Clinical and Pathogenic Characteristics of Lower Respiratory Tract Infection Treated at the Vietnam National Children’s Hospital

Abstract

Lower respiratory tract infections are commonly caused by viruses and cause significant morbidity and mortality among children. Early identification of the pathological agent causing these infections is essential to avoid unnecessary antibiotic use and improve patient management. Multiplex PCR techniques were recently developed to detect multiple viral pathogens using a single PCR reaction. In this study, we identify viral pathogens in children with respiratory infections. We collected 194 nasopharyngeal aspirates from infants (2-24 months old) with lower respiratory tract infections treated at the Vietnam National Children's Hospital between November 2014 and June 2015 and assessed the presence of 16 virus types and subtypes by multiplex PCR using the xTAG Respiratory Viral Panel (RVP) assay. Overall, 73.7% of the samples were positive for at least one virus, and 24.2% corresponded to infections with multiple viruses. e most common viruses were respiratory syncytial virus and enterovirus/ rhinovirus. ese viruses were more frequent among younger patients (2-5 months old) and caused symptoms similar to those of bronchiolitis and pneumonia. e most common clinical manifestation caused by respiratory tract infection was bronchiolitis. Elevated neutrophils levels were associated with adenovirus infection. Our results showed that the xTAG Respiratory Viral Panel (RVP) can effectively detect multiple viruses causing respiratory infections in children and that the nasopharyngeal aspirates are a good sample choice to detect respiratory viruses in children. Applying this approach in the clinical setting would improve patient management and allow early diagnosis, thus avoiding the unnecessary use of antibiotics.

Morbidity and Mortality Patterns in Children Admitted to Hospital in Thai Binh, Vietnam: A Five-year Descriptive Study with a Focus on Infectious Diseases

“…We observed a high rate of LRTI and influenza in hospitalised children. Previous studies in Vietnam showed that respiratory syncytial virus, enterovirus/rhinovirus, parainfluenza virus and adenovirus were frequently associated with LRTI [ 18 – 23 ]. Bacteria classically described to cause community-acquired pneumonia in Vietnamese children include Streptococcus pneumoniae , Hib and Staphylococcus aureus [ 24 ].…”

“…A previous study on 722 hospitalised Vietnamese children [ 25 ], showed that atypical pathogens were identified in 29.8% of cases, mainly Mycoplasma pneumoniae (26.3%). Viral and virus-bacteria co-­infections were frequently detected in children with LRTI [ 18 – 21 , 25 ].…”

Clinical profile of acute lower respiratory tract infections in children aged 2–60 months: An observational study

“…Acute lower respiratory tract infections (ALRIs) are the substantial cause of morbidity and mortality in children, especially in developing countries. [ 1 2 ] Pneumonia and bronchiolitis are most common among children. [ 3 ] Worldwide, around 18% of annual deaths in children below 5 years of age occur due to pneumonia.…”

Auxiliary role of mesenchymal stem cells as regenerative medicine soldiers to attenuate inflammatory processes of severe acute respiratory infections caused by COVID-19

“…The most important agent of ARIs which can cause a wide range of infections in the upper and lower respiratory tract are viruses (Leung et al 2020;Bhuyan et al 2017;Botti et al 2018). Here, more well-known respiratory viruses are influenza, parainfluenza, rhinovirus (RV), coronavirus (CoV), adenovirus, and respiratory syncytial virus (RSV) (Nichols et al 2008;Modena et al 2011;Pham et al 2020). CoVs are a large family of viruses ranging from the common cold virus to the causes of more serious diseases such as severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS), and CoV disease 2019 Paules et al 2020).…”