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BMC Pediatrics
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009–2014

Authors: Jiayi Chen, Pengwei Hu, Tao Zhou, Tianli Zheng, Lingxu Zhou, Chunping Jiang, Xiaofang Pei

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

Acute respiratory infection (ARI) is the leading cause of morbidity and mortality in pediatric patients worldwide and imposes an intense pressure on health care facilities. Data on the epidemiology profiles of ARIs are scarce in the western and rural areas of China. The purpose of the current study is to provide data on the presence of potential pathogens of ARIs in hospitalized children in Chengdu, west China.

Methods

Respiratory specimens were obtained from hospitalized patients (under 6 years old) with ARIs in a local hospital in Chengdu. Eight respiratory viruses were identified by PCR and 6 respiratory bacteria by biochemical reactions and Analytical Profile Index (API). Pathogens profiles, clinical characteristics and seasonality were analyzed.

Results

Fifty-one percent of patients were identified with at least one respiratory pathogen. Human rhinovirus (HRV) (23%), Respiratory syncytial virus (RSV) (22.7%) was the most commonly identified viruses, with Klebsiella pneumoniae (11.5%) the most commonly identified bacterium in the study. The presences of more than one pathogen were found, and multiple viral, bacterial, viral/bacterial combinations were identified in 14.9, 3.3 and 13.9% of patients respectively. Respiratory viruses were identified throughout the year with a seasonal peak in December–February. Pathogens profiles and clinical associations were different between infants (< 1 year of age) and older children (> 1 year of age). Infants with ARIs were more likely to have one or more viruses than older children. Infants identified with multiple pathogens had significantly higher proportions of tachypnea than infants that were not.

Conclusions

This study demonstrated that viral agents were frequently found in hospitalized children with ARI in Chengdu during the study period. This study gives us better information on the pathogen profiles, clinical associations, co-infection combinations and seasonal features of ARIs in hospitalized children, which is important for diagnoses and treatment of ARIs, as well as implementation of vaccines in this area. Moreover, future efforts in reducing the impact of ARIs will depend on programs in which available vaccines, especially vaccines on RSV, HRV and S. pneumoniae could be employed in this region and new vaccines could be developed against common pathogens.
Literature
1.
Shi T, McLean K, Campbell H, Nair H. Aetiological role of common respiratory viruses in acute lower respiratory infections in children under five years: A systematic review and meta-analysis. J Glob Health. 2015;5:010408.PubMedPubMedCentral
2.
Nair H, Simões EAF, Rudan I, Gessner BD, Azziz-Baumgartner E, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381:1380–90.CrossRefPubMedPubMedCentral
3.
Rudan I, Chan KY, Zhang JSF, Theodoratou E, Feng XL, et al. Causes of death in children younger than 5 years in China in 2008. Lancet. 2010;375:1083–9.CrossRefPubMed
4.
Liu L, Oza S, Hogan D, Perin J, Rudan I, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385:430–40.CrossRefPubMed
5.
Doan Q, Enarson P, Kissoon N, Klassen TP, Johnson DW. Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department. Cochrane Database Syst Rev. 2014;15(9):CD006452.
6.
Sung RY, Chan PK, Tsen T, Li AM, Lam WY, et al. Identification of viral and atypical bacterial pathogens in children hospitalized with acute respiratory infections in Hong Kong by multiplex PCR assays. J Med Virol. 2009;81:153–9.CrossRefPubMed
7.
8.
Tregoning JS, Schwarze J. Respiratory viral infections in infants: causes, clinical symptoms, virology, and immunology. Clin Microbiol Rev. 2010;23:74–98.CrossRefPubMedPubMedCentral
9.
Zhang Y, Yuan L, Zhang Y, Zhang X, Zheng M, et al. Burden of respiratory syncytial virus infections in China: Systematic review and meta-analysis. J Glob Health. 2015;5:020417.CrossRefPubMedPubMedCentral
10.
Nair H, Brooks WA, Katz M, Roca A, Berkley JA, et al. Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Lancet. 2011;378:1917–30.CrossRefPubMed
11.
Dong W, Chen Q, Hu Y, He D, Liu J, et al. Epidemiological and clinical characteristics of respiratory viral infections in children in Shanghai. China Arch Virol. 2016;161:1907–13.CrossRefPubMed
12.
Wang H, Zheng Y, Deng J, Wang W, Liu P, et al. Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen. China Virol J. 2016;13:39.CrossRefPubMed
13.
Cai X, Wang Q, Lin G, Cai Z, Lin C-X, et al. Respiratory Virus Infections Among Children in South China. J Med Virol. 2014;86:1249–55.CrossRefPubMed
14.
Zhang C, Zhu N, Xie Z, Lu R, He B, et al. Viral etiology and clinical profiles of children with severe acute respiratory infections in China. PLoS One. 2013;8:e72606.CrossRefPubMedPubMedCentral
15.
Jiao W. Analysis on Influenza Vaccination Status in Chengdu, 2010–2013. J Prev Med Inf. 2015;31:688–90.
16.
Coiras M, Pérez-Breña P, García M, Casas I. Simultaneous detection of influenza A, B, and C viruses, respiratory syncytial virus, and adenoviruses in clinical samples by multiplex reverse transcription nested-PCR assay. J Med Virol. 2003;69:132–44.CrossRefPubMed
17.
Coiras MT, Aguilar JC, García ML, Casas I, Pérez-Breña P. Simultaneous detection of fourteen respiratory viruses in clinical specimens by two multiplex reverse transcription nested-PCR assays. J Med Virol. 2004;72:484–95.CrossRefPubMed
18.
Allard A, Girones R, Juto P, Wadell G. Polymerase chain reaction for detection of adenoviruses in stools samples. J Clin Microbiol. 1991;29:2683.PubMedPubMedCentral
19.
Woo PCY, Lau SKP, Chu C-M, Chan K-H, Tsoi H-W, et al. Characterization and complete genome sequence of a novel coronavirus, coronavirus HKU1, from patients with pneumonia. J Virol. 2005;79:884–95.CrossRefPubMedPubMedCentral
20.
Kapoor A, Simmonds P, Slikas E, Li L, Bodhidatta L, et al. Human Bocaviruses Are Highly Diverse, Dispersed Recombination Prone, and Prevalent in Enteric Infections. J Infect Dis. 2010;201:1633–43.CrossRefPubMedPubMedCentral
21.
Liu J, Ai H, Xiong Y, Li F, Wen Z, et al. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China. PLoS One. 2015;10:e0119170.CrossRefPubMedPubMedCentral
22.
Jin Y, Zhang RF, Xie ZP, Yan KL, Gao HC, et al. Newly identified respiratory viruses associated with acute lower respiratory tract infections in children in Lanzou, China, from 2006 to 2009. Clin Microbiol Infect. 2012;18:74–80.CrossRefPubMed
23.
Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–55.
24.
Agoti CN, Mwihuri AG, Sande CJ, Onyango CO, Medley GF, et al. Genetic relatedness of infecting and reinfecting respiratory syncytial virus strains identified in a birth cohort from rural Kenya. J Infect Dis. 2012;206:1532–41.CrossRefPubMedPubMedCentral
25.
Hu P, Zheng T, Chen J, Zhou T, Chen Y, et al. Alternate circulation and genetic variation of human respiratory syncytial virus genotypes in Chengdu, West China, 2009–2014. J Med Virol. 2017;89:32–40.CrossRefPubMed
26.
27.
Message SD, Laza-Stanca V, Mallia P, Parker HL, Zhu J, et al. Rhinovirus-induced lower respiratory illness is increased in asthma and related to virus load and Th1/2 cytokine and IL-10 production. Proc Natl Acad Sci U S A. 2008;105:13562–7.CrossRefPubMedPubMedCentral
28.
Gern JE, Brooks GD, Meyer P, Chang A, Shen K, et al. Bidirectional interactions between viral respiratory illnesses and cytokine responses in the first year of life. J Allergy Clin Immunol. 2006;117:72–8.CrossRefPubMed
29.
Cilla G, Onate E, Perez-Yarza EG, Montes M, Vicente D, et al. Viruses in community-acquired pneumonia in children aged less than 3 years old: High rate of viral coinfection. J Med Virol. 2008;80:1843–9.CrossRefPubMed
30.
Asner SA, Science ME, Tran D, Smieja M, Merglen A, et al. Clinical disease severity of respiratory viral co-infection versus single viral infection: a systematic review and meta-analysis. PLoS One. 2014;9:e99392.CrossRefPubMedPubMedCentral
31.
Franz A, Adams O, Willems R, Bonzel L, Neuhausen N, et al. Correlation of viral load of respiratory pathogens and co-infections with disease severity in children hospitalized for lower respiratory tract infection. J Clin Virol. 2010;48:239–45.CrossRefPubMed
32.
Martin ET, Kuypers J, Wald A, Englund JA. Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children. Influenza Other Respir Viruses. 2012;6:71–7.CrossRefPubMed
33.
Goka EA, Vallely PJ, Mutton KJ, Klapper PE. Single, dual and multiple respiratory virus infections and risk of hospitalization and mortality. Epidemiol Infect. 2015;143:37–47.CrossRefPubMed
34.
35.
Nohynek H, Madhi S, Grijalva CG. Childhood bacterial respiratory diseases: past, present, and future. Pediatr Infect Dis J. 2009;28:S127–32.CrossRefPubMed
36.
UNICEF. Pneumonia The Forgotten Killer of Children. New York and Geneva: UNICEF/WHO; 2006.
37.
Ma HM, Lee KP, Woo J. Predictors of viral pneumonia: The need for viral testing in all patients hospitalized for nursing home-acquired pneumonia. Geriatr Gerontol Int. 2013;13:949–57.CrossRefPubMed
38.
Watt JP, Wolfson LJ, o’Brien KL, Henkle E. knoll MD, et al. Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates. Lancet. 2009;374:903–11.CrossRefPubMed
39.
O’Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, et al. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet. 2009;374:893–902.CrossRefPubMed
40.
Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381:1405–16.CrossRefPubMed
41.
Poll Tvd OSM. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. Lancet. 2009;374:1543–56.CrossRef
42.
Thorburn K, Riordan A. Pulmonary bacterial coinfection in infants and children with viral respiratory infection. Expert Rev Anti-Infect Ther. 2012;10:909–16.CrossRefPubMed
43.
McCullers JA. The co-pathogenesis of influenza viruses with bacteria in the lung. Nat Rev Microbiol. 2014;12:252–62.CrossRefPubMed
44.
Bosch AA, Biesbroek G, Trzcinski K, Sanders EA, Bogaert D. Viral and bacterial interactions in the upper respiratory tract. PLoS Pathog. 2013;9:e1003057.CrossRefPubMedPubMedCentral
45.
46.
Nguyen T, Kyle UG, Jaimon N, Tcharmtchi MH, Coss-Bu JA, et al. Coinfection with Staphylococcus aureus increases risk of severe coagulopathy in critically ill children with influenza A (H1N1) virus infection. Crit Care Med. 2012;40:3246–50.CrossRefPubMedPubMedCentral
Metadata
Title
Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009–2014
Authors
Jiayi Chen
Pengwei Hu
Tao Zhou
Tianli Zheng
Lingxu Zhou
Chunping Jiang
Xiaofang Pei
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1203-y

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