Role of respiratory viruses in infants less than six months of age with upper respiratory tract infections

Year 2017, Volume: 39 Issue: 3, 564 - 569, 19.09.2017

Eda Karadağ Öncel Demet Başer Ayça Kömürlüoğlu Meral Ciblak Yasemin Özsürekçi Cihangül Bayhan Selim Badur Mehmet Ceyhan

https://doi.org/10.7197/223.v39i31705.347455

Abstract

Objective: With a wide range of clinical presentations, respiratory tract
infections remain a significant cause of morbidity and mortality worldwide,
particularly in infants. The aim of this cross-sectional descriptive study was to determine the frequency of respiratory viruses
responsible for upper respiratory tract infections during the 2013-2014
influenza season in infants less than 6 months of age.

Method: Nasal swabs
were obtained from patients with symptoms suggestive of an influenza-like
illness (ILI) between January and April 2014. Specimens were evaluated by
RT-PCR to help identify the causative viral pathogens.

Results: A total of
150 patients with ILI were enrolled in the study. A respiratory virus was
successfully detected in 126 (86%) infants; RSV in 41 (32.5%),
rhinovirus in 17 (13.4%), metapneumovirus in 15 (11.9%), coronavirus in 11
(8.7%), adenovirus in 5 (3.9%), parainfluenza virus in 2 (1.5%) and bocavirus
in 2 (1.5%) infants. Thirty-three (26.1%) patients were found to be co-infected
with both two viruses. Rhinorrhea and developing complications were
significantly more frequently seen in RT-PCR positive patients (p=0.023 and
p=0.019, respectively). All complications were seen in RT-PCR positive group,
especially in metapneumovirus, RSV and multiple viruses positive patients.

Conclusions: With an overall viral pathogen detection rate of 86%, findings of
our study present that influenza viruses were not seen in infants less than 6
months of age in our study population, whether RSV and multiple viral
infections were the most common causes in this age group.

Keywords

infants, influenza-like illness, real-time PCR, respiratory viruses

Altı ay altındaki süt çocuklarında üst solunum yolu enfeksiyonlarında solunum yolu viruslarının rolü

Abstract

Amaç: Solunum yolu enfeksiyonları
tüm dünyada özellikle süt çocuklarında mortalite ve morbiditenin önemli bir
nedenidir.  Bu kesitsel- tanımlayıcı
çalışmanın amacı, 6 ay altındaki süt çocuklarında 2013-2014 influenza sezonu
boyunca üst solunum yolu enfeksiyonlarından sorumlu olan solunum yolu
viruslarının saptanmasıdır.

Yöntem:
Ocak - Nisan 2014 tarihleri arasında akut üst solunum yolu
enfeksiyonu (ÜSYE) semptomları ile başvuran hastalardan nazofaringeal sürüntü
(swab)  alındı. Örneklerden solunum yolu
virusları için RT-PCR çalışıldı.

Bulgular:
150 hasta çalışmaya alındı. 126 (% 86) hastada solunum
yolu virusları pozitif bulundu. Virus pozitif hastaların 41'inde (% 32.5) RSV,
17'sinde (% 13.4) rinovirus, 15’inde  (%
11.9) metapnömovirus, 11’inde (% 8.7) koronavirus, beşinde (% 3.9) adenovirus,
ikisinde (% 1.5) parainfluenza ve ikisinde (% 1.5) bokavirus saptandı. Otuz üç
(% 26.1) hastanın iki virusle ko-enfeksiyonu olduğu tespit edildi. Burun
akıntısı ve komplikasyon gelişimi RT-PCR pozitif hastalarda daha fazla idi
(sırasıyla p = 0.023 ve p = 0.019). Tüm komplikasyonlar RT-PCR pozitif grupta
özellikle metapnömovirus, RSV ve çoklu virus pozitif hastalarda görüldü.

Sonuç: Viral
patojen pozitifliği %86 saptanan çalışmamızda, 6 ay altındaki süt
çocuklarında  influenza virusu
görülmediği, RSV ve çoklu viral enfeksiyonların bu yaş grubunda  en sık 
neden olduğu ortaya konmuştur.

Keywords

süt çocuğu, influenza benzeri hastalık, RT-PCR, solunum yolu virusları

References

• 1. Williams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C. Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis 2002; 2: 25-32.
• 2. Cilla G, Onate E, Perez-Yarza EG, Montes M, Vicente D, Perez-Trallero E. 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.
• 3. Bramley TJ, Lerner D, Sames M. Productivity losses related to the common cold. J Occup Environ Med 2002; 44:822-9.
• 4. Fendrick AM, Monto AS, Nightengale B, Sarnes M. The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med 2003; 24:487-94.
• 5. Mistry RD, Fischer JB, Prasad PA, Coffin SE, Alpern ER. Severe complications in influenza-like illnesses. Pediatrics 2014; 134: 684-90.
• 6. Anders KL, Nguyen HL, Nguyen NM, Van Thuy NT, Hong Van NT, Hieu NT, et al. Epidemiology and virology of acute respiratory infections during the first year of life: a birth cohort study in Vietnam. Pediatr Infect Dis J 2015; 34: 361-70.
• 7. Luoto R, Jartti T, Ruuskanen O, Waris M, Lehtonen L, Heikkinen T. Review of the clinical significance of respiratory virus infections in newborn infants. Acta Paediatr. 2016; 105: 1132-9.
• 8. CDC. Seasonal influenza (flu)—FluView Interactive. Available at: www.cdc.gov/flu/weekly/ fluviewinteractive.htm. Accessed October 8, 2013
• 9. Karadag-Oncel E, Ciblak MA, Ozsurekci Y, Badur S, Ceyhan M. Viral etiology of influenza-like illnesses during the influenza season between December 2011 and April 2012. J Med Virol 2014; 86: 865-71.
• 10. Brittain-Long R, Nord S, Olofsson S, Westin J, Anderson LM, Lindh M. Multiplex real-time PCR for detection of respiratory tract infections. J Clin Virol 2008; 41: 53-6.
• 11. Ambrosioni J, Bridevaux PO, Wagner G, Mamin A, Kaiser L. Epidemiology of viral respiratory infections in a tertiary care centre in the era of molecular diagnosis, Geneva, Switzerland, 2011-2012. Clin Microbiol Infect 2014; 20: 578-4.
• 12. Drieghe S, Ryckaert I, Beuselinck K, Lagrou K, Padalko E. Epidemiology of respiratory viruses in bronchoalveolar lavage samples in a tertiary hospital. J Clin Virol 2014; 59: 208-11.
• 13. Khamis FA, Al-Kobaisi MF, Al-Areimi WS, Al-Kindi H, Al-Zakwani I. Epidemiology of respiratory virus infections among infants and young children admitted to hospital in Oman. J Med Virol 2012; 84: 1323-9.
• 14. Luchsinger V, Ampuero S, Palomino MA, Chnaiderman J, Levican J, Gaggero A, et al. Comparison of virological profiles of respiratory syncytial virus and rhinovirus in acute lower tract respiratory infections in very young Chilean infants, according to their clinical outcome. J Clin Virol 2014; 61: 138-44.
• 15. Zhang G, Hu Y, Wang H, Zhang L, Bao Y, Zhou X. High incidence of multiple viral infections identified in upper respiratory tract infected children under three years of age in Shanghai, China. PLoS ONE 2012; 7: 44568.
• 16. Kouni S, Karakitsos P, Chranioti A, Theodoridou M, Chrousos G, Michos A. Evaluation of viral co-infections in hospitalized and non-hospitalized children with respiratory infections using microarrays. Clin Microbiol Infect 2013; 19: 772-7.