Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
권호 표지
DOI QR코드

DOI QR Code

Clinical characteristics of acute lower respiratory tract infections according to respiratory viruses in hospitalized children without underlying disease during the last 3 years

최근 3년간 기저질환이 없는 소아 입원 환자에서 호흡기 바이러스에 따른 급성 하기도 감염의 임상적 특징

  • Seo, Min Hae (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Kim, Hyung Young (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Um, Tae Min (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Kim, Hye-Young (Department of Pediatrics, Pusan National University Hospital) ;
  • Park, Hee-Ju (Department of Pediatrics, Pusan National University School of Medicine)
  • 서민해 (부산대학교 의학전문대학원 소아청소년과학교실) ;
  • 김형영 (부산대학교 의학전문대학원 소아청소년과학교실) ;
  • 엄태민 (부산대학교 의학전문대학원 소아청소년과학교실) ;
  • 김혜영 (부산대학교병원 소아청소년과) ;
  • 박희주 (부산대학교 의학전문대학원 소아청소년과학교실)
  • Received : 2016.12.29
  • Accepted : 2017.06.08
  • Published : 2017.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. Methods: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. Results: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ${\geq}6$ years. In addition, asthma was predominantly caused by rhinovirus in children aged ${\geq}6$ years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p<0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. Conclusion: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

Keywords

References

  1. Kwak KJ, Kim YH, Choi HJ. Clinical characteristics of respiratory viral infection in children during spring/summer: focus on human bocavirus. Allergy Asthma Respir Dis 2015;3:410-6. Korean. https://doi.org/10.4168/aard.2015.3.6.410
  2. Lim JS, Woo SI, Kwon HI, Baek YH, Choi YK, Hahn YS. Clinical characteristics of acute lower respiratory tract infections due to 13 respiratory viruses detected by multiplex PCR in children. Korean J Pediatr 2010;53:373-9. Korean. https://doi.org/10.3345/kjp.2010.53.3.373
  3. Choi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, et al. The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000-2005. Clin Infect Dis 2006;43:585-92. https://doi.org/10.1086/506350
  4. Selwyn BJ. The epidemiology of acute respiratory tract infection in young children: comparison of findings from several developing countries. Coordinated Data Group of BOSTID Researchers. Rev Infect Dis 1990;12(Suppl 8):S870-88. https://doi.org/10.1093/clinids/12.Supplement_S870
  5. Shann F. Etiology of severe pneumonia in children in developing countries. Pediatr Infect Dis 1986;5:247-52. https://doi.org/10.1097/00006454-198603000-00017
  6. Cheong HY, Lee JH, Kim YB, Nam HS, Choi YJ, Kim CJ, et al. Viral etiologic agents in acute viral lower respiratory tract detected by multiplex RT-PCR. Pediatr Allergy Respir Dis 2007;17:334-53. Korean.
  7. Kwon JH, Chung YH, Lee NY, Chung EH, Ahn KM, Lee SI. An epidemiological study of acute viral lower respiratory tract infections in hospitalized children from 2002 to 2006 in Seoul, Korea. Pediatr Allergy Respir Dis 2008;18:26-36. Korean.
  8. Kim SH, Huh JH, Bae SY, Kim JS, Yoon SY, Lim CS, et al. Epidemiology of respiratory viral infection in 2004-2006. Korean J Lab Med 2006;26:351-7. Korean. https://doi.org/10.3343/kjlm.2006.26.5.351
  9. Kim KH, Kim JH, Kim KH, Kang C, Kim KS, Chung HM, et al. Identification of viral pathogens for lower respiratory tract infection in children at seoul during autumn and winter seasons of the year of 2008-2009. Korean J Pediatr Infect Dis 2010;17:49-55. Korean. https://doi.org/10.14776/kjpid.2010.17.1.49
  10. Kim HY, Kim KM, Kim SH, Son SK, Park HJ. Clinical manifestations of respiratory viruses in hospitalized children with acute viral lower respiratory tract infections from 2010 to 2011 in Busan and Gyeongsangnam-do, Korea. Pediatr Allergy Respir Dis 2012;22:265-72. Korean. https://doi.org/10.7581/pard.2012.22.3.265
  11. Denny FW, Clyde WA Jr. Acute lower respiratory tract infections in nonhospitalized children. J Pediatr 1986;108:635-46. https://doi.org/10.1016/S0022-3476(86)81034-4
  12. Chai H, Farr RS, Froehlich LA, Mathison DA, McLean JA, Rosenthal RR, et al. Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol 1975;56:323-7. https://doi.org/10.1016/0091-6749(75)90107-4
  13. Castro-Rodriguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000;162:1403-6. https://doi.org/10.1164/ajrccm.162.4.9912111
  14. Paramore LC, Ciuryla V, Ciesla G, Liu L. Economic impact of respiratory syncytial virus-related illness in the US: an analysis of national databases. Pharmacoeconomics 2004;22:275-84. https://doi.org/10.2165/00019053-200422050-00001
  15. Pedraza-Bernal AM, Rodriguez-Martinez CE, Acuna-Cordero R. Predictors of severe disease in a hospitalized population of children with acute viral lower respiratory tract infections. J Med Virol 2016;88:754-9. https://doi.org/10.1002/jmv.24394
  16. 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.
  17. Kwon JM, Shim JW, Kim DS, Jung HL, Park MS, Shim JY. Prevalence of respiratory viral infection in children hospitalized for acute lower respiratory tract diseases, and association of rhinovirus and influenza virus with asthma exacerbations. Korean J Pediatr 2014;57:29-34. https://doi.org/10.3345/kjp.2014.57.1.29
  18. Hall CB. Respiratory syncytial virus and parainfluenza virus. N Engl J Med 2001;344:1917-28. https://doi.org/10.1056/NEJM200106213442507
  19. Weber MW, Mulholland EK, Greenwood BM. Respiratory syncytial virus infection in tropical and developing countries. Trop Med Int Health 1998;3:268-80. https://doi.org/10.1046/j.1365-3156.1998.00213.x
  20. Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med 2009;360:588-98. https://doi.org/10.1056/NEJMoa0804877
  21. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, 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. https://doi.org/10.1016/S0140-6736(10)60206-1
  22. Esper F, Martinello RA, Boucher D, Weibel C, Ferguson D, Landry ML, et al. A 1-year experience with human metapneumovirus in children aged <5 years. J Infect Dis 2004;189:1388-96. https://doi.org/10.1086/382482
  23. Williams JV, Harris PA, Tollefson SJ, Halburnt-Rush LL, Pingsterhaus JM, Edwards KM, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med 2004;350:443-50. https://doi.org/10.1056/NEJMoa025472
  24. Edwards KM, Zhu Y, Griffin MR, Weinberg GA, Hall CB, Szilagyi PG, et al. Burden of human metapneumovirus infection in young children. N Engl J Med 2013;368:633-43. https://doi.org/10.1056/NEJMoa1204630
  25. Chung WJ, Kang SS, Bang KW, Chun YH, Yoon JS, Kim HH, et al. Comparison of respiratory disease by human metapneumovirus and respiratory syncytial virus in children. Allergy Asthma Respir Dis 2013;1:157-63. Korean. https://doi.org/10.4168/aard.2013.1.2.157
  26. Marguet C, Lubrano M, Gueudin M, Le Roux P, Deschildre A, Forget C, et al. In very young infants severity of acute bronchiolitis depends on carried viruses. PLoS One 2009;4:e4596. https://doi.org/10.1371/journal.pone.0004596
  27. Meissner HC. Economic impact of viral respiratory disease in children. J Pediatr 1994;124:S17-21. https://doi.org/10.1016/S0022-3476(94)70186-5
  28. Purcell K, Fergie J. Driscoll Children's Hospital respiratory syncytial virus database: risk factors, treatment and hospital course in 3308 infants and young children, 1991 to 2002. Pediatr Infect Dis J 2004;23:418-23. https://doi.org/10.1097/01.inf.0000126273.27123.33
  29. Hon KL, Leung TF, Cheng WY, Ko NM, Tang WK, Wong WW, et al. Respiratory syncytial virus morbidity, premorbid factors, seasonality, and implications for prophylaxis. J Crit Care 2012;27:464-8. https://doi.org/10.1016/j.jcrc.2011.12.001
  30. Kimpen JL, Simoes EA. Respiratory syncytial virus and reactive airway disease. New developments prompt a new review. Am J Respir Crit Care Med 2001;163:S1. https://doi.org/10.1164/ajrccm.163.supplement_1.2011108
  31. Ogra PL. Respiratory syncytial virus: the virus, the disease and the immune response. Paediatr Respir Rev 2004;5(Suppl A):S119-26. https://doi.org/10.1016/S1526-0542(04)90023-1
  32. Morikawa S, Kohdera U, Hosaka T, Ishii K, Akagawa S, Hiroi S, et al. Seasonal variations of respiratory viruses and etiology of human rhinovirus infection in children. J Clin Virol 2015;73:14-9. https://doi.org/10.1016/j.jcv.2015.10.001
  33. Lemanske RF Jr, Jackson DJ, Gangnon RE, Evans MD, Li Z, Shult PA, et al. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol 2005;116:571-7. https://doi.org/10.1016/j.jaci.2005.06.024
  34. Jackson DJ, Gangnon RE, Evans MD, Roberg KA, Anderson EL, Pappas TE, et al. Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children. Am J Respir Crit Care Med 2008;178:667-72. https://doi.org/10.1164/rccm.200802-309OC
  35. Cox DW, Bizzintino J, Ferrari G, Khoo SK, Zhang G, Whelan S, et al. Human rhinovirus species C infection in young children with acute wheeze is associated with increased acute respiratory hospital admissions. Am J Respir Crit Care Med 2013;188:1358-64. https://doi.org/10.1164/rccm.201303-0498OC