Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China

PLoS One. 2015 Mar 9;10(3):e0119170. doi: 10.1371/journal.pone.0119170. eCollection 2015.

Abstract

Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children's Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for pathogens in children with ARTIs. This study provides useful information for improving case prevention and management.

MeSH terms

  • Acute Disease
  • Adenoviruses, Human / isolation & purification*
  • Adolescent
  • Child
  • Child, Hospitalized*
  • Child, Preschool
  • China / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza B virus / isolation & purification*
  • Male
  • Mycoplasma pneumoniae / isolation & purification*
  • Prevalence
  • Regression Analysis
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / microbiology*
  • Respiratory Tract Infections / pathology

Grants and funding

This work was supported by research grants from the Major State Basic Research Development Program (973 Program) (2012CB518900), the National Natural Science Foundation of China (31230005 and 81171525), the National Mega Project on Major Infectious Disease Prevention (2012ZX10002006-003 and 2012ZX10004-207). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.