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Abstract
Purpose
This study aimed to investigate the association between respiratory virus infection and pneumococcal colonization in children. Methods: From May 2009 to June 2010, nasopharyngeal (NP) aspirates were obtained from patients under 18 years old who visited Seoul National University Children' s Hospital for respiratory symptoms. NP samples were used to detect respi-ratory viruses (influenza virus A and B, parainfluenza virus 1, 2 and 3, respiratory syncytial virus A and B, adenovirus, rhinovirus A/B, human metapneumovirus, human coronavirus 229E/NL63 and OC43/HKU1) by RT-PCR and pneumococcus by culture. Results: Median age of the patients was 27 months old. A total of 1,367 NP aspirates were tested for respiratory viruses and pneumococcus. Pneumococcus was isolated from 228 (16.7%) of samples and respiratory viruses were detected from 731 (53.5%). Common viruses were rhinovirus (18.4%), respiratory syncytial virus (RSV) A (10.6%), adenovirus (6.9%), influ-enza virus A (6.8%). Pneumococcal isolation rate was significantly higher in the cases of positive virus detection than negative detection [21.3% (156/731) vs. 11.3% (72/636), P<0.001]. For individual viruses, pneumococcal isolation rate was positively associated with detection of influenza virus A [24.7% (23/93) vs 16.1% (205/1274), P=0.001], RSV A [28.3% (41/145) vs 15.3% (187/1222), P=0.001], RSV B [31.3% (10/32) vs 16.3% (218/1335), P=0.042], rhinovirus A/B [22.6% (57/252) vs 15.3% (171/1115), P=0.010]. Conclusion: The study revealed that pneumococcal isolation from NP aspirates is related with respiratory virus detection. The result of this study could be used to investigate how respiratory viruses and pneumococcus cause clinical diseases.
References
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Table 1.
The serotypes of Streptococcus pneumoniae isolated from nasopharyngeal aspirates of study pop-ulation, Seoul National University Children's Hospital, 2009–2010 (N=228)
| Serotype | N (%) |
|---|---|
| PCV7 | |
| Subtotal | 36 (15.8) |
| 19F | 20 (8.8) |
| 23F | 8 (3.5) |
| 6B | 4 (1.8) |
| 9V | 2 (0.9) |
| 4 | 1 (0.4) |
| 14 | 1 (0.4) |
| PCV10∗ | |
| Subtotal | 0 (0.0) |
| PCV13† | |
| Subtotal | 56 (24.6) |
| 19A | 29 (12.3) |
| 6A | 27 (11.8) |
| Non-PCV13 | |
| Subtotal | 136 (59.6) |
| 6D | 12 (5.3) |
| 35B | 12 (5.3) |
| 15C | 9 (3.9) |
| 34 | 9 (3.9) |
| 11A | 8 (3.5) |
| 15A | 8 (3.5) |
| 15B | 8 (3.5) |
| 23A | 7 (3.1) |
| 6C | 2 (0.9) |
| others | 16 (7.0) |
| Nontypeable | 45 (19.7) |
| Total | 228 (100.0) |
Table 2.
The Detection Rates of Respiratory Viruses Isolated from the Children with Acute Respiratory Illnesses, Seoul National University Children's Hospital
| Viruses | N (%∗) |
|---|---|
| Rhinovirus A/B | 252 (30.2) |
| Respiratory syncytial virus A | 145 (17.4) |
| Adenovirus | 95 (11.4) |
| Influenza virus A | 93 (11.2) |
| Parainfluenza virus 3 | 72 (8.6) |
| Metapneumovirus | 36 (4.3) |
| Respiratory syncytial virus B | 32 (3.8) |
| Influenza virus B | 31 (3.7) |
| Parainfluenza virus 2 | 23 (2.8) |
| Coronavirus OC43/HKU1 | 23 (2.8) |
| Coronavirus 229E/NL63 | 17 (2.0) |
| Parainfluenza virus 1 | 15 (1.8) |
| Total | 834 (100.0) |
Table 3.
Association between Isolation of Respiratory Viruses and Colonization of Streptococcus pneumoniae
| Pneumococcus | Total | P-value | ||
|---|---|---|---|---|
| Positive | Negative | |||
| Respiratory virus | ||||
| Positive | 156 (21.3%) | 575 (78.7%) | 731 | |
| Negative | 72 (11.3%) | 564 (88.7%) | 636 | |
| Total | 228 (16.7%) | 1,139 (83.1%) | 1,367 | <0.001 |
Table 4.
Association between Types of Respiratory Viruses Isolated and Colonization of Streptococcus pneumoniae
| P-value | Adjusted OR∗ | 95% CI of Adjusted OR | Adjusted P -value | |
|---|---|---|---|---|
| Any virus | <0.001 | 2.02 | 1.49–2.75 | <0.001 |
| Influenza A | 0.031 | 2.37 | 1.40–4.01 | 0.001 |
| RSV A | <0.001 | 1.95 | 1.30–2.92 | 0.001 |
| Rhinovirus | 0.005 | 1.57 | 1.12–2.21 | 0.010 |
| RSV B | 0.025 | 2.23 | 1.03–4.86 | 0.042 |
| Influenza B | 0.168 | 1.85 | 0.80–4.28 | 0.153 |
| Metapneumovirus | 0.175 | 1.43 | 0.66–3.10 | 0.372 |
| Parainfluenza 3 | 0.998 | 0.95 | 0.50–1.80 | 0.867 |
| Parainfluenza 2 | 1.000 | 0.91 | 0.30–2.72 | 0.862 |
| Parainfluenza 1 | 1.000 | 0.64 | 0.16–3.16 | 0.700 |
| Coronavirus 229E/NL63 | 0.335 | 0.30 | 0.04–2.27 | 0.241 |
| Coronavirus OC43/HKU1 | 0.406 | 0.40 | 0.09–1.73 | 0.218 |
| Adenovirus | 0.273 | 0.67 | 0.36–1.25 | 0.207 |
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