Etiology and Clinical Characteristics of Single and Multiple Respiratory Virus Infections Diagnosed in Croatian Children in Two Respiratory Seasons

Abstract

The aim of this study was to determine the causative agent of acute respiratory infection (ARI) in hospitalized children, as well as investigate the characteristics of ARIs with single and multiple virus detection in two respiratory seasons. In 2010 and 2015, nasopharyngeal and pharyngeal swabs from a total of 134 children, admitted to the hospital due to ARI, were tested using multiplex PCR. Viral etiology was established in 81.3% of the patients. Coinfection with two viruses was diagnosed in 27.6% of the patients, and concurrent detection of three or more viruses was diagnosed in 12.8% of the patients. The most commonly diagnosed virus in both seasons combined was respiratory syncytial virus (RSV) (28.6%), followed by parainfluenza viruses (PIVs) types 1–3 (18.4%), rhinovirus (HRV) (14.3%), human metapneumovirus (10.1%), adenovirus (AdV) (7.1%), influenza viruses types A and B (4.8%), and coronaviruses (4.2%). In 2015, additional pathogens were investigated with the following detection rate: enterovirus (13.2%), bocavirus (HBoV) (10.5%), PIV-4 (2.6%), and parechovirus (1.3%). There were no statistical differences between single and multiple virus infection regarding patients age, localization of infection, and severity of disease (P > 0.05). AdV, HRV, HBoV, and PIVs were significantly more often detected in multiple virus infections compared to the other respiratory viruses (P < 0.001).

Human coronavirus OC43 and other respiratory viruses from acute respiratory infections of Egyptian children

“…Viral infections were confirmed in 58.5% and 33.9% of the males and females respectively with male to female ratio of 1.4:1. Similar ratio was reported by Ljubin-Sternak et al [41], who detected ARI in 109 out of 134 patients with a male to female ratio of 1.5: 1. Liu et al [42] examined 4,242 pediatric patients in southern China for respiratory viruses and reported even a higher male to female ratio of 1.92:1.…”

“…Liu et al [42] also detected HCoVs in only 5.8% of their 2,361 cases. Similarly, Ljubin-Sternak et al [41] detected HCoVs in 4.2% of their cases.…”

“…Respiratory enteroviruses have been extensively studied during the past years and development of molecular tools has allowed better detection of enteroviruses which had remained undetected due to their inability to grow in standard cell culture [2]. Ljubin-Sternak et al [41] detected enteroviruses in 13.2% of their cases preceded only by RSV. Liu et al [42] using real-time polymerase chain detected enterovirus in, 13.3% out of their 2,361 children.…”

Epidemiology of human respiratory viruses in children with acute respiratory tract infection in a 3-year hospital-based survey in Northern Italy

“…The viruses most frequently detected are: influenza viruses A and B (IAV, IBV), human parainfluenza virus (HPIV), human adenovirus (HADV), human metapneumovirus (HMPV), and human respiratory syncytial virus (HRSV). This list is constantly evolving along with improvement in the performance of diagnostic tests (Ljubin-Sternak et al, 2016;Tregoning and Schwarze, 2010) and the discovery of more recent viruses, for example, human bocavirus (HBOV) (Allander et al, 2005), human coronaviruses (HCOVs) NL63 and HKU1, and new human enterovirus (HEV), parechovirus, and rhinovirus strains (Berry et al, 2015).…”

Identification of viral etiology of acute respiratory tract infections in children and adults in Tabanan, Bali, Indonesia

“…Studies have reported co-detection rates of respiratory viruses ranging from 7 to 40 % [18,35,37]. Co-detection was observed in the form of influenza-CMV and HMPV-CMV in 8.5 % of specimens especially in children under the age of 6 years, none of which were associated with severe clinical manifestations.…”