Nadia Soudani1,2,3, Miguela A Caniza4,5, Aia Assaf-Casals2,6, Rouba Shaker2,6, Mireille Lteif2,6, Yin Su7, Li Tang7, Imad Akel2,6, Samar Muwakkit6,8, Ahmad Chmaisse1,2, Maysam Homsi5, Ghassan Dbaibo2,6, Hassan Zaraket1,2. 1. Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut Faculty of Medicine, Beirut, Lebanon. 2. Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon. 3. Department of Biology, Faculty of Sciences, EDST, Lebanese University, Lebanon. 4. Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee. 5. Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee. 6. Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon. 7. Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee. 8. Children's Cancer Center of Lebanon, American University of Beirut, Beirut, Lebanon.
Abstract
BACKGROUND: Patients with pediatric cancer have a higher risk of morbidity and mortality because of respiratory viral infections than other patient populations. OBJECTIVES: To investigate the causative viruses of respiratory infections and their burden among patients with pediatric cancer in Lebanon. STUDY DESIGN: Nasopharyngeal swabs along with clinical and demographic data were collected from patients with pediatric cancer presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by the real-time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections. RESULTS: We obtained 89 nasopharyngeal swabs from patients with pediatric cancer (mean age, 5.8 ± 4.2 years). Real-time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV; 26%), influenza type B (26%), human metapneumovirus (24.6%), and human coronavirus (HCoV; 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission. CONCLUSION: Patients with pediatric cancer have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use.
BACKGROUND:Patients with pediatric cancer have a higher risk of morbidity and mortality because of respiratory viral infections than other patient populations. OBJECTIVES: To investigate the causative viruses of respiratory infections and their burden among patients with pediatric cancer in Lebanon. STUDY DESIGN: Nasopharyngeal swabs along with clinical and demographic data were collected from patients with pediatric cancer presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by the real-time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections. RESULTS: We obtained 89 nasopharyngeal swabs from patients with pediatric cancer (mean age, 5.8 ± 4.2 years). Real-time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV; 26%), influenza type B (26%), human metapneumovirus (24.6%), and human coronavirus (HCoV; 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission. CONCLUSION:Patients with pediatric cancer have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use.
Authors: Augustina K Arjarquah; Evangeline Obodai; Hannah Ayettey Anie; Michael Aning Osei; John Kofi Odoom; Joseph H K Bonney; Eric Behene; Erasmus N Kotey; James Aboagye; Stephen O Nyarko; Jeannette Bentum; Clara Yeboah; Selassie Kumordjie; Bright Agbodzi; Keren Attiku; Gifty Mawuli; Andrew Letizia; William K Ampofo; Osbourne Quaye Journal: PLoS One Date: 2022-07-26 Impact factor: 3.752