Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy

Abstract

Objective: To estimate the prevalence of infection by respiratory viruses in pediatric patients with cancer and acute respiratory infection (ARI) and/or fever. Methods: Cross-sectional study, from January 2011 to December 2012. The secretions of nasopharyngeal aspirates were analyzed in children younger than 21 years with acute respiratory infections. Patients were treated at the Grupo em Defesa da Criança Com Câncer (Grendacc) and University Hospital (HU), Jundiaí, SP. The rapid test was used for detection of influenza virus (Kit Biotrin, Inc., Ireland), and real-time multiplex polymerase chain reaction (FTD, Respiratory pathogens, multiplex Fast Trade Kit, Malta) for detection of influenza virus (H1N1, B), rhinovirus, parainfluenza virus, adenovirus, respiratory syncytial virus, human parechovirus, bocavirus, metapneumovirus, and human coronavirus. The prevalence of viral infection was estimated and association tests were used ( 2 or Fisher's exact test). Results: 104 samples of nasopharyngeal aspirate and blood were analyzed. The median age was 12 ± 5.2 years, 51% males, 68% whites, 32% had repeated ARIs, 32% prior antibiotic use, 19.8% cough, and 8% contact with ARIs. A total of 94.3% were in good general status. Acute lymphocytic leukemia (42.3%) was the most prevalent neoplasia. Respiratory viruses were detected in 50 samples: rhinoviruses (23.1%), respiratory syncytial virus AB (8.7%), and coronavirus (6.8%). Codetection occurred in 19% of cases with 2 viruses and in 3% of those with 3 viruses, and was more frequent between rhinovirus and coronavirus 43. Fever in neutropenic patients was observed in 13%, of which four (30.7) were positive for viruses. There were no deaths. Conclusions: The prevalence of respiratory viruses was relevant in the infectious episode, with no increase in morbidity and mortality. Viral co-detection was frequent in patients with cancer and ARIs. ଝ This section contains original articles from the Paediatrics Journals of the Paediatric Societies of the Cono Sur selected in the 20 th Editors Meeting held in the city of Montevideo, Uruguay, in September 2015, to be published by the participating countries during the year 2016. 0370-4106/$ -see front matter http://dx.

Etiology of Coinfections in Children with Influenza during 2015/16 Winter Season in Nepal

“…Details of pathogens in single and multiple respiratory infections with influenza-positive cases.Similar findings of single and multiple pathogen coinfections with influenza have been reported from Brazil, Turkey, Japan, and China[29][30][31][32][33][34].To the best of our knowledge, this could be the first study undertaken with multiplex RT-PCR kit on 21 respiratory pathogen for detection of influenza A, A/H1N1, influenza B, RV, RSV A-B, PIV 1-4, coronavirus OC43, NL63, 229E, and HKU1, MPV A-B, BV, Mycoplasma pneumoniae, AV, EV, and PeV. Recently, Rutvisuttinunt et al have reported the detection rate of viral pathogens (71.3%) in specimens of ARI cases collected from South East Asian countries including Nepal.…”

Efficacy and safety of withholding antimicrobial treatment in children with cancer, fever and neutropenia, with a demonstrated viral respiratory infection: a randomized clinical trial

“…Knowledge on the epidemiology of respiratory viral infection in immunocompromised children is scarce with few systematic studies aimed to determine their clinical impact [6]. RSV, influenza virus, parainfluenza virus, adenovirus and picornaviruses have been the most common aetiological agents detected in this population [6,7,12]. The increasing detection of viruses highlights the relevance of optimizing viral diagnosis in children with FN [1].…”

“…Until recently, the most common aetiological agents reported in FN episodes occurring in children with cancer have been bacterial and fungal pathogens. Viral infections, particularly respiratory viruses, have been increasingly recognized as significant aetiological agents of FN in this population [6,7].…”