Enteroviruses as major cause of microbiologically unexplained acute respiratory tract infections in hospitalized pediatric patients

• Published in: The Journal of infection Vol. 66; no. 6; pp. 494 - 502
• Main Authors: Renois, Fanny, Lévêque, Nicolas, Deliège, Pierre-Guillaume, Fichel, Caroline, Bouin, Alexis, Abely, Michel, N'Guyen, Yohan, Andréoletti, Laurent
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.06.2013; Elsevier; WB Saunders; The British Infection Association. Published by Elsevier Ltd
• Subjects: Acute Disease; Biological and medical sciences; Bronchiolitis; Bronchiolitis - epidemiology; Bronchiolitis - virology; Child; Child, Preschool; Clinical severity; Enterovirus - classification; Enterovirus - genetics; Enterovirus - isolation & purification; Enterovirus genus; Epidemiology; Female; France - epidemiology; General aspects; Hepatitis E virus; Hospitalization - statistics & numerical data; Human health and pathology; Humans; Infant; Infectious Disease; Infectious diseases; Life Sciences; Male; Medical sciences; Nasopharynx - virology; Pediatric patients; Pediatrics; Phylogeny; Picornaviridae Infections - epidemiology; Picornaviridae Infections - virology; Pulmonology and respiratory tract; Real-Time Polymerase Chain Reaction; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - virology; Retrospective Studies; Rhinovirus; Rhinovirus - classification; Rhinovirus - genetics; Rhinovirus - isolation & purification; RT-qPCR assay; Wheezing; France; Clinical severity; Enterovirus genus; Wheezing; RT-qPCR assay; Pediatric patients; Epidemiology; Bronchiolitis; Rhinovirus; Human; Hospitalization; Respiratory system infection; Respiratory disease; Child; Acute; epidemiology; enterovirus genus; wheezing; rhinovirus; RTqPCR assay; bronchiolitis; clinical severity; pediatric patients
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2013.03.007

Summary Objective To assess the etiological role and the clinical characteristics of HRV and HEV infections in pediatric patients hospitalized for acute respiratory tract infections (ARTIs). Methods RT-qPCR assays and molecular sequencing methods were used to identify HRV and HEV strains in nasopharyngeal aspirates of 309 hospitalized pediatric patients with microbiologically unexplained ARTIs and in 210 hospitalized pediatric patients without respiratory symptoms from September 2009 to June 2010 in France. Results Among the 309 ARTI cases, 15 HEV and 172 HRV strains were identified whereas only 1 HEV and 37 HRV strains were observed in control patients (187 vs. 38: P  < 10−3 ). HRV strains were identified in 150 of the 164 lower ARTIs whereas HEV strains were identified in only 14 of these cases. Among bronchiolitis and asthma exacerbation cases ( n  = 133), HEV infected cases were older (Median age (months) 36 vs. 11, P  = 0.003) and were more frequently associated with a respiratory distress ( P  = 0.01) and a need for oxygen supply at the time of admission ( P  = 0.01) than cases infected by HRV strains. Conclusion HRV and HEV strains were identified as potential etiological causes of 60.5% of microbiologically unexplained ARTIs diagnosed in hospitalized pediatric cases. A higher clinical severity was observed in HEV infected bronchiolitis or asthma exacerbation cases in comparison to HRV infected cases.