Prevalence of respiratory pathogens during two consecutive respiratory syncytial virus seasons at a tertiary medical care center

Abstract

Aim: To determine the etiological profiles of lower respiratory tract infection (LRI) in neonates during respiratory syncytial virus(RSV) season, and to define the clinical features of RSV-related infection and others. Methods: The retrospective study included newborn infants who were hospitalized for LRI during the two consecutive RSV seasons, and then tested for possible etiological agent by multiplex real-time polymerase chain reaction. All relevant data were reviewed, and the clinical characteristics of RSV-related infection were compared to those of others. Results: Of 224 patients, 160 (71 %) were positive for at least one potentially causative agent. Of them, 65 % had RSV, and 15 % had more than on ecausative agent (co-infection). The RSV group had more the findings of respiratory distress (p< 0.01), abnormal chest radiography (p< 0.01), need for intensive care (p< 0.01), and duration of oxygen requirement (p< 0.01) but less fever on admission and duration of antibiotic use (for both, p< 0.01), and no longer hospital stay. Need of intensive care nursery was more common in patients with co-infection than others (25 % vs. 6.5 %, p< 0.01). Conclusion: This study highlighted that RSV was the most frequent agent in neonates hospitalized for LRI during the season, with a more severe clinical course than other detected pathogens. The disease severity of RSV infection may have seemed to be increased by the presence of coinfection and abnormal chest radiography.

Respiratory Syncytial Virus: A Systematic Review and Meta-Analysis of Tomographic Findings (2000–2022)

“…On the one hand, respiratory syndromes associated with RSV have a variable clinical presentation that can lead to a complicated differential diagnosis from other respiratory infections (e.g., bacterial pneumonia, viral upper respiratory tract infections, acute otitis media, and sinusitis) [27]. On the other hand, obtaining appropriate specimens from the respiratory tract may be quite difficult, particularly in children and small infants, as the collection of lower airway secretions requires invasive diagnostic procedures that cannot be routinely used, particularly in newborns and infants aged less than the 2 years (i.e., the highest risk group) [28][29][30]. Unfortunately, noninvasive procedures for the collection of pulmonary specimens (e.g., exhaled breath condensate) have not been extensively validated, and available studies have stressed their substantial shortcomings [31][32][33][34].…”

“…Unfortunately, noninvasive procedures for the collection of pulmonary specimens (e.g., exhaled breath condensate) have not been extensively validated, and available studies have stressed their substantial shortcomings [31][32][33][34]. Moreover, the upper respiratory tract may not accurately reflect the cause of the clinical syndrome, while rapid diagnostic tests on nasal, rhinopharyngeal, or salivary specimens usually lack diagnostic accuracy and are of limited value in the managing of differential diagnosis [27][28][29][30]35].…”