Clinical Impact of Mixed Respiratory Viral Infection in Children with Adenoviral Infection
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Background: Although adenovirus (ADV) infection occurs steadily all year round in Korea and the identification of respiratory viral coinfections has been increasing following the introduction of multiplex real-time polymerase chain reaction tests, the clinical impact of viral coinfection in children with ADV infection has rarely been reported. Materials and Methods: Medical records of children diagnosed with ADV infection were retrospectively reviewed. The enrolled children were divided into two groups based on the identified respiratory viruses: ADV group and coinfection group. Clinical and laboratory parameters were compared between the two groups. Results: In total, 105 children (60 males and 45 females) with a median age of 29 months (range: 0-131 months) diagnosed with an ADV infection were enrolled. Fever (99.0%) was by far the most frequent symptom, followed by respiratory (82.9%), and gastrointestinal (22.9%) symptoms. Upper and lower respiratory tract infections were diagnosed in 56 (53.3%), and 32 (30.5%) children, respectively. Five (4.8%) children received oxygen therapy, and no child died due to ADV infection. Coinfection was diagnosed in 32 (30.5%) children, with rhinovirus (46.9%), and respiratory syncytial virus (21.9%) being the most frequent. The proportions of children younger than 24 months (P <0.001), with underlying medical conditions (P = 0.020), and diagnosed with lower respiratory tract infection (P = 0.011) were significantly higher in the coinfection group than in the ADV group. In a multivariate analysis, only the younger age was significantly associated with coinfection (P <0.001). Although more children in the coinfection group received oxygen therapy (P = 0.029), the duration of fever and hospitalization was not significantly different between the two groups. Conclusion: Respiratory viral coinfection with ADV occurred more frequently in children younger than 24 months of age compared with children aged 24 months or older. Respiratory viral coinfection may increase the severity of ADV infection, however, appropriate therapy prevented prolonged hospitalization and poor prognosis due to coinfection.
Abstract
Background: Although adenovirus (ADV) infection occurs steadily all year round in Korea and the identification of respiratory viral coinfections has been increasing following the introduction of multiplex real-time polymerase chain reaction tests, the clinical impact of viral coinfection in children with ADV infection has rarely been reported. Materials and Methods: Medical records of children diagnosed with ADV infection were retrospectively reviewed. The enrolled children were divided into two groups based on the identified respiratory viruses: ADV group and coinfection group. Clinical and laboratory parameters were compared between the two groups. Results: In total, 105 children (60 males and 45 females) with a median age of 29 months (range: 0-131 months) diagnosed with an ADV infection were enrolled. Fever (99.0%) was by far the most frequent symptom, followed by respiratory (82.9%), and gastrointestinal (22.9%) symptoms. Upper and lower respiratory tract infections were diagnosed in 56 (53.3%), and 32 (30.5%) children, respectively. Five (4.8%) children received oxygen therapy, and no child died due to ADV infection. Coinfection was diagnosed in 32 (30.5%) children, with rhinovirus (46.9%), and respiratory syncytial virus (21.9%) being the most frequent. The proportions of children younger than 24 months (P <0.001), with underlying medical conditions (P = 0.020), and diagnosed with lower respiratory tract infection (P = 0.011) were significantly higher in the coinfection group than in the ADV group. In a multivariate analysis, only the younger age was significantly associated with coinfection (P <0.001). Although more children in the coinfection group received oxygen therapy (P = 0.029), the duration of fever and hospitalization was not significantly different between the two groups. Conclusion: Respiratory viral coinfection with ADV occurred more frequently in children younger than 24 months of age compared with children aged 24 months or older. Respiratory viral coinfection may increase the severity of ADV infection, however, appropriate therapy prevented prolonged hospitalization and poor prognosis due to coinfection.
참고문헌 (30)
- Gröndahl B, "Rapid identification of nine microorganisms causing acute respiratory tract infections by single-tube multiplex reverse transcription-PCR: feasibility study", J Clin Microbiol, 37, pp.1~7 (1999)
- Kim MR, "Epidemiology of acute viral respiratory tract infections in Korean children", J Infect, 41, pp.152~158 (2000)
- Kwon HJ, "Clinical manifestations of respiratory adenoviral infection among hospitalized children in Korea", Pediatr Int, 55, pp.450~454 (2013)
- Chau SK, "Adenovirus respiratory infection in hospitalized children in Hong Kong: serotype-clinical syndrome association and risk factors for lower respiratory tract infection", Eur J Pediatr, 173, pp.291~301 (2014)
- Munoz FM, "Disseminated adenovirus disease in immunocompromised and immunocompetent children", Clin Infect Dis, 27, pp.1194~1200 (1998)
- Lynch JP 3rd, "Adenovirus", Semin Respir Crit Care Med, 32, pp.494~511 (2011)
- Chuang Y, "Severe adenovirus infection in children", J Microbiol Immunol Infect, 36, pp.37~40 (2003)
- Lee J, "Clinical severity of respiratory adenoviral infection by serotypes in Korean children over 17consecutive years (1991-2007)", J Clin Virol, 49, pp.115~120 (2010)
- Hong JY, "Lower respiratory tract infections due to adenovirus in hospitalized Korean children: epidemiology, clinical features, and prognosis", Clin Infect Dis, 32, pp.1423~1429 (2001)
- Gray GC, "Genotype prevalence and risk factors for severe clinical adenovirus infection, United States 2004-2006", Clin Infect Dis, 45, pp.1120~1131 (2007)
- Cao B, "Emergence of community-acquired adenovirus type 55 as a cause of community-onset pneumonia", Chest, 145, pp.79~86 (2014)
- Kuypers J, "Comparison of real-time PCR assays with fluorescent-antibody assays for diagnosis of respiratory virus infections in children", J Clin Microbiol, 44, pp.2382~2388 (2006)
- Freymuth F, "Comparison of multiplex PCR assays and conventional techniques for the diagnostic of respiratory virus infections in children admitted to hospital with an acute respiratory illness", J Med Virol, 78, pp.1498~1504 (2006)
- Drews AL, "Dual respiratory virus infections", Clin Infect Dis, 25, pp.1421~1429 (1997)
- Scotta MC, "Respiratory viral coinfection and disease severity in children: a systematic review and meta-analysis", J Clin Virol, 80, pp.45~56 (2016)
- Semple MG, "Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis", J Infect Dis, 191, pp.382~386 (2005)
- Calvo C, "Multiple simultaneous viral infections in infants with acute respiratory tract infections in Spain", J Clin Virol, 42, pp.268~272 (2008)
- Palomino MA, "Adenovirus and respiratory syncytial virus-adenovirus mixed acute lower respiratory infections in Chilean infants", Pediatr Infect Dis J, 23, pp.337~341 (2004)
- 김태현, "단일 기관에서 경험한 호흡기 아데노바이러스 감염의 임상적 고찰", Allergy Asthma & Respiratory Diseases, 3(6), pp.402~409 (2015), 대한 소아알레르기 호흡기학회[DOI]
- Aberle JH, "Single versus dual respiratory virus infections in hospitalized infants: impact on clinical course of disease and interferon-gamma response", Pediatr Infect Dis J, 24, pp.605~610 (2005)
- Rodríguez-Martínez CE, "Respiratory syncytial virus, adenoviruses, and mixed acute lower respiratory infections in children in a developing country", J Med Virol, 87, pp.774~781 (2015)
- Liu C, "Adenovirus infection in children with acute lower respiratory tract infections in Beijing, China, 2007 to 2012", BMC Infect Dis, 15, pp.408~ (2015)
- Ruuskanen O, "Adenoviral diseases in children: a study of 105 hospital cases", Pediatrics, 76, pp.79~83 (1985)
- Sun Q, "Epidemiology and clinical features of respiratory adenoviral infections in children", Eur J Pediatr, 173, pp.441~444 (2014)
- Moro MR, "Clinical features, adenovirus types, and local production of inflammatory mediators in adenovirus infections", Pediatr Infect Dis J, 28, pp.376~380 (2009)
- Tabain I, "Adenovirus respiratory infections in hospitalized children: clinical findings in relation to species and serotypes", Pediatr Infect Dis J, 31, pp.680~684 (2012)
- Cilla G, "Viruses in community-acquired pneumonia in children aged less than 3 years old: high rate of viral coinfection", J Med Virol, 80, pp.1843~1849 (2008)
- Cebey-López M, "Viral co-infections in pediatric patients hospitalized with lower tract acute respiratory infections", PLos One, 10, pp.e0136526~ (2015)
- Castro-Rodriguez JA, "Adenovirus pneumonia in infants and factors for developing bronchiolitis obliterans: a 5-year follow-up", Pediatr Pulmonol, 41, pp.947~953 (2006)
- Edmond K, "Long term sequelae from childhood pneumonia; systematic review and meta-analysis", PLoS One, 7, pp.e31239~ (2012)