Background
Molecular techniques can often reveal a broader range of pathogens in respiratory infections.
We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized
with lower tract acute respiratory infection (LT-ARI), using molecular techniques.
Methods
A nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus,
respiratory syncytial virus (RSV), parainfluenza (1–4), rhinovirus, adenovirus
(A—F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children
with acute respiratory infection prospectively admitted to any of the GENDRES network
hospitals between 2011–2013. The results were corroborated in an independent cohort collected
in the UK.
Results
A total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK
cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and
36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples
(45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12–24
months age group. The most frequently observed co-infection patterns were RSV—Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV—bocavirus / bocavirus—influenza
(5 patients, 5.2%, UK cohort).
Conclusion
The presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is
very frequent and seems to peak at 12–24 months of age. The clinical significance of these
findings is unclear but should warrant further analysis.