The clinical characteristics in infantile bronchiolitis and pneumonia according to respiratory syncytial virus subgroups: experience of single tertiary medical center from 2010 to 2012

Ga Hyun Yoon; Yeo Hyang Kim

doi:10.4168/aard.2013.1.1.84

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Yoon and Kim: The clinical characteristics in infantile bronchiolitis and pneumonia according to respiratory syncytial virus subgroups: experience of single tertiary medical center from 2010 to 2012

Original Article

Allergy Asthma Respir Dis 2013;1(1):84-89.

Published online: 5 March 2013

DOI: https://doi.org/10.4168/aard.2013.1.1.84

The clinical characteristics in infantile bronchiolitis and pneumonia according to respiratory syncytial virus subgroups: experience of single tertiary medical center from 2010 to 2012

Ga Hyun Yoon, Yeo Hyang Kim

Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea

Correspondence to: Yeo Hyang Kim Department of Pediatrics, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea Tel: +82-53-250-7524, Fax: +82-53-250-7783, E-mail : kimyhped@hanmail.net

• The research was supported by the Bisa Research Grant of Keimyung University in 2012.

Received 6 December 20127 March 2013 Accepted 7 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The most common cause of bronchiolitis and pneumonia in infants is respiratory syncytial virus (RSV). We evaluated the clinical characteristics according to RSV subgroup in infantile bronchiolitis and pneumonia.

Methods

This study enrolled infants with bronchiolitis or pneumonia infected by single virus. Virus infection was confirmed by respiratory virus reverse transcriptase polymerase chain reaction in two consecutive seasons (2010–2011, 2011–2012). They were di-vided into 3 groups: group 1 with RSV A, group 2 with RSV B, and group 3 with other virus. We retrospectively reviewed the medical charts to collect data on the hospitalized patients.

Results

Seventy four and 181 infants were included in the two seasons, respectively. The most common virus was RSV B in 2010–2011 and RSV A in 2011–2012. Among 255 infants, 55% (141/255) were group 1, 20% (49/255) group 2, 25% (65/255) group 3. Infants younger than 3 months were 55%. There were no significant age differences between groups. In comparison to group 3, group 1 and 2 showed frequent abnormal chest auscultation, high symptom severity score and need for systemic corticosteroid (P<0.05). In comparison to group 1 and 3, group 2 had longer hospitalization and time to need for normalization of lung sound (P<0.05). The recurrence rates within 6 months showed no significant differences between groups.

Conclusion

The RSV subgroup changed from one year to another. Patients’ clinical manifestations and symptom severity may vary according to infected virus subgroup.

Keywords: Infant, Respiratory syncytial viruses, Bronchiolitis, Pneumonia

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Fig. 1.

Proportion of infants according to virus species from September 2010 to May 2011 (A), and from September 2011 to May 2012 (B). RSV, respiratory syncytial virus.

Fig. 2.

Annual distribution of virus in infants with lower respiratory infection, from September 2010 to May 2011, and from September 2011 to May 2012. RSV, respiratory syncytial virus.

Fig. 3.

Gender proportion according to virus species in infants with lower respiratory infection. RSV, respiratory syncytial virus.

Fig. 4.

Age proportion according to virus species in infants with lower respiratory infection. RSV, respiratory syncytial virus.

Fig. 5.

Symptom severity score according to virus species in infants with lower respiratory infection. RSV, respiratory syncytial virus.

Table 1.

Comparison of clinical manifestations according to causing virus in total 255 infants with bronchiolitis and/or pneumonia by single virus infection

Variable	RSV A	RSV B	Others
Total no.	141	49	65
Sex (male:female)	79:62	32:17	46:19
Median age (mo)	2	4	4
Past history
Prematurity	34 (24.1)	8 (16.3)	19 (29.2)
Respiratory distress syndrome	9 (6.4)	1 (2.0)	8 (12.3)
Bronchopulmonary dysplasia	1 (0.7)	0 (0)	2 (3.1)
Congenital heart disease	5 (3.5)	4 (8.1)	2 (3.1)
Chromosomal anomaly	0 (0)	2 (4.0)	1 (1.5)
Others	8 (5.6)	1 (2.0)	2 (3.1)
Present illness
Fever (>38)	55 (39.0)	22 (44.9)	40 (61.5)∗^,†
Grunting	6 (4.3)	3 (6.1)	4 (6.2)
Tachypnea	0 (0)	0 (0)	0 (0)
Hypoxia (oxygen saturation<92%)	0 (0)	3 (6.1)^‡	1 (1.5)
Rale	100 (70.9)∗	32 (65.3)	35 (53.8)
Wheezing	83 (58.9)∗	31 (63.3)^†	25 (38.5)
Decreased aeration	72 (51.0)	9 (18.3)^‡	28 (43.0)
Treatment
Systemic steroid	52 (36.9)∗	21 (42.9)^†	14 (21.5)
Inhaled steroid	63 (44.9)	21 (42.9)	27 (41.5)
Oxygen supply	28 (19.9)	9 (18.4)	14 (21.5)
Ventilator use	0 (0)	0 (0)	1 (1.5)
Prognosis
Duration of hospitalization (day) (SD	) 5.7 (1.9)	7 (2.9)^†,‡	5.8 (3.2)
Recur	14 (9.9)	4 (8.2)	6 (9.2)

Values are presented as number (%) unless otherwise indicated.

RSV, respiratory syncytial virus; SD, standard deviation.

^∗ P<0.0, 5 group 1 vs. group 3.

^† P<0.05, group 2 vs. group 3.

^‡ P<0.05, group 1 vs. group 2.

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