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Yeol Ryoon Woo1, Hyun Jin Kim1, Min Sub Kim1, Hyo Jung Koh1, Seong Gyu Lee2, Yeon Hwa Ahn1
Abstract
Purpose
We investigated the clinical difference between single infection and coinfection with respiratory virus in hospitalized children with acute respiratory tract infections.
Methods
We reviewed 727 patients who were admitted with the diagnosis of acute respiratory infection at the Department of Pediatrics, Bundang Jesaeng Hospital between January and December of 2014. Diagnoses were made using the multiplex reverse transcriptase polymerase chain reaction (RT-PCR) assay targeting 16 viruses in nasopharyngeal swabs. Subjects were classified as the single virus infection and coinfection groups.
Results
A total of 439 patients were enrolled; 359 (77.2%) under 24 months. Single virus was detected in 279 (63.6%). Coinfection with multiple virus was detected in 160 (36.4%): 126 (28.7%) with 2 viruses, 30 (6.8%), and 4 (0.9%) with 3 to 4 viruses. Viral coinfection was detected in 28 samples (17.5%), with respiratory syncytial virus (RSV) A and rhinovirus being the most dominating combination. There were no clinical differences between the single infection and coinfection groups, except sputum and the frequency of high RSV load. Sputum was significantly more frequent in the coinfection group (P=0.043), and the frequency of high RSV load was significantly higher in the single infection group (P=0.029). Disease severity (high fever, the duration of fever [≥5 days], and the length of hospital stay [≥5 days], O2 therapy) did not differ significantly between both groups. RSV was a frequent virus of single infection during winter. Coinfection was most common in winter.
Figures and Tables
Fig. 1
Percentage of coinfection, by respiratory virus. RSV, respiratory syncytial virus; RV, rhinovirus; MPV, metapneumovirus; PIV, parainfluenza; AdV, adenovirus; BoV, bocavirus; CoV, coronavirus; EV, enterovirus; IFV, influenza virus.
Fig. 2
Monthly distribution of single and coinfection. RSV, respiratory syncytial virus; RV, rhinovirus; MPV, metapneumovirus; PIV, parainfluenza; AdV, adenovirus; BoV, bocavirus; CoV, coronavirus; EV, enterovirus; IFV, influenza virus.
Table 1
Demographic and clinical characteristics of the subjects (n=439)
Table 2
Clinical characteristics of excluded subjects (n=128)
Table 3
Comparison of clinical characteristics between single and coinfection
Values are presented as number, mean±standard deviation, or number of cases (%).
WBC, white blood cell; CRP, C-reactive protein; RSV, respiratory syncytial virus; RV, rhinovirus; AdV, adenovirus; MPV, metapneumovirus.
*1–12 months, respiratory rate≥55/min; 13–36 months, respiratory rate≥30/min; 37–72 months, respiratory rate≥25/min; ≥73 months, respiratory rate≥22/min.
Table 4
Comparison of severity between single and coinfection
Table 5
Prevalence of viral single and coinfection
Table 6
Prevalence of single and coinfection for 4 viral subtypes
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