 1998 to 2007. J Clin Microbiol. 2009, 47 (6): 1800-1810.CrossRefPubMedPubMedCentral
49.
Gaunt ER, Jansen RR, Poovorawan Y, Templeton KE, Toms GL, Simmonds P: Molecular epidemiology and evolution of human respiratory syncytial virus and human metapneumovirus. PLoS ONE. 2011, 6 (3): e17427-CrossRefPubMedPubMedCentral
50.
Hayashi S, Hogg JC: Adenovirus infections and lung disease. Curr Opin Pharmacol. 2007, 7 (3): 237-243.CrossRefPubMed
51.
Berk AJ: Adenoviridae:The Viruses and Their Replication. Fields Virology. Edited by: Knipe DM, Howley PM. 2007, Lippincott Williams & Wilkins, Philadelphia, 2355-2394. 5
52.
Dizbay M, Tunccan OG, Sezer BE, Aktas F, Arman D: Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance. J Infect Dev Ctries. 2009, 3 (4): 273-277.PubMed
53.
Loukil C, Saizou C, Doit C, Bidet P, Mariani-Kurkdjian P, Aujard Y, Beaufils F, Bingen E: Epidemiologic investigation of Burkholderia cepacia acquisition in two pediatric intensive care units. Infect Control Hosp Epidemiol. 2003, 24 (9): 707-710.CrossRefPubMed
54.
Govan JR, Hughes JE, Vandamme P: Burkholderia cepacia: medical, taxonomic and ecological issues. J Med Microbiol. 1996, 45 (6): 395-407.CrossRefPubMed
55.
Waterer GW, Jones CB, Wunderink RG: Bacteremic community-acquired pneumonia in an immunocompetent adult due to Burkholderia cepacia. Chest. 1999, 116 (6): 1842-1843.CrossRefPubMed
56.
Romero-Gomez MP, Quiles-Melero MI, Pena Garcia P, Gutierrez Altes A, Garcia de Miguel MA, Jimenez C, Valdezate S, Saez Nieto JA: Outbreak of Burkholderia cepacia bacteremia caused by contaminated chlorhexidine in a hemodialysis unit. Infect Control Hosp Epidemiol. 2008, 29 (4): 377-378.CrossRefPubMed
57.
Shah SS, Dugan MH, Bell LM, Grundmeier RW, Florin TA, Hines EM, Metlay JP: Blood cultures in the emergency department evaluation of childhood pneumonia. Pediatr Infect Dis J. 2011, 30 (6): 475-479.PubMedPubMedCentral
58.
Lynch T, Bialy L, Kellner JD, Osmond MH, Klassen TP, Durec T, Leicht R, Johnson DW: A systematic review on the diagnosis of pediatric bacterial pneumonia: when gold is bronze. PLoS ONE. 2010, 5 (8): e11989-CrossRefPubMedPubMedCentral
59.
Ruuskanen O, Mertsola J: Childhood community-acquired pneumonia. Semin Respir Infect. 1999, 14 (2): 163-172.PubMed
60.
Vuori-Holopainen E, Salo E, Saxen H, Hedman K, Hyypia T, Lahdenpera R, Leinonen M, Tarkka E, Vaara M, Peltola H: Etiological diagnosis of childhood pneumonia by use of transthoracic needle aspiration and modern microbiological methods. Clin Infect Dis. 2002, 34 (5): 583-590.CrossRefPubMed
61.
Sombrero L, Nissinen A, Esparar G, Lindgren M, Siira L, Virolainen A: Low incidence of antibiotic resistance among invasive and nasopharyngeal isolates of Streptococcus pneumoniae from children in rural Philippines between 1994 and 2000. Eur J Clin Microbiol Infect Dis. 2008, 27 (10): 929-935.CrossRefPubMed
62.
Nickerson EK, West TE, Day NP, Peacock SJ: Staphylococcus aureus disease and drug resistance in resource-limited countries in south and east Asia. Lancet Infect Dis. 2009, 9 (2): 130-135.CrossRefPubMed
63.
Markowitz RB, Thompson HC, Mueller JF, Cohen JA, Dynan WS: Incidence of BK virus and JC virus viruria in human immunodeficiency virus-infected and -uninfected subjects. J Infect Dis. 1993, 167 (1): 13-20.CrossRefPubMed
64.
Richman DD, Murphy BR, Baron S, Uhlendorf C: Three strains of influenza A virus (H3N2): interferon sensitivity in vitro and interferon production in volunteers. J Clin Microbiol. 1976, 3 (3): 223-226.PubMedPubMedCentral
Metadata
Title
Respiratory viruses from hospitalized children with severe pneumonia in the Philippines
Authors
Akira Suzuki
Socorro Lupisan
Yuki Furuse
Naoko Fuji
Mariko Saito
Raita Tamaki
Hazel Galang
Lydia Sombrero
Melisa Mondoy
Rapunzel Aniceto
Remigio Olveda
Hitoshi Oshitani
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2012
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-12-267

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