Bronchiolitis in Abha, Southwest Saudi Arabia: viral etiology and predictors for hospital admission.

BACKGROUND: Bronchiolitis is the most common lower respiratory tract infection in children less than 24 months of age and the most frequent cause of hospitalization in infants under 6 months of age.
OBJECTIVES: To determine the viral etiology and predictors for hospital admission of children with bronchiolitis in Abha city, southwest Saudi Arabia. METHODS AND MATERIALS: Children five years old or younger diagnosed with bronchiolitis were enrolled in the study as a study-group of admitted cases (n=51) and a control-group of non-admitted cases (n=115). Clinical features and risk factors of bronchiolitis were recorded at the time of presentation and the clinical course was monitored during the hospital stay. Nasopharyngeal aspirates (NPA) for respiratory virus isolation were obtained from each of the admitted cases at the time of hospital admission.
RESULTS: Prematurity, chronic lung diseases, atopic dermatitis, pure formula feeding, passive smoking and age = one year were significant predictors of admission. Respiratory syncytial virus (RSV) was isolated in 40% of the admitted cases. Eighty percent of brochiolitis due to RSV were in children less than six months of age. Adenovirus was isolated in 22% of cases. Other viruses isolated were: Influenza virus A (11%), influenza virus B (7%), Parainfluenza viruses (18%), parainfluenza virus type 1 (4%), parainfluenza virus type 2 (2%) and parainfluenza virus type 3 (13 %).
CONCLUSIONS: Respiratory syncytial virus was the most frequent cause of admitted-cases of bronchiolitis, followed by adenovirus, parainfluenza virus and influenza virus, respectively. Prematurity, history of atopy, chronic lung disease, passive smoking, age = one year and lack of pure breast-feeding were significant predictors for admission of bronchiolitis cases.