Respiratory viruses associated with community-acquired pneumonia in children: matched case–control study

Rhedin, Samuel; Lindstrand, Ann; Hjelmgren, Annie; Rinder, Malin Ryd; Öhrmalm, Lars; Tolfvenstam, Thomas; Örtqvist, Åke; Rotzén-Östlund, Maria; Zweygberg-Wirgart, Benita; Henriques‐Normark, Birgitta; Broliden, Kristina; Nauclér, Pontus

doi:10.1136/thoraxjnl-2015-206933

Cited by 126 publications

(176 citation statements)

References 33 publications

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“…The proportion of diagnostic seroresponses was higher for all patients with high virus loads (lower C T values), which would be predicted for primary virus infections and is consistent with case-control studies that have shown higher virus loads among RT-PCR-positive symptomatic patients than among matched asymptomatic controls (9,16,21). The relative prevalences of virus detection and patterns of age distribution found in this study were similar for RT-PCR and serology and were consistent with those reported in other CAP studies (9,10,19). Finally, for most viruses, positive test results obtained by both methods were temporally concordant with each other and with the seasonal circulation patterns of the respective respiratory viruses described by regional NREVSS data over the study period.…”

Section: Discussionsupporting

confidence: 64%

“…More infections were detected by RT-PCR than by serology for all viruses tested. It is generally recognized that detection of RSV, HMPV, and PIVs by RT-PCR in the upper respiratory tract is sufficient to explain clinical illness (9,16,17). Even in the absence of serologic confirmation, a positive RT-PCR result with these viruses would be sufficient for disease association.…”

Section: Discussionmentioning

confidence: 99%

“…Although often associated with clinically mild infections, respiratory viruses can also cause severe lower respiratory tract illnesses, including pneumonia, particularly in young children and elderly adults. Respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza viruses (PIVs), and adenovirus (AdV), among other respiratory viruses, have frequently been associated with CAP (5)(6)(7)(8)(9)(10)(11).…”

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confidence: 99%

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Serology Enhances Molecular Diagnosis of Respiratory Virus Infections Other than Influenza in Children and Adults Hospitalized with Community-Acquired Pneumonia

et al. 2017

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Both molecular and serological assays have been used previously to determine the etiology of community-acquired pneumonia (CAP). However, the extent to which these methods are correlated and the added diagnostic value of serology for respiratory viruses other than influenza virus have not been fully evaluated. Using data from patients enrolled in the Centers for Disease Control and Prevention (CDC) Etiology of Pneumonia in the Community (EPIC) study, we compared real-time reverse transcription-PCR (RT-PCR) and serology for the diagnosis of respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus 1 to 3 (PIV1, PIV2, and PIV3), and adenovirus (AdV) infections. Of 5,126 patients enrolled, RT-PCR and serology test results were available for 2,023, including 1,087 children below the age of 18 years and 936 adults. For RSV, 287 (14.2%) patients were positive by RT-PCR and 234 (11.6%) were positive by serology; for HMPV, 172 (8.5%) tested positive by RT-PCR and 147 (7.3%) by serology; for the PIVs, 94 (4.6%) tested positive by RT-PCR and 92 (4.6%) by serology; and for AdV, 111 (5.5%) tested positive by RT-PCR and 62 (3.1%) by serology. RT-PCR provided the highest number of positive detections overall, but serology increased diagnostic yield for RSV (by 11.8%), HMPV (by 25.0%), AdV (by 32.4%), and PIV (by 48.9%). The method concordance estimated by Cohen's kappa coefficient () ranged from good (for RSV; ϭ 0.73) to fair (for AdV; ϭ 0.27). Heterotypic seroresponses observed between PIVs and persistent low-level AdV shedding may account for the higher method discordance observed with each of these viruses. Serology can be a helpful adjunct to RT-PCR for research-based assessment of the etiologic contribution of respiratory viruses other than influenza virus to CAP.KEYWORDS respiratory virus infections, community-acquired pneumonia, PCR assays and serology, serology, PCR assays C ommunity-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide (1, 2). In the United States, despite high pneumococcal vaccine coverage among children, CAP remains a common cause of hospitalization for all ages and an

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Serology Enhances Molecular Diagnosis of Respiratory Virus Infections Other than Influenza in Children and Adults Hospitalized with Community-Acquired Pneumonia

et al. 2017

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“…Further studies in African children preceding the availability of PCV, [18,19] and several recent case-control studies in children well vaccinated with PCV13, mostly from high-income countries, have reported RSV to be a predominant pathogen in children hospitalised with pneumonia. [20,21] Consistent with other studies, RSV occurred in young infants with the peak incidence under 6 months. [22] Maternal immunisation against RSV during late pregnancy may therefore be an attractive novel strategy to prevent disease in young infants.…”

Section: Guest Editorialsupporting

confidence: 78%

Childhood pneumonia – the Drakenstein Child Health Study

et al. 2016

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“…The authors calculated that the odds ratio of a positive viral identification in a symptomatic subject (again all relatively mild community infections), as opposed to an asymptomatic infant with RSV, was 11.7. RHEDIN et al [9] found that the identification of RSV, human metapneumovirus (hMPV), influenza and adenovirus was significantly higher in cases of community-acquired pneumonia than in healthy controls, but this was not the case for rhinovirus and other viruses such as bocavirus. A broader systematic review of published literature in relation to acute lower respiratory tract infections by SHI et al [10] essentially confirmed these findings, reporting strong evidence for causal attribution of RSV (OR 9.8), influenza (OR 5.0), parainfluenza (OR 3.4) and hMPV (OR 3.8).…”

Section: Identification Of Pathogens and Relationship To Disease And mentioning

confidence: 99%

Paediatric respiratory infections

Everard

2016

Eur Respir Rev

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Pulmonary infections remain a major cause of infant and child mortality worldwide and are responsible for a substantial burden of morbidity. During the 2015 European Respiratory Society International Congress in Amsterdam, some of the main findings from peer-reviewed articles addressing this topic that were published in the preceding 12 months were reviewed in a Paediatric Clinical Year in Review session. The following article highlights some of the insights provided by these articles into the complex interactions of the human host with the extensive and dynamic populations of microorganisms that call an individual "home". @ERSpublications A review of publications from the past year addressing acute life-threatening and chronic respiratory infections http://ow.ly/W4ahI

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Respiratory viruses associated with community-acquired pneumonia in children: matched case–control study

Cited by 126 publications

References 33 publications

Serology Enhances Molecular Diagnosis of Respiratory Virus Infections Other than Influenza in Children and Adults Hospitalized with Community-Acquired Pneumonia

Serology Enhances Molecular Diagnosis of Respiratory Virus Infections Other than Influenza in Children and Adults Hospitalized with Community-Acquired Pneumonia

Childhood pneumonia – the Drakenstein Child Health Study

Paediatric respiratory infections

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