Does Viral Co-Infection Influence the Severity of Acute Respiratory Infection in Children?

被引:49
|
作者
Cebey-Lopez, Miriam [1 ,2 ,3 ]
Herberg, Jethro [4 ]
Pardo-Seco, Jacobo [1 ,2 ,3 ,5 ,6 ]
Gomez-Carballa, Alberto [1 ,2 ,3 ,5 ,6 ]
Martinon-Torres, Nazareth [1 ,2 ,3 ]
Salas, Antonio [1 ,2 ,5 ,6 ]
Maria Martinon-Sanchez, Jose [1 ,2 ,3 ]
Justicia, Antonio [1 ,2 ,3 ]
Rivero-Calle, Irene [1 ,2 ,3 ]
Sumner, Edward [7 ]
Fink, Colin [7 ]
Martinon-Torres, Federico [1 ,2 ,3 ]
机构
[1] Hosp Clin Univ, Grp Invest Genet Vacunas Infecc & Pediat, Galicia, Spain
[2] Univ Santiago de Compostela, Galicia, Spain
[3] Hosp Clin Univ Santiago, Dept Pediat, Translat Pediat & Infect Dis Sect, Santiago De Compostela, Galicia, Spain
[4] Univ London Imperial Coll Sci Technol & Med, Div Infect Dis, Paediat Sect, South Kensington Campus, London, England
[5] Univ Santiago de Compostela, Dept Anat Patol & Ciencias Forenses, Unidade Xenet, Fac Med, Galicia, Spain
[6] Univ Santiago de Compostela, Inst Ciencias Forenses, Grp Med Xenom, Fac Med, Galicia, Spain
[7] Univ Warwick, Micropathol Ltd, Sci Pk, Coventry CV4 7AL, W Midlands, England
来源
PLOS ONE | 2016年 / 11卷 / 04期
基金
英国惠康基金;
关键词
INCREASED DISEASE SEVERITY; LENGTH-OF-STAY; HOSPITALIZED CHILDREN; SYNCYTIAL VIRUS; HUMAN METAPNEUMOVIRUS; STREPTOCOCCUS-PNEUMONIAE; PROSPECTIVE MULTICENTER; BOCAVIRUS INFECTION; TRACT INFECTIONS; ETIOLOGY;
D O I
10.1371/journal.pone.0152481
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Multiple viruses are often detected in children with respiratory infection but the significance of co-infection in pathogenesis, severity and outcome is unclear. Objectives To correlate the presence of viral co-infection with clinical phenotype in children admitted with acute respiratory infections (ARI). Methods We collected detailed clinical information on severity for children admitted with ARI as part of a Spanish prospective multicenter study (GENDRES network) between 2011-2013. A nested polymerase chain reaction (PCR) approach was used to detect respiratory viruses in respiratory secretions. Findings were compared to an independent cohort collected in the UK. Results 204 children were recruited in the main cohort and 97 in the replication cohort. The number of detected viruses did not correlate with any markers of severity. However, bacterial superinfection was associated with increased severity (OR: 4.356; P-value = 0.005), PICU admission (OR: 3.342; P-value = 0.006), higher clinical score (1.988; P-value = 0.002) respiratory support requirement (OR: 7.484; P-value < 0.001) and longer hospital length of stay (OR: 1.468; P-value < 0.001). In addition, pneumococcal vaccination was found to be a protective factor in terms of degree of respiratory distress (OR: 2.917; P-value = 0.035), PICU admission (OR: 0.301; P-value = 0.011), lower clinical score (-1.499; P-value = 0.021) respiratory support requirement (OR: 0.324; P-value = 0.016) and oxygen necessity (OR: 0.328; P-value = 0.001). All these findings were replicated in the UK cohort. Conclusion The presence of more than one virus in hospitalized children with ARI is very frequent but it does not seem to have a major clinical impact in terms of severity. However bacterial superinfection increases the severity of the disease course. On the contrary, pneumococcal vaccination plays a protective role.
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页数:12
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