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 ଝ Please cite this article as: Benites EC, Cabrini DP, Silva AC, Silva JC, Catalan DT, Berezin EN, et al. Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy. J Pediatr (Rio J). 2014;90:370---6.

Impaired comfort in children and adolescents with cancer

“…A research conducted in the pediatric oncology sector showed similar data to those of this study. In such research, the participants had median age of 12 years (12) .…”

Prevalence of Infectious Complications in Children with Cancer

“…Respiratory viruses have become a frequently observed source of infection in about half of the patients with respiratory tract infections in children undergoing chemotherapy [10]. Koskenvuo et al [11] documented the presence of respiratory infection in 44% of the cases of children and adolescents with leukaemia and fever, and Srinivasan et al [12] observed rates of 75% in their study.…”

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

“…Immunocompromised patients, such as those with cancer and hematopoietic stem cell transplantation, have a higher risk for respiratory infections, and single or mixed respiratory viruses are frequently detected in those with acute respiratory symptoms . Defects in innate and adaptive immunity coupled with damage in the mucosal membrane and frequent exposure to a healthcare environment contribute to increased morbidity and mortality of respiratory infections in these patients . In healthy children, respiratory viruses are usually confined to the upper respiratory tract; in immunocompromised patients, progression to the lower respiratory tract is a more frequent and feared complication .…”

“…Respiratory infections are major causes of febrile episodes in patients with pediatric cancer . These patients often are initiated on broad‐spectrum antibiotics to cover serious bacterial diseases, leading to unnecessary increased exposure to antibiotics and the potential emergence of antibiotic resistance .…”

“…Respiratory infections are major causes of febrile episodes in patients with pediatric cancer . These patients often are initiated on broad‐spectrum antibiotics to cover serious bacterial diseases, leading to unnecessary increased exposure to antibiotics and the potential emergence of antibiotic resistance . Accurate respiratory viral diagnosis and early access to treatment can improve outcomes, allow the prompt initiation of infection control measures, and limit antibiotic use .…”