Prevalence of respiratory pathogens in children hospitalised with lower respiratory tract infection in Greece

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Scope

Aim of the present study was to determine the prevalence of respiratory pathogens, including recently recognised viruses, in children hospitalised with lower respiratory tract infection (LRTI) [1].

Definition

During September 2006 to August 2007, nasopharyngeal swab samples were collected from 375 previously healthy children, aged 14 days to 14 years old, admitted to paediatric wards of two hospitals in Greece, because of acute laryngotracheobronchitis, bronchiolitis, bronchitis or pneumonia. Genetic material was extracted and PCRs were performed for detection of Mycoplasma pneumoniae, respiratory syncytial virus (RSV), human metapneumovirus(hMPV), influenza viruses, adenoviruses, coronaviruses (HCoVs), human bocavirus (HBoV) and mimivirus.

Result

At least one aetiologic agent was detected in 37.06% of cases. Current infection due to M. pneumoniae was diagnosed in 11 (2.93%) children, aged 4 to13 years (with an exception of a 6 months old infant), presented mainly with bronchopneumonia or lobar pneumonia. RSV was detected in 61 (16.27%) children, aged 18 days to 3.5 years, while hMPV was detected in 4 (1.07%) children, aged 1.5 months to 1.5 years, most of them with acute bronchiolitis. Adenoviruses were detected in 26 (6.93%) children, aged 2 months to 7 years admitted for acute bronchiolitis or pneumonia. HBoV was detected in 13 (3.47%) children aged 2 months to 5 years with acute bronchiolitis, bronchopneumonia or laryngotracheobronchitis. Influenza viruses were detected in 10 (2.67%) children, aged 14 days to 6 years with bronchopneumonia and bronchiolitis. Coronaviruses were detected in 4 (1.07%) children, aged 2.5 months to 5 years. Mimivirus was not detected in any of the samples tested. Dual infections were identified in 10 (2.67%) children while one triple infection was also present.

Conclusion

Atypical pathogens and respiratory viruses are responsible for a large number of LRTI cases in children. RSV was the most common cause of viral lower respiratory tract infection while M. pneumoniae was a frequent cause of LRTI in children older than 5 years old, mainly presenting with pneumonia not associated with wheezing. Clinical characteristics of patients diagnosed with M. pneumoniae, RSV and adenovirus infection are relatively distinct. HBoV, a potential causative agent of LRTI, was frequently detected in preschool children with acute bronchiolitis or bronchopneumonia.

Acknowledgements

Study summary from: Swatee P Patel, Marjo-Riitta Järvelin and Mark P Little. Systematic review of worldwide variations of the prevalence of wheezing symptoms in children. Environmental Health 2008, 7:57.

References

  1. Papa A., Goutaki M., Matsini I., Papadimitriou E., Damianidou L., Eboriadou M., Haidopoulou K. Prevalence of respiratory pathogens in children hospitalised with lower respiratory tract infection in Greece. Abstract number: P1607. 18th European Congress of Clinical Microbiology and Infectious Diseases. Barcelona, Spain, 19–22 April 2008