Skip to main content
Top
Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | Respiratory Syncytial Virus Infection | Research article

Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou

Authors: Jiahong Tan, Jinfeng Wu, Wujun Jiang, Li Huang, Wei Ji, Yongdong Yan, Meijuan Wang, Xuejun Shao

Published in: BMC Infectious Diseases | Issue 1/2021

Login to get access

Abstract

Background

Bronchiolitis is a clinical syndrome commonly encountered in practice, particularly among infants and young children. To investigate the prevalence of pathogens in hospitalized children with bronchiolitis and study the clinical characteristics of bronchiolitis with or without coinfections.

Methods

We investigated the respiratory specimens and clinical data of 1012 children with bronchiolitis who were treated at the Children’s Hospital of Soochow University between November 2011 and December 2018. The nasopharyngeal aspirates were examined to detect viruses by direct immunofluorescence assay or polymerase chain reaction (PCR). Mycoplasma pneumoniae (MP) was tested by PCR and enzyme-linked immunosorbent assay.

Results

Of the 1134 children less than 2 years with bronchiolitis, 122 were excluded by exclusion criteria. Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). Coinfection was identified in 13.5% (137 of 1012) of the patients. Coinfection included mixed virus infection and virus infection with MP infection. Children with single virus infection had a higher rate of oxygen therapy compared with single MP infection.

Conclusions

The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia.
Literature
1.
go back to reference Midulla F, Petrarca L, Frassanito A, et al. Bronchiolitis clinics and medical treatment. Minerva Pediatr. 2018;70(6):600–11.CrossRef Midulla F, Petrarca L, Frassanito A, et al. Bronchiolitis clinics and medical treatment. Minerva Pediatr. 2018;70(6):600–11.CrossRef
2.
go back to reference Simes EAF, Bont L, Manzoni P, et al. Past, present and future approaches to the prevention and treatment of respiratory syncytial virus infection in children. Infect Dis Ther. 2018;7(1):87–120.CrossRef Simes EAF, Bont L, Manzoni P, et al. Past, present and future approaches to the prevention and treatment of respiratory syncytial virus infection in children. Infect Dis Ther. 2018;7(1):87–120.CrossRef
3.
go back to reference Kp K, Lee S. Complementary and alternative medicine for the treatment of bronchiolitis in infants: a systematic review. PLoS One. 2017;12(2):e0172289.CrossRef Kp K, Lee S. Complementary and alternative medicine for the treatment of bronchiolitis in infants: a systematic review. PLoS One. 2017;12(2):e0172289.CrossRef
4.
go back to reference Shawn L, Ralston AS, et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 2015;136(4):782. Shawn L, Ralston AS, et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 2015;136(4):782.
5.
go back to reference Zhang QL, Guo ZQ, Langle, et al. Respiratory syncytial virus-associated intensive care unit admission in children in Southern China. BMC Res Notes. 2013;6:447.CrossRef Zhang QL, Guo ZQ, Langle, et al. Respiratory syncytial virus-associated intensive care unit admission in children in Southern China. BMC Res Notes. 2013;6:447.CrossRef
6.
go back to reference Shi T, McAllister DA, O’Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946–58.CrossRef Shi T, McAllister DA, O’Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946–58.CrossRef
7.
go back to reference Pavilack M, Clifford RA, Gonzales T, et al. Trends in utilization of outpatient respiratory syncytial virus prophylaxis with Palivizumab among Medicaid- and commercially insured infants. Infect Dis Ther. 2018;7(1):121–34.CrossRef Pavilack M, Clifford RA, Gonzales T, et al. Trends in utilization of outpatient respiratory syncytial virus prophylaxis with Palivizumab among Medicaid- and commercially insured infants. Infect Dis Ther. 2018;7(1):121–34.CrossRef
8.
go back to reference Vandini S, Biagi C, Lanari M, et al. Respiratory syncytial virus: the influence of serotype and genotype variability on clinical course of infection. Int J Mol Sci. 2017;18(8):1717.CrossRef Vandini S, Biagi C, Lanari M, et al. Respiratory syncytial virus: the influence of serotype and genotype variability on clinical course of infection. Int J Mol Sci. 2017;18(8):1717.CrossRef
9.
go back to reference Anderson E, Carbonell-Estrany X, Blanken M, et al. Burden of severe respiratory syncytial virus disease among 33–35 weeks’ gestational age infants born during multiple respiratory syncytial virus seasons. Pediatr Infect Dis J. 2017;36(2):160–7.CrossRef Anderson E, Carbonell-Estrany X, Blanken M, et al. Burden of severe respiratory syncytial virus disease among 33–35 weeks’ gestational age infants born during multiple respiratory syncytial virus seasons. Pediatr Infect Dis J. 2017;36(2):160–7.CrossRef
10.
go back to reference American Academy of Pediatrics Subcommittee. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774–93.CrossRef American Academy of Pediatrics Subcommittee. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774–93.CrossRef
11.
go back to reference Bezerra PGM, Britto MCA, Correia JB, et al. Viral and atypical bacterial detection in acute respiratory infection in children under five years. PLoS One. 2011;6(4):e18928.CrossRef Bezerra PGM, Britto MCA, Correia JB, et al. Viral and atypical bacterial detection in acute respiratory infection in children under five years. PLoS One. 2011;6(4):e18928.CrossRef
12.
go back to reference Zirakishvili D, Chkhaidze I, Barnabishvili N, et al. Mycoplasma Pneumoniae and Chlamydophila pneumoniae in hospitalized children with bronchiolitis. Georg Med News. 2015;240:73–8. Zirakishvili D, Chkhaidze I, Barnabishvili N, et al. Mycoplasma Pneumoniae and Chlamydophila pneumoniae in hospitalized children with bronchiolitis. Georg Med News. 2015;240:73–8.
13.
go back to reference Yanhong L, Xinxing Z, Yongdong Y, et al. Effects of mixed infection factors on refractory mycoplasma pneumoniae. J Clin Pediatr. 2017;35(2):81–5. Yanhong L, Xinxing Z, Yongdong Y, et al. Effects of mixed infection factors on refractory mycoplasma pneumoniae. J Clin Pediatr. 2017;35(2):81–5.
14.
go back to reference Ben-Shmuel A, Sheiner E, Wainstock T, et al. The association between gender and pediatric respiratory morbidity. Pediatr Pulmonol. 2018;53(9):1225–30.CrossRef Ben-Shmuel A, Sheiner E, Wainstock T, et al. The association between gender and pediatric respiratory morbidity. Pediatr Pulmonol. 2018;53(9):1225–30.CrossRef
15.
go back to reference Xiaobo Z, Lijuan L, Peng S, et al. Risk factors for acute respiratory syncytial virus infection of lower respiratory tract in hospitalized infants. Chin J Pediatr. 2014;52(5):373–7. Xiaobo Z, Lijuan L, Peng S, et al. Risk factors for acute respiratory syncytial virus infection of lower respiratory tract in hospitalized infants. Chin J Pediatr. 2014;52(5):373–7.
16.
go back to reference De Jacobis IT, Vona R, Straface E, et al. Sex differences in blood pro-oxidant status and platelet activation in children admitted with respiratory syncytial virus bronchiolitis: a pilot study. Ital J Pediatr. 2020;46(1):29.CrossRef De Jacobis IT, Vona R, Straface E, et al. Sex differences in blood pro-oxidant status and platelet activation in children admitted with respiratory syncytial virus bronchiolitis: a pilot study. Ital J Pediatr. 2020;46(1):29.CrossRef
17.
go back to reference Kathryn EM, Tebeb G, Carroll KN, et al. Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J. 2013;32(9):950–5.CrossRef Kathryn EM, Tebeb G, Carroll KN, et al. Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J. 2013;32(9):950–5.CrossRef
18.
go back to reference Hervas D, Reina J, Yanez A, et al. Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis. 2012;31(8):1975–81.CrossRef Hervas D, Reina J, Yanez A, et al. Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis. 2012;31(8):1975–81.CrossRef
19.
go back to reference Praznik A, Vinsek N, Erculj V, et al. Risk factors for bronchiolitis severity: a retrospective review of patients admitted to the university hospital from central region of Slovenia. Influ Other Respi Viruses. 2018;12(6):76–771. Praznik A, Vinsek N, Erculj V, et al. Risk factors for bronchiolitis severity: a retrospective review of patients admitted to the university hospital from central region of Slovenia. Influ Other Respi Viruses. 2018;12(6):76–771.
20.
go back to reference Hall CB, Weinberg GA, Blumkin AK, et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics. 2013;132(2):e341.CrossRef Hall CB, Weinberg GA, Blumkin AK, et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics. 2013;132(2):e341.CrossRef
21.
go back to reference Mecklin M, Heikkila P, Korppi M. Low age, low birthweight and congenital heart disease are risk factors for intensive care in infants with bronchiolitis. Acta Pacdiatr. 2017;106(12):2004–10.CrossRef Mecklin M, Heikkila P, Korppi M. Low age, low birthweight and congenital heart disease are risk factors for intensive care in infants with bronchiolitis. Acta Pacdiatr. 2017;106(12):2004–10.CrossRef
22.
go back to reference Ramos-Fermandez JM, Hernandez-Yuste A, Cordon Martinez AM, et al. Does exposure of pregnant women to epidemic respiratory syncytial virus affect the severity of bronchiolitis? Enferm Infect Microbiol Clin. 2019;37(4):251–5.CrossRef Ramos-Fermandez JM, Hernandez-Yuste A, Cordon Martinez AM, et al. Does exposure of pregnant women to epidemic respiratory syncytial virus affect the severity of bronchiolitis? Enferm Infect Microbiol Clin. 2019;37(4):251–5.CrossRef
23.
go back to reference Pientong C, Ekalaksananan T, Teeratakulpisarn J, et al. Atypical bacterial pathogen infection in children with acute bronchiolitis in Northeast Thailand. J Microbiol Immunol Infect. 2011;44:95–100.CrossRef Pientong C, Ekalaksananan T, Teeratakulpisarn J, et al. Atypical bacterial pathogen infection in children with acute bronchiolitis in Northeast Thailand. J Microbiol Immunol Infect. 2011;44:95–100.CrossRef
24.
go back to reference Jonathan M, Pedro A, Stephen J, et al. Prospective, multicenter study of viral etiology and hospital length-of-stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med. 2013;166(8):700–6. Jonathan M, Pedro A, Stephen J, et al. Prospective, multicenter study of viral etiology and hospital length-of-stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med. 2013;166(8):700–6.
25.
go back to reference Gokce S, Kurugol Z, Cerit Z, et al. The effect of respiratory syncytial virus on the severity of acute bronchiolitis in hospitalized infants : a prospective study from Turkey. Iran J Pediatr. 2018;28(2):0–5.CrossRef Gokce S, Kurugol Z, Cerit Z, et al. The effect of respiratory syncytial virus on the severity of acute bronchiolitis in hospitalized infants : a prospective study from Turkey. Iran J Pediatr. 2018;28(2):0–5.CrossRef
26.
go back to reference Nascimento MS, Andre I, Rodrigues JC, et al. High rate of viral identification and Coinfections in infants with acute bronchiolitis. Clin Sci. 2010;65(11):1133–7. Nascimento MS, Andre I, Rodrigues JC, et al. High rate of viral identification and Coinfections in infants with acute bronchiolitis. Clin Sci. 2010;65(11):1133–7.
27.
go back to reference Marwa Ghazaly SN. Characteristics of children admitted to intensive care with acute bronchiolitis. Eur J Pediatr. 2018;177(6):913–20.CrossRef Marwa Ghazaly SN. Characteristics of children admitted to intensive care with acute bronchiolitis. Eur J Pediatr. 2018;177(6):913–20.CrossRef
28.
go back to reference Nathalie R, Florence KP, Etienne J, et al. The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J. 2008;27(3):213–7.CrossRef Nathalie R, Florence KP, Etienne J, et al. The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J. 2008;27(3):213–7.CrossRef
29.
go back to reference Petrarca L, Nenna R, Frassanito A, et al. Acute bronchiolitis: influence of viral coinfection in infants hospitalized over 12 consecutive epidemic seasons. J Med Virol. 2018;90(4):631–8.CrossRef Petrarca L, Nenna R, Frassanito A, et al. Acute bronchiolitis: influence of viral coinfection in infants hospitalized over 12 consecutive epidemic seasons. J Med Virol. 2018;90(4):631–8.CrossRef
30.
go back to reference Chen YW, Huang YC, Ho TH, et al. Viral etiology of bronchiolitis among pediatric inpatients in northern Taiwan with emphasis on newly identified respiratory viruses. J Microbiol Immunol Infect. 2014;47(2):116–21.CrossRef Chen YW, Huang YC, Ho TH, et al. Viral etiology of bronchiolitis among pediatric inpatients in northern Taiwan with emphasis on newly identified respiratory viruses. J Microbiol Immunol Infect. 2014;47(2):116–21.CrossRef
31.
go back to reference de Souza APD, de Azeredo Leitao LA, Luisi F, et al. Lack of association between viral load and severity of acute bronchiolitis in infants. J Bras Pneumol. 2016;42(4):261–5.CrossRef de Souza APD, de Azeredo Leitao LA, Luisi F, et al. Lack of association between viral load and severity of acute bronchiolitis in infants. J Bras Pneumol. 2016;42(4):261–5.CrossRef
32.
go back to reference Zorc JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics. 2010;125(2):342–9.CrossRef Zorc JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics. 2010;125(2):342–9.CrossRef
33.
go back to reference Sarah H, Genie R, Sara D, et al. Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis. Pediatrics. 2012;129(3):e605–10.CrossRef Sarah H, Genie R, Sara D, et al. Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis. Pediatrics. 2012;129(3):e605–10.CrossRef
34.
go back to reference Marie G, Melanie V, Sylvain M, et al. Impact of home oxygen therapy on hospital stay for infants with acute bronchiolitis. Eur J Pediatr. 2012;171(12):1839–44.CrossRef Marie G, Melanie V, Sylvain M, et al. Impact of home oxygen therapy on hospital stay for infants with acute bronchiolitis. Eur J Pediatr. 2012;171(12):1839–44.CrossRef
35.
go back to reference Denver N, Brett L, Arvind B, et al. Retrospective review of clinical and chest X-ray findings in children admitted to a Community Hospital for Respiratory Syncytial Virus Infection. Clin Pediatr (Phila). 2018;57(14):1686–92.CrossRef Denver N, Brett L, Arvind B, et al. Retrospective review of clinical and chest X-ray findings in children admitted to a Community Hospital for Respiratory Syncytial Virus Infection. Clin Pediatr (Phila). 2018;57(14):1686–92.CrossRef
Metadata
Title
Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou
Authors
Jiahong Tan
Jinfeng Wu
Wujun Jiang
Li Huang
Wei Ji
Yongdong Yan
Meijuan Wang
Xuejun Shao
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-021-05772-x

Other articles of this Issue 1/2021

BMC Infectious Diseases 1/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.