Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe—results from the PED-MERMAIDS multicentre case–control study
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Published:2021-07
Issue:1
Volume:8
Page:e000887
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ISSN:2052-4439
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Container-title:BMJ Open Respiratory Research
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language:en
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Short-container-title:BMJ Open Resp Res
Author:
Kohns Vasconcelos MalteORCID, Loens Katherine, Sigfrid Louise, Iosifidis Elias, Epalza Cristina, Donà Daniele, Matheeussen Veerle, Papachristou Savvas, Roilides Emmanuel, Gijon Manuel, Rojo Pablo, Minotti Chiara, Da Dalt Liviana, Islam Samsul, Jarvis JessicaORCID, Syggelou Aggeliki, Tsolia Maria, Nyirenda Nyang’wa Maggie, Keers Sophie, Renk Hanna, Gemmel Anna-Lena, D’Amore Carmen, Ciofi degli Atti Marta, Rodríguez-Tenreiro Sánchez Carmen, Martinón-Torres Federico, Burokienė Sigita, Goetghebuer Tessa, Spoulou Vana, Riordan Andrew, Calvo Cristina, Gkentzi Despoina, Hufnagel Markus, Openshaw Peter J, de Jong Menno D, Koopmans Marion, Goossens Herman, Ieven Margareta, Fraaij Pieter L A, Giaquinto Carlo, Bielicki Julia A, Horby Peter, Sharland Michael
Abstract
BackgroundBoth pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to estimate the aetiological fractions for ARI hospitalisation in children for respiratory syncytial virus (RSV) and influenza virus and to determine whether detection of specific respiratory pathogens on NP samples was associated with ARI hospitalisation.Methods349 children up to 5 years of age hospitalised for ARI (following a symptom-based case definition) and 306 hospital controls were prospectively enrolled in 16 centres across seven European Union countries between 2016 and 2019. Admission day NP swabs were analysed by multiplex PCR for 25 targets.ResultsRSV was the leading single cause of ARI hospitalisations, with an overall population attributable fraction (PAF) of 33.4% and high seasonality as well as preponderance in younger children. Detection of RSV on NP swabs was strongly associated with ARI hospitalisation (OR adjusted for age and season: 20.6, 95% CI: 9.4 to 45.3). Detection of three other viral pathogens showed strong associations with ARI hospitalisation: influenza viruses had an adjusted OR of 6.1 (95% CI: 2.5 to 14.9), parainfluenza viruses (PIVs) an adjusted OR of 4.6 (95% CI: 1.8 to 11.3) and metapneumoviruses an adjusted OR of 4.5 (95% CI: 1.3 to 16.1). Influenza viruses had a PAF of 7.9%, PIVs of 6.5% and metapneumoviruses of 3.0%. In contrast, most other pathogens were found in similar proportions in cases and controls, including Streptococcus pneumoniae, which was weakly associated with case status, and endemic coronaviruses.ConclusionRSV is the predominant cause of ARI hospitalisations in young children in Europe and its detection, as well as detection of influenza virus, PIV or metapneumovirus, on NP swabs can establish aetiology with high probability. PAFs for RSV and influenza virus are highly seasonal and age dependent.
Subject
Pulmonary and Respiratory Medicine
Reference39 articles.
1. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 2. Prevalence of pneumonia and its associated factors among under-five children in East Africa: a systematic review and meta-analysis;Beletew;BMC Pediatr,2020 3. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis 4. Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis;McAllister;Lancet Glob Health,2019 5. Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia;Jiang;BMC Infect Dis,2017
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