Viral and atypical bacterial infection in young children hospitalized due to acute lower respiratory tract infection in Southern Thailand

K. Ruangnapa, Phatthareeda Kaeotawee, Pornapat Surasombatpattana, M. Kemapunmanus, U. Intusoma, Kantara Saelim, W. Anuntaseree
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Abstract

Background: The etiology of acute lower respiratory tract infection (ALTI) in Thailand is not well established. Aims: This study aims to determine the prevalence of viral and atypical bacterial infections in young children hospitalized due to ALTI. Settings and Design: This was a retrospective study. Subjects and Methods: Eighty-two leftover nasopharyngeal specimens obtained from children with ALTI admitted from May to October 2017 in Songklanagarind Hospital were analyzed. Multiplex polymerase chain reaction and the bead hybridization method (NxTAG® Respiratory Pathogen Panel) were used to detect 18 instances of respiratory virus and atypical bacteria. The clinical data for the children were retrospectively reviewed and analyzed from the medical records. Results: From a total of 82 ALTI patients, 60% were male. The median (interquartile range) age was 14.8 (8.0–38.1) months. Seventy-six percent of the patients were positive for at least one viral pathogen. The three most identified pathogens were respiratory syncytial virus (RSV) B (39.0%), RSV A (20.7%), and hRV (12.2%), while atypical bacteria were not found. Patients with RSV infection had significantly higher fever on admission (P < 0.01) and a longer duration of fever (log-rank P < 0.001) compared to the non-RSV group. Conclusions: Viral pathogens were detected in 76% of the children hospitalized due to ALTI. Further, 79% were positive for RSV with significantly high-grade fever.
泰国南部因急性下呼吸道感染住院的幼儿的病毒和非典型细菌感染
背景:泰国急性下呼吸道感染(ALTI)的病因尚不明确。目的:本研究旨在确定因ALTI住院的幼儿中病毒和非典型细菌感染的患病率。环境与设计:这是一项回顾性研究。对象与方法:对2017年5 - 10月Songklanagarind医院收治的ALTI患儿鼻咽标本82份进行分析。采用多重聚合酶链反应和头杂交法(NxTAG®Respiratory Pathogen Panel)对18例呼吸道病毒和非典型细菌进行检测。对患儿的临床资料进行回顾性分析。结果:82例ALTI患者中,男性占60%。年龄中位数(四分位数间距)为14.8(8.0-38.1)个月。76%的患者至少有一种病毒病原体呈阳性。检出最多的3种病原体分别是呼吸道合胞病毒(RSV) B(39.0%)、RSV A(20.7%)和hRV(12.2%),未检出非典型细菌。与非RSV组相比,RSV感染患者入院时发热明显升高(P < 0.01),发热持续时间明显延长(log-rank P < 0.001)。结论:76%因ALTI住院的患儿检出病毒性病原体。此外,79%的RSV病毒呈阳性,伴有明显的高等级发热。
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