Details:

Alternative Title:
Clin Infect Dis
Personal Author:
Mazur, Natalie I. ; Bont, Louis ; Cohen, Adam L. ; Cohen, Cheryl ; von Gottberg, Anne ; ... More +
Mazur, Natalie I. ; Bont, Louis ; Cohen, Adam L. ; Cohen, Cheryl ; von Gottberg, Anne ; Groome, Michelle J. ; Hellferscee, Orienka ; Klipstein-Grobusch, Kerstin ; Mekgoe, Omphile ; Naby, Fathima ; Moyes, Jocelyn ; Tempia, Stefano ; Treurnicht, Florette K. ; Venter, Marietje ; Walaza, Sibongile ; Wolter, Nicole ; Madhi, Shabir A. Less -
Corporate Authors:
for the South African Severe Acute Respiratory Illness (SARI) Surveillance Group
Description:
Background.

Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort.

Methods.

Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009–December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death.

Results.

Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)–associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39–1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6–7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0–4.5; P = .05) compared with RSV monoinfection.

Conclusions.

RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.


Subjects:
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Child, Preschool Coinfection Critical Care Female Humans Infant Major Article Male Molecular Diagnostic Techniques Nasopharynx Prospective Studies Respiration, Artificial Respiratory Tract Infections Survival Analysis Virus Diseases Viruses
Source:
Clin Infect Dis. 2016; 64(4):443-450
Pubmed ID:
27927871
Pubmed Central ID:
PMC5712444
Document Type:
Journal Article
Funding:
U01 IP001048/IP/NCIRD CDC HHS/United States ; U51 IP000155/IP/NCIRD CDC HHS/United States ; U51 IP000528/IP/NCIRD CDC HHS/United States
U01 IP001048/IP/NCIRD CDC HHS/United States ; U51 IP000155/IP/NCIRD CDC HHS/United States ; U51 IP000528/IP/NCIRD CDC HHS/United States Less -
Place as Subject:
South Africa
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:4136683136cc5081f43f1bed0b822cd7a7ce7ad1d899c0b17676c23c56a1bebc
Download URL:
https://stacks.cdc.gov/view/cdc/50458/cdc_50458_DS1.pdf
File Type:

Supporting Files

• 	ciw756.nxml	xml
  	ciw75601.gif	gif
  	ciw75601.jpg	jpeg
  	ciw756_Supplementary_Data.zip	zip

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