Clinical characteristics of the lower respiratory tract infection caused by a single infection or coinfection of the human parainfluenza virus in children

J Med Virol. 2019 Sep;91(9):1625-1632. doi: 10.1002/jmv.25499. Epub 2019 May 29.

Abstract

Background: Human parainfluenza virus (HPIV), usually combined with other pathogens, causes lower respiratory tract infection (LRTI) in children. However, clinical characteristics of HPIV coinfection with other pathogens were unclear. This study aimed to investigate the viral and atypical bacterial etiology of LRTI in children and compare the clinical characteristics of HPIV single infection with those of coinfection.

Methods: This study included 1335 patients, aged between 1 to 71 months, diagnosed with LRTI in Yuying Children's Hospital, Zhejiang, China, from December 2013 to June 2015. Nasopharyngeal secretions were collected, and respiratory pathogens were detected using Multiplex polymerase chain reaction. The clinical data of patients were collected and analyzed.

Results: At least 1 pathogen was detected in 1181/1335 (88.5%) patients. The pathogens identified most frequently were respiratory syncytial virus, human rhinovirus, HPIV, adenovirus, and human metapneumovirus. The coinfection rate was 24.8%. HPIV coinfection with other viruses was more associated with running nose, shortness of breath, and oxygen support compared with HPIV single infection. Moreover, HPIV coinfection with atypical bacteria was more related to running nose, moist rales, and longer hospital duration compared with HPIV single infection, and also to longer hospital duration compared with coinfection with other viruses.

Conclusions: This study demonstrated that viral infections were highly associated with LRTI and the rate of coinfection was high. HPIV single infection was milder than coinfection with other viruses. Moreover, HPIV coinfection with atypical bacteria was more serious than HPIV single infection and coinfection with other viruses.

Keywords: children; clinical characteristics; coinfection; human parainfluenza virus; lower respiratory tract infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Child, Preschool
  • China / epidemiology
  • Coinfection / epidemiology*
  • Coinfection / virology*
  • Comorbidity
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Multiplex Polymerase Chain Reaction
  • Paramyxoviridae Infections / diagnosis
  • Paramyxoviridae Infections / epidemiology*
  • Paramyxoviridae Infections / virology*
  • Public Health Surveillance
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / virology*
  • Respirovirus* / classification
  • Respirovirus* / genetics