Viral aetiology and clinical outcomes in hospitalised infants presenting with respiratory distress

Acta Paediatr. 2014 Jun;103(6):625-9. doi: 10.1111/apa.12623. Epub 2014 Apr 1.

Abstract

Aim: To determine the prevalence of various types of viruses in infants hospitalised due to respiratory distress, compare molecular diagnostic tests and evaluate symptom severity.

Methods: All 136 nasopharyngeal aspirates from infants hospitalised for respiratory distress over a 9-month period were analysed for virus type by in-house respiratory syncytial virus (RSV) polymerase chain reaction (PCR) microarray-based and/or Luminex-based multiplex molecular tests. Medical records were reviewed retrospectively for clinical data.

Results: Viral aetiology was confirmed in 126 subjects (92.6%) with 26 infected by more than one virus. RSVA/B was the most common (50.9%), followed by entero/rhinovirus (21.6%), human metapneumovirus (10.5%), parainfluenza virus (5.9%) and influenza (3.3%). RSV-infected infants had significantly lower saturation levels (89% versus 92%, p < 0.001), higher demand for oxygen (42.7% versus 21.6%, p = 0.021) and fluids (28% versus 9.8%; p = 0.014) and longer hospital stays (4 versus 3 days, <0.001) than other viruses. Luminex assays gave repeatable, slightly less sensitive results than in-house RSV PCR. Microarray-based assays were more sensitive, however, producing some unrepeatable results.

Conclusion: Respiratory syncytial virus dominates as the viral cause in hospitalised infants with respiratory distress in Sweden during the winter season, resulting in a clinical course that is significantly more severe. The multiplex assays produced reasonably concordant results.

Keywords: Infants; Multiplex assay; Polymerase chain reaction; Respiratory viruses.

MeSH terms

  • Chromatography, Affinity
  • Coinfection / epidemiology
  • Coinfection / virology
  • Enterovirus / isolation & purification
  • Female
  • Humans
  • Infant
  • Inpatients
  • Length of Stay
  • Male
  • Microarray Analysis
  • Molecular Diagnostic Techniques / methods*
  • Multiplex Polymerase Chain Reaction
  • Nasopharynx / virology
  • Prevalence
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / virology*
  • Respiratory Syncytial Virus Infections / diagnosis*
  • Respiratory Syncytial Virus Infections / epidemiology
  • Respiratory Syncytial Virus Infections / physiopathology
  • Respiratory Syncytial Virus, Human / isolation & purification
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / physiopathology
  • Respiratory Tract Infections / virology*
  • Retrospective Studies
  • Rhinovirus / isolation & purification
  • Severity of Illness Index
  • Sweden / epidemiology