Viral pathogens associated with acute lower respiratory tract infections in children younger than 5 years of age in Bulgaria

Abstract

Acute lower respiratory infections (ALRIs) are a leading cause of morbidity and hospital admissions in children. This study aimed to determine the viral etiology of these infections in children aged < 5 years during three successive epidemic seasons in Bulgaria. Nasopharyngeal and throat specimens were collected from children with bronchiolitis and pneumonia during the 2015/ 2016, 2016/2017, and 2017/2018 seasons. The viral etiology was determined by individual real-time PCR assays against 11 respiratory viruses. Of the 515 children examined, 402 (78.1%) were positive for at least one virus. Co-infections with two and three viruses were found in 64 (15.9%) of the infected children. Respiratory syncytial virus (RSV) was the predominant pathogen (37.5%), followed by rhinoviruses (13.8%), metapneumovirus (9.1%), adenoviruses (7%), bocaviruses (7%), influenza A(H1N1)pdm09 (4.9%), A(H3N2) (4.3%), type B (4.1%), and parainfluenza viruses 1/2/3 (2.9%). RSV-B were more prevalent than RSV-A during the three seasons. At least one respiratory virus was identified in 82.6% and 70.1% of the children with bronchiolitis and pneumonia, respectively. Respiratory viruses, especially RSV, are principal pathogens of ALRIs in children aged < 5 years. Diagnostic testing for respiratory viruses using molecular methods may lead to the reduced use of antibiotics and may assist in measures to control infection.

Pulmonary Hypertension in Children with Lower Respiratory Tract Infections in the Konya Province of Turkey

“…This supports the fact that viral agents are responsible for the majority of LRTI. 2,4 The laboratory findings and symptoms did not predict the risk of developing PH because the present study compared patients with and without PH, and heart failure and PA infiltration were found to be more common in patients with PH.…”

“…LRTI is the main cause of morbidity and mortality due to infectious disease in children aged under 5 years around the world. 2,9 It is an important public health problem that is costly in terms of medical and socioeconomic aspects due to multiple polyclinic examinations, hospitalization, and loss of parents' working hours. 2 In line with the literature, the majority of the patients in our study were male and aged 1 year or younger.…”

“…2,9 It is an important public health problem that is costly in terms of medical and socioeconomic aspects due to multiple polyclinic examinations, hospitalization, and loss of parents' working hours. 2 In line with the literature, the majority of the patients in our study were male and aged 1 year or younger. 10 Factors paving the way for LRTI such as the history of passive smoking, family history of asthmaatopy, at least one family member who had a respiratory tract infection in the last month, a sibling going to school or daycare, 11 and living in the city center 12 were detected.…”

“…Bronchiolitis affects the smallest branches of the bronchial tree in children at <2 years of age and most often has viral etiology. 2 Pneumonia is an acute inflammation that develops in the lung parenchyma (alveoli and interstitium) in response to infectious or noninfectious agents such as bacteria and viruses. It occurs when pathogenic viruses and bacteria invade the mucosa in the upper respiratory tract and spread to the lower respiratory tract.…”

Peripheral blood T cells response in human parainfluenza virus-associated lower respiratory tract infection in children

“…The lower respiratory tract infections (LRTIs) remain a persistent health issue and a leading cause of hospitalization of about 11.9 million young children and mortality worldwide ( Korsun et al, 2019 , McAllister et al, 2019 ). LRTIs are responsible for 6.8% of deaths in neonates, 20% of deaths in children aged 1–12 months, and 12% of deaths in children aged 1–4 years ( Sonawane et al, 2019 ).…”