Comparison of the multiple viral respiratory infections incidence in dependence of the localization and clinical presentation of infections in children

Infekcija dišnog sustava vodeći je uzrok hospitalizacije djece, posebice mlađe od godinu dana. U ovom istraživanju upotrebljena je brza i osjetljiva metoda (multipleks PCR test) za detekciju 12 respiratornih patogena uključujući virus influence A, virus influence B, virus parainfluence (PIV) tip 1, 2 i 3, respiratorni sincicijski virus (RSV) grupe A i B, adenovirus, ljudski rinovirus A i B, ljudski metapneumovirus (MPV), te koronaviruse OC43/HKU1 i 229E/NL63 u uzorcima iz respiratornog sustava 62 djeteta liječena u tromjesečnom razdoblju (veljača-svibanj) zbog infekcije dišnog sustava u Klinici za dječje bolesti u Zagrebu. Virusi su identificirani u 54 (87,1%) djece. Influenca A i influenca B virusi nisu detektirani, RSV je detektiran u 29 (46,8%), PIV u 25 (40,3%), rinovirus u 17 (27,4%), MPV u devet (14,5%), adenovirus u šest (9,7%) i koronavirusi u tri (4,8%) istraživana pacijenta. Koinfekcija s dva ili više virusa opažena je u 27 (50%) djece. Osamnaest pacijenata (60%) inficiranih RSV-om imalo je koinfekciju, dok je šest od devet pacijenata u kojih je dokazan MPV imalo koinfekciju (2/3). RSV je bio značajno udružen s infekcijama donjeg dišnog sustava (χ²=10,6; p0,05). Multipleks PCR test je u dijagnostici najznačajnijih virusa koji izazivaju respiratorne infekcije osjetljiviji od konvencionalnih metoda, a rezultati su dostupni u klinički relevantnom vremenu. Daljnja istraživanja su potrebna da bi se bolje shvatilo značenje višestrukih infekcija.Acute respiratory tract infection is a leading cause of hospitalization of children, particulary infants younger than one year. This study used a rapid and sensitive method (multiplex PCR assay) to detect 12 different respiratory pathogens including influenza A, influenza B, parainfluenza (PIV) types 1, 2 and 3, respiratory syncytial virus (RSV) groups A and B, adenovirus, human rhinovirus, human metapneumovirus (MPV) and human coronavirus OC43/HKU1 and 229E/NL63 from respiratory specimens of 62 children treated over 3-month period (February-May) for acute respiratory tract infections in the Clinic for children diseases in Zagreb. Viruses were identified in 54 (87.1%) of the children. Influenza A and influenza B viruses were not detected, RSV was detected in 29 (46.8%), PIV in 25 (40.3%), rhinovirus in 17 (27.4%), MPV in nine (14.5%), adenovirus in six (9.7%) and coronaviruses in three (4.8%) of the patients. Coinfections with two or more viruses were observed in 27 (50%) patients. Eighteen patients (60%) infected with RSV had a coinfection, while six out of nine patients tested positive for MPV had a coinfection (2/3). RSV was significantly associated with lower respiratory tract infections (χ²=10.6; p0.05). Multiplex PCR assay is more sensitive for diagnosis of the main viruses that cause respiratory tract infections compared with conventional methods and obtains results in a clinically relevant time period. Further investigations are needed to broaden our understanding of the significance of multiple infections