Allergy Asthma Respir Dis.  2013 Dec;1(4):370-376. 10.4168/aard.2013.1.4.370.

Clinical characteristics of respiratory virus infection in children admitted to an intensive care unit

Affiliations
  • 1Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea. pdlks@dankook.ac.kr
  • 2Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea.
  • 3Department of Pediatrics, National Medical Center, Seoul, Korea.

Abstract

PURPOSE
To investigate the clinical characteristics and the risk factors for mechanical ventilator treatment and incidence of complications in children admitted to an intensive care unit (ICU) with detected respiratory viruses.
METHODS
Eighty-two patients who were detected respiratory viruses by multiplex real-time polymerase chain reaction from nasopharyngeal aspirates were enrolled among the 123 children admitted to ICU with acute respiratory manifestations during the study period from January 2006 to December 2012.
RESULTS
Detection rate of respiratory viruses were 66% and 13 patients (16%) had two viruses isolated. The most common respiratory virus isolated was respiratory syncytial virus (RSV) (35%) followed by rhinovirus (19%), adenovirus (13%), parainfluenza virus (11%), influenza virus (11%), human metapneumovirus (6%), and human coronavirus (5%). Pneumonia (70%) was the most common clinical diagnosis. The mean age of patient with RSV infection was the youngest and with influenza virus infection was the oldest among other viruses infection (mean+/-standard deviation, 5.9+/-10.1 months vs. 51.0+/-26.1 months; P=0.01). Forty Patients (49%) who had the underlying diseases were not associated with incidence of mechanical ventilator treatment and complications. Bacterial coinfection with respiratory virus was the significant risk factor of mechanical ventilator care and incidence of complications (odds ratio [OR], 50.003; 95% confidence interval [CI], 3.955-632.144; P=0.003, and OR, 15,569; 95% CI, 1.803-134.452; P=0.013).
CONCLUSION
The significant morbidity of pediatric patient admitted to ICU with respiratory virus infection (RVI) was associated with bacterial coinfection. Furthermore, multicenter study should be performed to investigate the epidemiology of RVI in pediatric patients admitted to ICU in domestic.

Keyword

Respiratory virus; Intensive care units; Child

MeSH Terms

Adenoviridae
Child*
Coinfection
Coronavirus
Diagnosis
Epidemiology
Humans
Incidence
Intensive Care Units*
Critical Care*
Metapneumovirus
Orthomyxoviridae
Paramyxoviridae Infections
Pneumonia
Real-Time Polymerase Chain Reaction
Respiratory Syncytial Viruses
Rhinovirus
Risk Factors
Ventilators, Mechanical
Viruses*

Figure

  • Fig. 1 Incidence of respiratory viruses detected in pediatric patients admitted to intensive care unit with acute respiratory manifestations. RSV, respiratory syncytial virus; hRV, human rhinovirus; ADV, adenovirus; PIV, parainfluenza virus; IFV, influenza virus; hMPV, human metapneumovirus; CoV, coronavirus.

  • Fig. 2 Monthly distribution of respiratory viruses detected. CoV, coronavirus; hMPV, human metapneumovirus; hRV, human rhinovirus; IFV, influenza virus; ADV, adenovirus; PIV, parainfluenza virus; RSV, respiratory syncytial virus.


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Clinical characteristics of lower respiratory tract infection in low birth weight children
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