Braz, M

Carneiro, S

McMillan, M

Neto, A

Neves, M

English

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Copyright © 2018 Mónica Cró Braz – cheila.braz@jmellosaude.ptEpidemiology of Respiratory Viruses in a Pediatric Department with Real-time PCRBackground:Respiratory Tract Infections (RTI) are the mostcommon disease in children. They range fromshort, auto-limited infections to severe diseaserequiring admission, with great economic andsocial impact. The majority of RTI are causedby viruses with overlapping clinicalmanifestations. Knowledge of the etiology ofRTI may help to create a better understandingof the natural history of each virus, andeventually improve diagnosis and treatment.Real-time (RT) multiplex PCR is a highlyaccurate molecular test useful for identificationof respiratory viruses.Methods:Prospective observational study, fromDecember 2016 to May 2017 of patientsadmitted in a Pediatric inpatient service (< 18years) with respiratory symptoms.Demographic data, clinical symptoms and signswere collected. RT-PCR was performed onaspirated nasopharyngeal swabs for thefollowing viruses: respiratory syncytial virus(RSV) A and B, adenovirus, influenza A H1N1,H1N1pdm09, H3N2 and B, parainfluenza 1, 2, 3and 4, rhinovirus, human bocavirus,metapneumovirus, enterovirus and coronavirusOC43, 229E and NL63.Results and Discussion:Eighty-three patients were included in thisstudy, 50.6% (42) of which were boys. Thedistribution according to ages is shown intable 1, with one third of patients admittedbetween one and six months.Conclusions:This RT-PCR technique allowed theidentification of viruses in almost 90% ofadmitted patients with RTI. RSV was the mostprevalent virus in both age groups. About onethird of patients had co-infections. The RT-PCR technique is accurate and can help tounderstand the role of etiologic agents in RTIand to prevent nosocomial infection bycohort isolation of infected patients.Viruses n=830 101 522 15≥ 3 6Table 2- Number of viruses isolated inPediatric inpatientsM. Braz1, M. McMillan1, S. Carneiro1,2, M. Neves1, A. Pereira3, M. Menezes3,4, A.S. Neto11Hospital CUF Descobertas, Pediatric Department, Lisbon, Portugal2Hospital Dona Estefânia, Pediatric Department, Lisbon, Portugal3Centro de Medicina Laboratorial Germano de Sousa, Clinical Pathology, Lisbon, Portugal4Hospital CUF Descobertas, Clinical Pathology, Lisbon, PortugalAge group n=83Newborn 41-6M 337-12M 1313-24M 112-4A 125-9A 5≥10 A 5Table 1- Distribution ofPediatric inpatients per age group≤ 6 M (n=46)Viruses > 6M (n=56)24 RSV 2012 Rhinovirus 71 Adenovirus 91 Influenza 60 Parainfluenza 13 Metapneumovirus 32 Bocavirus 31 Enterovirus 62 Coronavirus 1Methods (cont.):The commercial tests used were AllplexTMRespiratory Panel Assays 1, 2 and 3 -Seegene® (specificity 100%; sensitivity 8copies/uL except for metapneumovirus andparainfluenza 4 with 80 copies/uL).Results and Discussion (cont.):In RSV infections, 38.6% (17/44) were co-infections (Figure 1), which were moreprevalent in older children (> 6 months).Three patients needed intensive care: onemonth old with RSV and enterovirus; newbornwith RSV and one year old with Influenza A.Table 3- Distribution of viruses per age group in Pediatric inpatientsAt least one virus was isolated in 87.95%(73/83) of children (Table 2). In patients withnegative RT-PCR, only two had less than 12months. Seventy-one percent (52/73) had onevirus identified, 21% (15/73) two and 8%(6/73) three or more viruses (Table 2).37% 19% 13% 6% 25% RhinovirusAdenovirusInfluenzaMetapneumovirusEnterovirusResults and Discussion (cont.):One hundred and two viruses were isolated in73 patients. The most common virusesisolated in children with less than six monthswere RSV (24/46) and rhinovirus (12/46). Inolder children, RSV (20/56) and adenovirus(9/56) were the most frequent (table 3).Figure 1 – RSV co-infectionsn=17http://hdl.handle.net/10400.26/22819

Epidemiology of respiratory viruses in a pediatric department with real-time PCR

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Epidemiology of respiratory viruses in a pediatric department with real-time PCR

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