Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU

Duyu, Muhterem; Karakaya, Zeynep

doi:10.1016/j.medin.2020.04.023

Cited by 8 publications

(4 citation statements)

References 36 publications

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“…The local epidemiology of these combinations may differ depending on the location, climate, and season. For example, RSV and hBoV or in uenza and hBoV were reported to be the most common combinations in children with ALRI in the United Kingdom (56,57). The current study demonstrated no signi cant differences in the in-hospital mortality and length of hospitalisation between the patients detected with one virus and those with two or more viruses.…”

Section: Discussioncontrasting

confidence: 41%

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Kamata¹,

Thein²,

Ja³

et al. 2021

Preprint

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Background Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major causative factors of ALRI after the introduction of bacterial conjugate vaccines. In Myanmar, ALRI is associated with high morbidity and mortality in children. However, detailed information on ALRI is currently lacking. Methods We conducted a prospective study to investigate the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The World Health Organization’s definitions of ALRI and severe ALRI were used with minor modifications. For the patients with suspected viral ALRI, a nasopharyngeal swab was obtained, and rapid tests for influenza and respiratory syncytial virus (RSV) were performed, followed by real-time PCR for the 16 respiratory viruses causing ALRI. Clinical information was extracted from the medical records. Results Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were randomly enrolled in the study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty of breathing (73%), while the most common signs were tachypnoea (78%) and chest indrawing (67%). Sixteen potentially causative viruses were detected in 502 (88%) patients, with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected simultaneously in 221 patients (37%). Severe ALRI was diagnosed in 107 patients (19%). The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected in such cases. Conclusions Viral ALRI in children has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected, while influenza virus and RSV were the most common causes of mortality.

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Section: Discussioncontrasting

confidence: 41%

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Kamata¹,

Thein²,

Ja³

et al. 2021

Preprint

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“…29 ARDS developed in 28.6% of the patients hospitalized in the PICU with a diagnosis of viral LRTI, and it was the most common complication among the patients hospitalized with viral infection. 30 In our study, the ratio of ARDS development was 9.4% in PCR-positive patients hospitalized in PICU with LRTIs.…”

Section: Discussionmentioning

confidence: 46%

Epidemiology and Acute Respiratory Distress Syndrome Propensity of Viral Respiratory Infections in Pediatric Intensive Care Units Prior to the Coronavirus Disease 2019 Pandemic

Evren¹,

Besci²,

Appak

et al. 2023

J Pediatr Infect Dis

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This study aimed to determine the epidemiology and acute respiratory distress syndrome (ARDS) propensity of common respiratory viruses in a tertiary pediatric intensive care unit (PICU) among hospitalized children who were tested for respiratory viruses by polymerase chain reaction (PCR) prior to the coronavirus disease 2019 (COVID-19) pandemic. Respiratory tract samples were collected from patients who were followed up in the Dokuz Eylul University Hospital pediatric intensive care unit between March 2015 and March 2020 and tested for viral pathogens. The results of 269 patients between 1 month and 18 years of age were evaluated retrospectively. In the 5 years preceding the COVID-19 pandemic, 269 patients with a lower respiratory infection were admitted to the PICU. A positive viral PCR result was detected in 160 patients (59.5%). Human rhinovirus was the most common virus (40%), followed by respiratory syncytial virus (26.3%), human bocavirus (10%), and seasonal coronaviruses (10%). Five (33.3%) of the fifteen children who developed ARDS were infected with influenza A/B, while four (26.7%) were infected with human metapneumovirus (hMPV).Although rhinovirus was the most common viral agent in critically ill children, the incidence of ARDS was higher in children aged over 1 year who had influenza or hMPV infection.

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“…In fact, the utility of FARPT in this indication is mainly epidemiological with a role of sanitary veil [35]. It has been published that the presence of a viral co-infection in bronchiolitis hospitalized in PICU can have a prognostic interest [36] but in this study, viral identification had no impact on the mortality rate. Regarding pneumonia, it would be interesting to study the real influence of PCR tests in the management of pneumonia in PICU.…”

Section: Discussionmentioning

confidence: 65%

Viral Identification Using Multiplex Polymerase Chain Reaction Testing Does Not Reduce Antibiotic Prescribing in Paediatric Intensive Care Units

et al. 2023

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PCR tests for viral identification, performed on nasopharyngeal secretions, have experienced a major boom in the last few years. Their use is very frequent, but their indications are still not well defined, especially in Paediatric Intensive Care Units (PICU). These tests are used for the microbiological diagnosis of lower respiratory infections but can be used in other situations. The aim of the study was to investigate the effect of viral identification on antibiotic therapy management. We conducted a single-centre retrospective study from 1 October 2017 to 31 December 2019. This study included all consecutive FilmArray® Respiratory Panel tests performed in patients hospitalised in a PICU. Patients were identified using the microbiology laboratory prospective database and data were extracted from the medical record. 544 tests corresponding to 408 patients were included. The main reasons for testing were pneumonia (34%) and bronchiolitis (24%). In 70% of cases, at least one virus was identified, with Human Rhinovirus (56%) and Respiratory Syncytial Virus (28%) being the two predominant. Bacterial co-infection was present in 25% of cases. Viral identification was not associated with reduced antibiotic therapy. On multivariate analysis, antibiotic management was significantly associated with clinical gravity, CRP value or radiology findings regardless of virus identification. Viral identification has an epidemiological value, but antibiotic prescription relies on other factors.

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Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU

Abstract: Objective: To determine the viral etiology of severe lower respiratory tract infections (LRTIs), their clinical significance and prognosis among critically ill children. Design: A prospective descriptive study was carried out.

Cited by 8 publications

References 36 publications

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Epidemiology and Acute Respiratory Distress Syndrome Propensity of Viral Respiratory Infections in Pediatric Intensive Care Units Prior to the Coronavirus Disease 2019 Pandemic

Viral Identification Using Multiplex Polymerase Chain Reaction Testing Does Not Reduce Antibiotic Prescribing in Paediatric Intensive Care Units

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