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Dian Z, Sun Y, Zhang G, Xu Y, Fan X, Yang X, Pan Q, Peppelenbosch M, Miao Z. Rotavirus-related systemic diseases: clinical manifestation, evidence and pathogenesis. Crit Rev Microbiol 2021; 47:580-595. [PMID: 33822674 DOI: 10.1080/1040841x.2021.1907738] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Rotaviruses, double-stranded, non-enveloped RNA viruses, are a global health concern, associated with acute gastroenteritis and secretory-driven watery diarrhoea, especially in infants and young children. Conventionally, rotavirus is primarily viewed as a pathogen for intestinal enterocytes. This notion is challenged, however, by data from patients and animal models documenting extra-intestinal clinical manifestations and viral replication following rotavirus infection. In addition to acute gastroenteritis, rotavirus infection has been linked to various neurological disorders, hepatitis and cholestasis, type 1 diabetes, respiratory illness, myocarditis, renal failure and thrombocytopenia. Concomitantly, molecular studies have provided insight into potential mechanisms by which rotavirus can enter and replicate in non-enterocyte cell types and evade host immune responses. Nevertheless, it is fair to say that the extra-intestinal aspect of the rotavirus infectious process is largely being overlooked by biomedical professionals, and there are gaps in the understanding of mechanisms of pathogenesis. Thus with the aim of increasing public and professional awareness we here provide a description of our current understanding of rotavirus-related extra-intestinal clinical manifestations and associated molecular pathogenesis. Further understanding of the processes involved should prove exceedingly useful for future diagnosis, treatment and prevention of rotavirus-associated disease.
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Affiliation(s)
- Ziqin Dian
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Yi Sun
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Guiqian Zhang
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Ya Xu
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Xin Fan
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Xuemei Yang
- Department of Clinical laboratory, Kunming Children's Hospital, Kunming, Yunnan, China
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Maikel Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Zhijiang Miao
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
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Seo YB, Song JY, Choi MJ, Kim IS, Yang TU, Hong KW, Cheong HJ, Kim WJ. Etiology and clinical outcomes of acute respiratory virus infection in hospitalized adults. Infect Chemother 2014; 46:67-76. [PMID: 25024868 PMCID: PMC4091371 DOI: 10.3947/ic.2014.46.2.67] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 02/24/2014] [Accepted: 03/17/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Etiologies and clinical profiles of acute respiratory viral infections need to be clarified to improve preventive and therapeutic strategies. MATERIALS AND METHODS A retrospective observational study at a single, university-affiliated center was performed to evaluate the respiratory viral infection etiologies in children compared to that in adults and to document the clinical features of common viral infections for adults from July 2009 to April 2012. RESULTS The common viruses detected from children (2,800 total patients) were human rhinovirus (hRV) (31.8%), adenovirus (AdV) (19.2%), respiratory syncytial virus (RSV) A (17.4%), RSV B (11.7%), and human metapneumovirus (hMPV) (9.8%). In comparison, influenza virus A (IFA) had the highest isolation rate (28.5%), followed by hRV (15.5%), influenza virus B (IFB) (15.0%), and hMPV (14.0%), in adults (763 total patients). Multiple viruses were detected in single specimens from 22.4% of children and 2.0% of adults. IFA/IFB, RSV A/B, and hMPV exhibited strong seasonal detection and similar circulating patterns in children and adults. Adult patients showed different clinical manifestations according to causative viruses; nasal congestion and rhinorrhea were more common in hRV and human coronavirus (hCoV) infection. Patients with RSV B, hRV, or AdV tended to be younger, and those infected with RSV A and hMPV were likely to be older. Those with RSV A infection tended to stay longer in hospital, enter the intensive care unit more frequently, and have a fatal outcome more often. The bacterial co-detection rate was 26.5%, and those cases were more likely to have lower respiratory tract involvement (P = 0.001), longer hospital stay (P = 0.001), and higher mortality (P = 0.001). CONCLUSIONS The etiologic virus of an acute respiratory infection can be cautiously inferred based on a patient's age and clinical features and concurrent epidemic data. Large-scale prospective surveillance studies are required to provide more accurate information about respiratory viral infection etiology, which could favorably influence clinical outcomes.
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Affiliation(s)
- Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Min Ju Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - In Seon Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Tea Un Yang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Wook Hong
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Almajhdi FN, Ali G. Report on influenza A and B viruses: their coinfection in a Saudi leukemia patient. BIOMED RESEARCH INTERNATIONAL 2013; 2013:290609. [PMID: 24078911 PMCID: PMC3775437 DOI: 10.1155/2013/290609] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 07/22/2013] [Indexed: 12/17/2022]
Abstract
PURPOSE Influenza A and B viruses are the leading cause of respiratory infections in children worldwide, particularly in developing countries. There is a lack of data on coinfection of influenza A and B viruses circulating in Saudi Arabia. In this study, we aimed to identify the circulation of influenza viruses that contribute to respiratory tract infections in Saudi children. METHODS We collected 80 nasopharyngeal aspirates (NPAs) from hospitalized children with acute respiratory illness (ARI) at Riyadh during the period extended from October 2010 till April 2011. Samples were tested for the common respiratory viruses including influenza viruses by RT-PCR. RESULTS Overall, 6 samples were found positive for influenza A and/or B viruses. Among these positive clinical samples, only one collected sample from a female one-year-old immunocompromised child with leukemia showed a coinfection with influenza A and B viruses. In present study coinfection was confirmed by inoculation of the clinical specimen in specific pathogenfree embryonating chicken eggs and identification of the virus isolates by hemagglutination and one-step RT-PCR. CONCLUSION This study opens the scene for studying the role of influenza virus's coinfection in disease severity and virus evolution. Further studies are required to better understand the clinical importance of viral coinfection.
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Affiliation(s)
- Fahad N. Almajhdi
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
- Center of Excellence in Biotechnology Research, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| | - Ghazanfar Ali
- Center of Excellence in Biotechnology Research, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
- Department of Biotechnology, University of Azad Jammu and Kashmir, P.O. Box 13100, Muzaffarabad, Pakistan
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Abstract
BACKGROUND The clinical impact of polymicrobial respiratory infections remains uncertain. Previous reports are contradictory regarding an association with severe disease. METHODS Three hundred forty-six specimens from children with acute respiratory illness identified at the University of Iowa Hospitals and Clinics Clinical Microbiology Laboratory were evaluated by direct immunofluorescent assay and/or viral culture by Clinical Microbiology Laboratory and later by molecular study for the presence of influenza, parainfluenza, respiratory syncytial virus, adenovirus, human metapneumovirus, rhinovirus and human bocavirus. Demographic and clinical data were abstracted from medical records. RESULTS Multiple viruses were detected in 46 (21.7%) of 212 virus-positive specimens with the most frequent virus-virus combinations being HRV-respiratory syncytial virus (n = 12), HRV-human bocavirus (n = 6) and HRV-parainfluenza virus 3 (n = 4). Risk factors for coinfection included male gender (OR [odds ratio]: 1.70, 95% confidence interval [CI]: 0.83-3.46), 6 months to 1 year age (OR: 2.15, 95% CI: 0.75-6.19) and history of immunosuppression (OR: 2.05, 95% CI: 0.99-4.23). Children with viral coinfections were less likely than children with single virus infections to be admitted to an intensive care unit (OR: 0.32, 95% CI: 0.08-1.27); however, this may be explained by undetected viral-bacterial coinfections. CONCLUSIONS HRV, respiratory syncytial virus, human bocavirus, and polymicrobial infections were prevalent in this study. Although the cross-sectional design could not easily examine polymicrobial infection and disease severity, prospective, population-based research regarding the clinical impact of such infections is warranted.
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Camargo C, Guatura SB, Bellei N. Respiratory viral coinfection among hospitalized patients with H1N1 2009 during the first pandemic wave in Brazil. Braz J Infect Dis 2013; 16:180-3. [PMID: 22552462 PMCID: PMC7129423 DOI: 10.1016/s1413-8670(12)70302-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Accepted: 10/03/2011] [Indexed: 11/23/2022] Open
Abstract
Influenza A coinfections with other respiratory viruses were investigated in 25.8% (41/159) of the samples from patients hospitalized in 2009 at our University Hospital. Out of the 41 influenza A cases, nine cases (21.9%) were coinfected with other viruses, with a similar frequency among children and adults (p = 0.47), and seasonal influenza cases were more prevalent than H1N1 2009 influenza virus. Adenovirus was the most frequently detected (4/9) among coinfected cases. Coinfection was not associated with higher morbidity or mortality (p = 0.75).
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Affiliation(s)
- Clarice Camargo
- Division of Infections Diseases, Medicine Department, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Stefanska I, Romanowska M, Donevski S, Gawryluk D, Brydak LB. Co-infections with influenza and other respiratory viruses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 756:291-301. [PMID: 22836647 PMCID: PMC7120114 DOI: 10.1007/978-94-007-4549-0_36] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Clinicians often do not consider the presence of more than one viral etiologic agent in respiratory infection, and in many cases they order diagnostics for influenza viruses or recently even only for A(H1N1)2009 virus. However, in a substantial number of patients with a respiratory tract disease, co-infection with various viral pathogens has been confirmed. Although the association between the occurrence of co-infection and substantially higher severity of disease is still unclear, a rapid and proper diagnostics of wide spectrum of viral respiratory pathogens reveals an accurate picture of the disease and is essential for appropriate therapeutic management and control of infection. In the present study we reported five cases of multiple respiratory infection in hospitalized immunosuppressed patients: two double infections with influenza virus (IV) type A/respiratory syncytial virus (RSV) type A and IV type A/coronavirus (CoV) OC43, one infection with four viruses - IV type A/RSV type A and B/CoV OC43, and two cases of mixed infections caused by five viral agents - IV type A and B/RSV type A and B/ parainfluenza type 3 or CoV OC43. Each patient had an underlying chronic disease and received immunosuppressive treatment. Despite a low number of tested specimens, our study shows that the inclusions of multiplex PCR methods for diagnostics of respiratory tract infections and the extension of diagnostic strategies by clinicians to detect viruses other than influenza are very important and make a contribution to identifying the true rate of co-infections and their correlation with the clinical symptoms and severity of disease.
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Affiliation(s)
- I Stefanska
- Department of Influenza Research, National Influenza Center, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
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Brouard J, Vabret A, Nimal-Cuvillon D, Bach N, Bessière A, Arion A, Freymuth F. Bronconeumopatías agudas del niño. EMC. PEDIATRIA 2011; 44:1-16. [PMID: 32308523 PMCID: PMC7158968 DOI: 10.1016/s1245-1789(09)70209-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Las infecciones infantiles afectan con frecuencia al aparato respiratorio inferior. Las clasificaciones convencionales, basadas en el tipo de afección anatómica, radiológica y etiopatogénica, permiten definir entidades clínicas (bronquitis, bronquiolitis, neumopatía); sin embargo, la evaluación de la gravedad del proceso es lo más útil para decidir el tipo y la rapidez del tratamiento. Aunque la etiología viral es la más frecuente, la estrategia fundamental para reducir la morbilidad e incluso la mortalidad de las infecciones respiratorias bajas se basa en el tratamiento adecuado de las neumonías bacterianas. Ante la ausencia de especificidad, es indispensable, cuando esté indicado, recurrir a una antibioticoterapia inicial probabilística que incluya el neumococo. En el niño, las muestras no suelen proceder del parénquima pulmonar y, además, la recogida de las secreciones bronquiales durante los primeros años de vida no es de buena calidad. Al contrario de lo que ocurre con los virus, el examen bacteriológico de las secreciones de las vías respiratorias altas es poco útil, porque los niños suelen ser portadores de gérmenes que pueden causar neumopatías. Los datos clínicos y radiológicos sólo pueden sugerir el diagnóstico. El desarrollo de técnicas que detectan antígenos microbianos o la búsqueda de material genético por biología molecular han permitido mejorar de manera significativa la identificación del patógeno responsable y la elección del tratamiento adecuado. Algunos grupos particulares de pacientes pueden padecer una afección respiratoria por agentes infecciosos inusuales o, incluso, oportunistas. Una proporción importante de la afectación respiratoria del adulto puede atribuirse a las agresiones pulmonares sufridas durante su infancia. La aplicación de vacunas, en especial, la antigripal y la antineumocócica, es fundamental para la prevención de estas afecciones respiratorias.
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Affiliation(s)
- J. Brouard
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - A. Vabret
- Laboratoire de virologie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - D. Nimal-Cuvillon
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - N. Bach
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - A. Bessière
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - A. Arion
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - F. Freymuth
- Laboratoire de virologie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
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Role of real-time reverse transcription polymerase chain reaction for detection of respiratory viruses in critically ill children with respiratory disease: Is it time for a change in algorithm? Pediatr Crit Care Med 2011; 12:e160-5. [PMID: 20711084 DOI: 10.1097/pcc.0b013e3181f36e86] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify the respiratory viral pathogens associated with acute lower respiratory tract infection in critically ill pediatric patients by using real-time reverse transcription-polymerase chain reaction, and compare results with those of direct fluorescence antibody assay testing. DESIGN Observational cohort study. SETTING Pediatric intensive care unit at a tertiary care academic hospital. PATIENTS Pediatric patients admitted to the pediatric intensive care unit with severe respiratory symptoms consistent with viral lower respiratory tract infection. INTERVENTIONS None. MEASUREMENTS Respiratory samples of pediatric patients admitted to the pediatric intensive care unit with severe respiratory symptoms between January 2008 and July 2009 were tested with direct fluorescence antibody assay and real-time reverse transcription-polymerase chain reaction. MAIN RESULTS At least one viral agent was detected in 70.5% of specimens by real-time reverse transcription-polymerase chain reaction and in 16.5% by direct fluorescence antibody assay (p < .001). Real-time reverse transcription-polymerase chain reaction increased the total viral yield five-fold compared to direct fluorescence antibody assay. Rhinovirus was the most commonly identified virus (41.6%). For viruses included in the direct fluorescence antibody assay panel, direct fluorescence antibody assay had a sensitivity of 0.42 (95% confidence interval 0.25-0.61) and a specificity of 1 (95% confidence interval 0.86-1.00) compared with real-time reverse transcription-polymerase chain reaction. Coinfections were not uncommon, in particular with rhinovirus, and these patients tended to have higher mortality. CONCLUSIONS Direct fluorescence antibody assay testing is a suboptimal method for the detection of respiratory viruses in critically ill children with lower respiratory tract infection. Given the importance of a prompt and accurate viral diagnosis for this group of patients, we suggest that real-time reverse transcription-polymerase chain reaction becomes part of the routine diagnostic algorithm in critically ill children when a viral etiology is suspected, even if conventional tests yield a negative result.
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Ju L, Jiang L, Yang J, Shi Q, Jiang Q, Shen H, Tan Y, Lu Y. Co-infection with influenza A/H1N1 and A/H3N2 viruses in a patient with influenza-like illness during the winter/spring of 2008 in Shanghai, China. J Med Virol 2011; 82:1299-305. [PMID: 21280055 DOI: 10.1002/jmv.21807] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Co-infection with different influenza viruses occurs naturally and plays an important role in epidemiology and pathogenicity. To monitor the prevalence of influenza viruses in humans during seasonal influenza epidemics in Shanghai, China, and to analyze the genetic characteristics of the viruses, 365 nasopharyngeal swabs collected from patients with influenza-like illness between January and April 2008, were tested by a colloidal gold assay, viral isolation in Madin-Darby canine kidney (MDCK) cells, direct immunofluorescence assay and multiplex RT-PCR. The genetic characteristics of the viruses were analyzed by full-length PCR amplification of the HA segment. One case of co-infection with influenza A/H1N1 and A/H3N2 viruses was detected among the 7 cases of A/H1N1, 84 cases of A/H3N2 and 48 cases of influenza B virus during the winter/spring of 2008. All influenza A/H1N1 and A/H3N2 isolates were similar, including the co-infecting isolates. The present study demonstrates the possibility of natural co-infection with different types of influenza viruses in humans, which could provide the opportunity for the occurrence of viral genetic reassortment within the human respiratory tract.
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Affiliation(s)
- Liwen Ju
- The MOE Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
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Calvo C, Pozo F, García-García ML, Sanchez M, Lopez-Valero M, Pérez-Breña P, Casas I. Detection of new respiratory viruses in hospitalized infants with bronchiolitis: a three-year prospective study. Acta Paediatr 2010; 99:883-7. [PMID: 20163373 PMCID: PMC7159545 DOI: 10.1111/j.1651-2227.2010.01714.x] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM We have designed a study with the objective of describing the clinical impact of other viruses different from the respiratory syncytial virus (RSV) in hospitalized infants with bronchiolitis. METHODS A 3 year prospective study was conducted on infants admitted to the Paediatrics Department of the Severo Ochoa Hospital (Spain). We studied the frequency of 16 respiratory viruses. Clinical characteristics of RSV-only infections were compared with other single agent viral infections. RESULTS Positive results were confirmed in 275 (86.5%) of the 318 children studied. A single virus was detected in 196 patients and 79 were dual or multiple viral infections. RSV was detected in 61.3% of total bronchiolitis. Rhinovirus (RV) was 17.4% of the identified virus, followed by human bocavirus (HBoV), adenovirus and metapneumovirus (hMPV). Only RV, HBoV and hMPV were significant as single infections. RSV patients were younger than HBoV (p > 0.0001) and hMPV (p = 0.025). Seasonality was clearly different between them. Children with RSV infection needed treatment in the intensive care unit more frequently than others. CONCLUSIONS In hospitalized infants, RSV was the most frequent agent in bronchiolitis in winter, but other viruses were present in 47% of the patients. RV, HBoV and hMPV had a significant proportion of single infections. Clinical characteristics were similar amongst them, but seasonality was clearly different.
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Affiliation(s)
- C Calvo
- Pediatrics Department, Severo Ochoa Hospital, Madrid, Spain.
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Ochoa Sangrador C, González de Dios J. [Consensus conference on acute bronchiolitis (II): epidemiology of acute bronchiolitis. Review of the scientific evidence]. An Pediatr (Barc) 2010; 72:222.e1-222.e26. [PMID: 20153707 PMCID: PMC7105046 DOI: 10.1016/j.anpedi.2009.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2009] [Accepted: 11/30/2009] [Indexed: 11/08/2022] Open
Abstract
A review of the evidence on epidemiology, risk factors, etiology and clinical-etiological profile of acute bronchiolitis is presented. The frequency estimates are very heterogeneous; in the population under two years the frequency of admission for bronchiolitis is between 1 and 3.5%, primary care consultations between 4 and 20% and emergency visits between 1 and 2%. The frequency of admissions for respiratory infection by respiratory syncytial virus in the risk population is: in premature infants < or =32 weeks of gestation between 4.4 and 18%, in patients with bronchopulmonary dysplasia between 7.3 and 42%, and in infants with congenital heart disease between 1.6 and 9.8%. The main risk factors are: prematurity, chronic lung disease or bronchopulmonary dysplasia, congenital heart disease and age less than 3-6 months at onset of the epidemic. Other factors are: older siblings or day care attendance, male gender, exposure to smoking, breastfeeding for less than 1-2 months and variables associated with lower socioeconomic status. Respiratory syncytial virus is the dominant etiological agent, constituting just over half the cases (median 56%; interval 27% to 73%). Other viruses implicated, in descending order of frequency, are rhinovirus, adenovirus, metapneumovirus, influenza viruses, parainfluenza, enterovirus and bocavirus. In studies with genomic detection techniques, between 20 and 25% of cases the virus involved is not identified and between 9% and 27% of cases have viral co-infection. Although respiratory syncytial virus bronchiolitis shows more wheezing and retractions, longer duration of respiratory symptoms and oxygen therapy and are associated with lower use of antibiotics. This pattern is associated with the younger age of the patients and does not help us to predict the etiology. In general, the etiological identification is not useful for the management of patients. However, in young infants (<3 months) with febrile bronchiolitis in the hospital environment, conservative management may help these patients and avoid diagnostic and therapeutic procedures.
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Mackay IM, Arden KE, Lambert SB. Epidemiology. COMMOND COLD 2009. [PMCID: PMC7123965 DOI: 10.1007/978-3-7643-9912-2_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The common cold is the result of an upper respiratory tract infection causing an acute syndrome characterised by a combination of non-specific symptoms, including sore throat, cough, fever, rhinorrhoea, malaise, headache, and myalgia. Respiratory viruses, alone or in combination, are the most common cause. The course f illness can be complicated by bacterial agents, causing pharyngitis or sinusitis, but the are a rare cause of cold and flu-like illnesses (CFLIs). Our understanding of CFLI epidemiology has been enhanced by molecular detection methods, particularly polymerase chain reaction (PCR) testing. PCR has not only improved detection of previously known viruses, but within the last decade has resulted in the detection of many divergent novel respiratory virus species. Human rhinovirus (HRV) infections cause nearly all CFLIs and they can be responsible for asthma and chronic obstructive pulmonary disease exacerbations. HRVs are co-detected with other respiratory viruses in statistically significant patterns, with HRVs occurring in the lowest proportion of co-detections, compared to most other respiratory viruses. Some recently identified rhinoviruses may populate an entirely new putative HRV species; HRV C. Further work is required to confirm a causal role for these newly identified viruses in CFLIs. The burden of illness associated with CFLIs is poorly documented, but where data are available, the impact of CFLIs is considerable. Individual infections, although they do not commonly result in more severe respiratory tract illness, are associated with substantial direct and indirect resource use. The product of frequency and burden for CFLIs is likely to be greater in magnitude than for any other respiratory syndrome, but further work is required to document this. Our understanding of the viral causes of CLFIs, although incomplete, has improved in recent years. Documenting burden is also an important step in progress towards improved control and management of these illnesses.
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Fournel I, Soulias M, Bour JB, Gouyon JB, Huet F, Aho LS. [Evolution of the number of rotavirus and respiratory syncytial virus infections in children hospitalised in a French university hospital between 1998 and 2005]. ACTA ACUST UNITED AC 2008; 58:406-14. [PMID: 19081201 DOI: 10.1016/j.patbio.2008.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 10/17/2008] [Indexed: 10/21/2022]
Abstract
AIM Respiratory syncytial virus (RSV) and Rotavirus infections represent up to 30% of cross infections in pediatric units. As they are a major public health problem, we studied their evolution and distribution at the Dijon University Hospital. POPULATION AND METHODS This exhaustive retrospective study included children under 15 with a new Rotavirus or RSV infection who were hospitalised at the Dijon University Hospital between 1998 and 2005. The general trend was determined by using moving averages, and the Spearman correlation coefficient r(s) was calculated. RESULTS From 1998 to 2005, 1886 new RSV (n=981) or Rotavirus (n=905) infections were identified in hospitalised children. The number of the infections decreased significantly, both for RSV (r(s)=-0.71 ; p<0.0001) and for Rotavirus (r(s)=-0.77 ; p<0.0001). Almost half of Rotavirus infections were nosocomial (46.3%) vs 5.3% of RSV infections, p<0.0001. There was no significant difference in the proportion of RSV nosocomial infections between the epidemic and non-epidemic period (4.9% of nosocomial infections vs 7.1% respectively, p=0.25). Rotavirus nosocomial infections were less frequent in epidemic period (41.6%) than in non-epidemic period (54.6%); p=0.0002. CONCLUSION RSV and Rotavirus infections significantly decreased between 1998 and 2005. Proportion of RSV or Rotavirus infections didn't increase in epidemic period, which could be explained both by an increased attention from healthcare professionals and by the effectiveness of hygiene measures taken.
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Affiliation(s)
- I Fournel
- Service d'hygiène et d'épidémiologie hospitalière, pôle des pathologies lourdes et des vigilances, CHU de Dijon, 1, boulevard Jeanne-d'Arc, 21079 Dijon cedex, France.
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Frequent detection of viral coinfection in children hospitalized with acute respiratory tract infection using a real-time polymerase chain reaction. Pediatr Infect Dis J 2008; 27:589-94. [PMID: 18520973 DOI: 10.1097/inf.0b013e3181694fb9] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Respiratory viruses are the main cause of acute respiratory tract infection (ARI) in children. Real-time polymerase chain reaction (PCR) technology is highly practicable for the rapid detection of viral pathogens. The simultaneous detection of a broad spectrum of viruses enables the diagnosis and evaluation of viral coinfection in ARI. METHODS A 1-step real-time PCR was developed for the detection of 12 respiratory viruses (10 RNA and 2 DNA viruses) in clinical samples. Clinical samples from 254 children admitted to the Departments of Pediatrics with ARI during a 10-month period were tested. RESULTS Respiratory syncytial virus (RSV) was the most frequently detected pathogen in 112 samples (44.1%), followed by human bocavirus (hBoV) in 49 (19.3%), and rhinovirus in 17 samples (6.7%). Viral coinfection was detected in 41 (16.1%) samples with RSV and hBoV being the most dominating combination (27 cases, 10.6%). Viral coinfection was found in 10 cases (17%) of children with bronchitis (n = 58) and in 7 cases (23%) of bronchiolitis (n = 30). In patients with pneumonia (n = 51), 17 cases (33%) were positive for 2 or more viral pathogens. CONCLUSIONS Simultaneous testing of respiratory viruses by real-time PCR is a suitable tool for the detection of viral coinfections. In children hospitalized because of respiratory infection viral coinfection is frequently detected with RSV and hBoV being a common combination.
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Calvo C, García-García ML, Blanco C, Vázquez MC, Frías ME, Pérez-Breña P, Casas I. Multiple simultaneous viral infections in infants with acute respiratory tract infections in Spain. J Clin Virol 2008; 42:268-72. [PMID: 18455958 PMCID: PMC7108242 DOI: 10.1016/j.jcv.2008.03.012] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2007] [Revised: 01/17/2008] [Accepted: 03/18/2008] [Indexed: 11/21/2022]
Abstract
Background The clinical significance of the presence of more than one type of virus in the respiratory specimens of children with respiratory infections is not clear. Objectives To describe the clinical characteristics of multiple viral infections versus single infection by respiratory syncytial virus (RSV) in hospitalized infants. Study design This is a prospective study conducted in all infants under 2 years of age admitted for acute respiratory infection (September 2000–June 2003) in a secondary teaching hospital. Virological diagnosis was made by two different multiplex reverse transcription-nested polymerase chain reaction (RT-PCR) assays in nasopharyngeal aspirates. We describe the clinical characteristics of the patients with multiple viral infections and compare them to a group of 86 randomly selected patients infected only with RSV. Results 749 specimens taken were analyzed. Respiratory viruses were detected in 65.9% of the samples. 86 children had multiple viral infections (17.4% of all positive specimens). The most frequent clinical diagnosis in this group was recurrent wheezing in 44% and bronchiolitis in 52%. Fever was significantly more frequent (p < 0.001), hospital stays were longer (p = 0.05), and antibiotic treatment was used more (p = 0.03) in infants with multiple viral infections than in the RSV-infected group. Conclusions Multiple viral infections are frequent in hospitalized children with respiratory tract disease (17.4%). Multiple viral infections are linked to higher fever, longer hospital stays and more frequent use of antibiotics than in the case of infants with single RSV infections.
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Affiliation(s)
- Cristina Calvo
- Pediatrics Department, Severo Ochoa Hospital, Madrid, Spain.
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16
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Falchi A, Arena C, Andreoletti L, Jacques J, Leveque N, Blanchon T, Lina B, Turbelin C, Dorléans Y, Flahault A, Amoros J, Spadoni G, Agostini F, Varesi L. Dual infections by influenza A/H3N2 and B viruses and by influenza A/H3N2 and A/H1N1 viruses during winter 2007, Corsica Island, France. J Clin Virol 2008; 41:148-51. [DOI: 10.1016/j.jcv.2007.11.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 11/01/2007] [Indexed: 11/28/2022]
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Brouard J, Vabret A, Bach N, Toutain F, Duhamel JF, Freymuth F. [Adenoviral respiratory diseases in healthy children: a study of 116 hospital cases]. ACTA ACUST UNITED AC 2008; 6:97-102. [PMID: 32288527 PMCID: PMC7146831 DOI: 10.1016/s1294-5501(04)94248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Adenoviruses most commonly cause respiratory illness; however, depending on the infecting serotype, they may also cause various other diseases. Diagnosis may be difficult to achieve.The clinical findings for 116 children hospitalised with adenoviral infection were studied retrospectively. In 71 children, the diagnosis was based on detection of adenovirus antigen in the nasopharyngeal specimens and in 71 children on viral culture. The clinical picture of adenoviral infection was characterised by high-grade (mean 39°1C) and prolonged fever (mean duration 4,3 days). Upper respiratory and lower respiratory symptoms were the most common infections. Twelve had been admitted to the hospital due to febrile convulsions, 6 had meningitis. Laboratory findings varied from normal values to values seen in bacterial infections. Thus it was difficult to distinguish adenoviral disease from a bacterial disease. Fifty-nine children were referred to the hospital due to infection unresponsive to antimicrobial therapy.Symptoms of respiratory infection caused by adenovirus may range from the common cold syndrome to pneumonia, croup and bronchiolitis. Adenoviruses can be responsible for severe consequences, even in previously healthy children. Studies of the molecular mechanisms of viral infections of the airways could provide important insights into the nature of the inflammatory process involved in asthma and chronic obstructive pulmonary disease. Most infections are mild and require no therapy or only symptomatic treatment. There are at present time no recognised antiviral agents that are effective in treating serious adenovirus disease. The rapid detection of adenovirus antigen in nasopharygeal specimens proved to have a great clinical value in the diagnosis.
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Affiliation(s)
- J Brouard
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - A Vabret
- Laboratoire de Virologie Humaine et Moléculaire, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - N Bach
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - F Toutain
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - J F Duhamel
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - F Freymuth
- Laboratoire de Virologie Humaine et Moléculaire, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
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18
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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; 126:53-63. [PMID: 15847919 PMCID: PMC7112904 DOI: 10.1016/j.jviromet.2005.01.020] [Citation(s) in RCA: 221] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Revised: 01/05/2005] [Accepted: 01/11/2005] [Indexed: 11/10/2022]
Abstract
Three multiplex hemi-nested RT-PCR assays were developed to detect simultaneously 12 RNA respiratory viruses: influenza viruses A, B and C, human respiratory syncytial virus (hRSV), human metapneumovirus (hMPV), parainfluenza virus types 1-4 (PIV-1, -2, -3 and -4), human coronavirus OC43 and 229E (HCoV) and rhinovirus (hRV). An internal amplification control was included in one of the RT-PCR assays. The RT-PCR multiplex 1 and the hemi-nested multiplex 1 detected 1 and 0.1 TCID50 of RSV A, respectively, and 0.01 and 0.001 TCID50 of influenza virus A/H3N2, respectively. Two hundred and three nasal aspirates from hospitalised children were retrospectively tested in comparison with two conventional methods: direct immunofluorescence assay and viral isolation technique. Almost all samples (89/91) that were positive by immunofluorescence assay and/or viral isolation technique were detected by the multiplex assay. This method also detected an additional 85 viruses and 33 co-infections. The overall sensitivity (98%), rapidity and enhanced efficiency of these multiplex hemi-nested RT-PCR assays suggest that they would be a significant improvement over conventional methods for the detection of a broad spectrum of respiratory viruses.
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MESH Headings
- Child
- Coronavirus 229E, Human/genetics
- Coronavirus 229E, Human/isolation & purification
- Coronavirus OC43, Human/genetics
- Coronavirus OC43, Human/isolation & purification
- Fluorescent Antibody Technique
- Humans
- Influenza A virus/genetics
- Influenza A virus/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/isolation & purification
- Gammainfluenzavirus/genetics
- Gammainfluenzavirus/isolation & purification
- Metapneumovirus/genetics
- Metapneumovirus/isolation & purification
- Nasal Cavity/virology
- Parainfluenza Virus 1, Human/genetics
- Parainfluenza Virus 1, Human/isolation & purification
- Parainfluenza Virus 2, Human/genetics
- Parainfluenza Virus 2, Human/isolation & purification
- Parainfluenza Virus 3, Human/genetics
- Parainfluenza Virus 3, Human/isolation & purification
- Parainfluenza Virus 4, Human/genetics
- Parainfluenza Virus 4, Human/isolation & purification
- Quality Control
- RNA Viruses/genetics
- RNA Viruses/isolation & purification
- RNA, Viral/analysis
- RNA, Viral/genetics
- Respiratory Syncytial Viruses/genetics
- Respiratory Syncytial Viruses/isolation & purification
- Respiratory Tract Infections/diagnosis
- Respiratory Tract Infections/virology
- Reverse Transcriptase Polymerase Chain Reaction/methods
- Reverse Transcriptase Polymerase Chain Reaction/standards
- Rhinovirus/genetics
- Rhinovirus/isolation & purification
- Sensitivity and Specificity
- Virus Cultivation
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Affiliation(s)
- S. Bellau-Pujol
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
| | - A. Vabret
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
| | - L. Legrand
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
| | - J. Dina
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
| | - S. Gouarin
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
| | - J. Petitjean-Lecherbonnier
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
| | - B. Pozzetto
- Laboratory of Virology, CHU Saint-Etienne, 42055 Saint-Etienne Cedex, France
| | - C. Ginevra
- Laboratory of Virology, CHU Saint-Etienne, 42055 Saint-Etienne Cedex, France
| | - F. Freymuth
- Laboratory of Human and Molecular Virology, University Hospital, av. Georges Clemenceau, 14033 Caen, France
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Cheng VCC, Hung IFN, Tang BSF, Chu CM, Wong MML, Chan KH, Wu AKL, Tse DMW, Chan KS, Zheng BJ, Peiris JSM, Sung JJY, Yuen KY. Viral replication in the nasopharynx is associated with diarrhea in patients with severe acute respiratory syndrome. Clin Infect Dis 2004; 38:467-75. [PMID: 14765337 PMCID: PMC7107995 DOI: 10.1086/382681] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2003] [Accepted: 01/09/2004] [Indexed: 12/15/2022] Open
Abstract
The role of severe acute respiratory syndrome (SARS) coronavirus as an enteric pathogen was investigated in a cohort of 142 patients with SARS who were treated with a standard treatment protocol. Data from daily hematological, biochemical, radiological, and microbiological investigations were prospectively collected, and the correlation of these findings with diarrhea was retrospectively analyzed. Sixty-nine patients (48.6%) developed diarrhea at a mean (± standard deviation [SD]) of 7.6 ± 2.6 days after the onset of symptoms. The diarrhea was most severe at a mean (±SD) of 8.8 ± 2.4 days after onset, with a maximum frequency of 24 episodes per day (median, 5 episodes; range, 3–24 episodes). A higher mean virus load in nasopharyngeal specimens obtained on day 10 after the onset of symptoms was significantly associated with the occurrence of diarrhea (3.1 log10 vs. 1.8 log10 copies/mL; P = .01) and mortality (6.2 vs. 1.7 log10 copies/mL; P < .01). However, diarrhea was not associated with mortality. The lung and the gastrointestinal tract may react differently to SARS coronavirus infection. Additional investigation of the role of SARS coronavirus in the pathogenesis of diarrhea in patients with SARS should be conducted.
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Affiliation(s)
- V. C. C. Cheng
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
| | - I. F. N. Hung
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
| | - B. S. F. Tang
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
| | - C. M. Chu
- Department of Medicine, United Christian Hospital, China
| | - M. M. L. Wong
- Department of Medicine and Geriatrics, Caritas Medical Centre, China
| | - K. H. Chan
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
| | - A. K. L. Wu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - D. M. W. Tse
- Department of Medicine and Geriatrics, Caritas Medical Centre, China
| | - K. S. Chan
- Department of Medicine, United Christian Hospital, China
| | - B. J. Zheng
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
| | - J. S. M. Peiris
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
| | - J. J. Y. Sung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - K. Y. Yuen
- Centre of Infection, Queen Mary Hospital, The University of Hong Kong, China
- Reprints or correspondence: Prof. K. Y. Yuen, Centre of Infection, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, China ()
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Guittet V, Brouard J, Vabret A, Lafay F, Guillois B, Duhamel JF, Freymuth F. [Rhinovirus and acute respiratory infections in hospitalized children. Retrospective study 1998-2000]. Arch Pediatr 2003; 10:417-23. [PMID: 12878334 PMCID: PMC7127855 DOI: 10.1016/s0929-693x(03)00090-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Rhinoviruses are the most common aetiological agents of colds, but the frequency and the severity of other locations of the infection are not well known. This study describes the clinical aspects and the severity of rhinovirus infections in hospitalised children. METHODS Isolation in culture and a RT-PCR were performed for the detection of rhinovirus in nasal aspirates from hospitalised children from September 1998 to October 2000. A group of 211 children found to be positive for rhinovirus was studied. RESULTS Rhinovirus-infected children suffered from the following clinical syndromes: 60 (28.4%) upper airway infections, 81 (38.4%) bronchiolitis, 25 (11.9%) pneumonias and 12 (4.7%) acute attacks of asthma. Clinical symptoms were wheezing (32%), ronchi (37%) and 29% of children presented with acute distress respiratory syndrome; 40% of the available chest X-Ray were abnormal. Eight children were hospitalised in the intensive care unit and two children died. Twenty-five children (10.9%) had a nosocomial infection; a dual infection was observed in 19 cases (9%) with the following viruses: RSV (3), influenza (2) parainfluenza (8), adenovirus (2), enterovirus (4); 19 (9%) children had a secondary bacterial infection. Rhinoviruses were detected in nasal aspirates in 112 cases (53%) according to the culture and in the rhinovirus culture-negative samples in 99 cases (47%) according to the RT-PCR assay. CONCLUSION After eliminating cases of bacterial or viral dual infections, the clinical aspects of rhinovirus infections in children are the following: upper respiratory tract infections (25.6%), bronchiolitis ou bronchitis (25.6%), pneumonia (6.2%), acute attack of asthma (5.7%). The virological diagnosis according to culture is mainly improved by molecular techniques.
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Affiliation(s)
- V Guittet
- Service de pédiatrie A, centre hospitalier universitaire Clémenceau, avenue Georges-Clémenceau, 14000 Caen, France
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21
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Gagneur A, Legrand M, Picard B, Baron R, Talbot P, de Parscau L, Sizun J. [Nosocomial infections due to human coronaviruses in the newborn]. Arch Pediatr 2002; 9:61-9. [PMID: 11865552 PMCID: PMC7126531 DOI: 10.1016/s0929-693x(01)00696-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2001] [Accepted: 09/10/2001] [Indexed: 10/26/2022]
Abstract
Human coronaviruses, with two known serogroups named 229-E and OC-43, are enveloped positive-stranded RNA viruses. The large RNA is surrounded by a nucleoprotein (protein N). The envelop contains 2 or 3 glycoproteins: spike protein (or protein S), matrix protein (or protein M) and a hemagglutinin (or protein HE). Their pathogen role remains unclear because their isolation is difficult. Reliable and rapid methods as immunofluorescence with monoclonal antibodies and reverse transcription-polymerase chain reaction allow new researches on epidemiology. Human coronaviruses can survive for as long as 6 days in suspension and 3 hours after drying on surfaces, suggesting that they could be a source of hospital-acquired infections. Two prospective studies conducted in a neonatal and paediatric intensive care unit demonstrated a significant association of coronavirus-positive nasopharyngal samples with respiratory illness in hospitalised preterm neonates. Positive samples from staff suggested either a patient-to-staff or a staff-to-patient transmission. No cross-infection were observed from community-acquired respiratory-syncitial virus or influenza-infected children to neonates. Universal precautions with hand washing and surface desinfection could be proposed to prevent coronavirus transmission.
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Affiliation(s)
- A. Gagneur
- Unité de réanimation pédiatrique, département de pédiatrie, CHU, 29609 Brest, France
| | - M.C. Legrand
- unité de virologie, département de microbiologie, CHU, 29609 Brest, France
| | - B. Picard
- unité de virologie, département de microbiologie, CHU, 29609 Brest, France
| | - R. Baron
- unité d’hygiène hospitalière, CHU, 29609 Brest, France
| | - P.J. Talbot
- laboratoire de neuro-immunovirologie, INRS-institut Armand-Frappier, université du Québec, Laval, Québec, Canada
| | - L. de Parscau
- Unité de réanimation pédiatrique, département de pédiatrie, CHU, 29609 Brest, France
| | - J. Sizun
- Unité de réanimation pédiatrique, département de pédiatrie, CHU, 29609 Brest, France
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