Viral coinfection in acute respiratory infection in Mexican children treated by the emergency service: A cross-sectional study

Abstract

BackgroundAcute respiratory infections (ARIs) cause illness. Children under five years of age are highly vulnerable to these infections. Viral coinfection or multiple viral infection is a variable that can have a significant impact on the evolution of these diseases.MethodsThis cross-sectional study was carried out in Mexican children (under five years of age) who had an ARI and who were treated by an emergency service in a hospital in Guadalajara, Jalisco, Mexico. The viral etiology, as well as the presence of multiple viral infections, was determined. A structured questionnaire was used to obtain demographic and clinical information. Odds ratio (OR) was calculated, and univariate and multivariate analyses using logistic regression were performed.ResultsIn the study population, metapneumovirus (hMPV) was the most frequent virus (22%), followed by adenovirus (hAD) (16%), respiratory syncytial virus (RSV) (14%), rhinovirus (hRV) (12%), bocavirus (hBoV) (9%), influenza virus (IF) (7%), and parainfluenza (PIF) (4%). The frequency of viral coinfections was 31.62%, and multiple logistic regression analysis revealed that hMPV, RSV, PIF, and hBoV were independently associated with multiple viral infection. No difference was found in the clinical manifestation of children with simple and multiple infections. Simple hMPV infection was associated with patients who presented with severe ARI. Using a multivariate analysis, we found that overcrowding is associated with coinfection when the viral etiology was hRV (OR = 2.56, 95% confidence interval (CI) 1.07 to 6.13), IF (OR = 2.56, 95% CI 1.07 to 6.13), PIF (OR = 2.96, 95% CI 1.15 to 7.65), hAD (OR = 2.56, 95% CI 1.07 to 6.13), and hBoV (OR = 2.9, 95% CI 1.14 to 7.34).ConclusionsViral coinfections are frequent in children requiring treatment by an emergency service. However, the severity of ARI is similar to that of children with a simple infection. The hMPV is common and may confer a significant disease burden in the Mexican population. Finally, overcrowding is a housing characteristic that favors the development of coinfections.Electronic supplementary materialThe online version of this article (doi:10.1186/s13052-015-0133-7) contains supplementary material, which is available to authorized users.

Human bocavirus and human metapneumovirus in hospitalized children with lower respiratory tract illness in Changsha, China

“…Our data support previous reports of RSV, PIV3, HBoV, ADV, and HMPV as the major agents associated with LRTIs among children in a hospital setting. 12,[19][20][21][22] The HBoV infection rate (24.1%) in the present study is consistent with earlier reports (1.9%-24.6% 8,9,16,[23][24][25][26], and the incidence of HMPV (18.2%) in patients with respiratory tract infections is similar to that in other regions (1.5%-18% 2,9,17,23,[26][27][28] ). Therefore, HMPV and HBoV are major causes of LRTIs worldwide.…”

Etiological characteristics of influenza-like illness in Jiangsu province from 2012 to 2016

“…Many reports have demonstrated that 2 or 3 viral species can be detected in 10%-20% of children with pneumonia, and that mixed viral-bacterial infection can be found in up to 45% of cases [16][17] , which is consistent with the results of our study. Detection of multiple pathogens in a fairly high proportion of cases has been a feature in etiological studies of respiratory infection when PCR is used.…”

“…Microorganisms causing ILI are complex and diverse, varying by region and season. Moreover, acute respiratory tract disease in humans sometimes presents with co-infection by more than one organism [16][17] .…”

Global epidemiology of non-influenza RNA respiratory viruses: data gaps and a growing need for surveillance

“…An important starting point is whom and how to sample. Groups at higher risk of disease associated with seasonal influenza virus and NIRV infections are similar and include children, [21][22][23][24][25] elderly individuals, [26][27][28][29][30] immunocompromised individuals, [31][32][33] and individuals with chronic comorbidities (eg, asthma, chronic obstructive pulmonary disease, cardiac and renal failure, or diabetes). Both influenza and NIRV infections can result in hospital admission due to exacerbation of these conditions.…”