Cheng Lei1, Lisong Yang2, Cheong Tat Lou1, Fan Yang2, Kin Ian SiTou1, Hao Hu2, King Io1, Kun Tat Cheok1, Baoquan Pan1, Carolina Oi Lam Ung3. 1. Department of Pediatrics, Kiang Wu Hospital, Macao SAR, China. 2. State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China. 3. State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China. carolinaung@um.edu.mo.
Abstract
BACKGROUND: Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. METHODS: A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. RESULTS: Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. CONCLUSIONS: This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.
BACKGROUND:Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. METHODS: A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. RESULTS: Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. CONCLUSIONS: This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratoryviral infections among children in Macao.
Authors: Evan J Anderson; Eric A F Simões; Jim P Buttery; Penelope H Dennehy; Joseph B Domachowske; Kathryn Jensen; Jay M Lieberman; Genevieve A Losonsky; Ram Yogev Journal: J Pediatric Infect Dis Soc Date: 2012-07-03 Impact factor: 3.164
Authors: Michael C Spaeder; Jason W Custer; Melania M Bembea; Devon O Aganga; Xiaoyan Song; Susanna Scafidi Journal: Pediatr Crit Care Med Date: 2013-03 Impact factor: 3.624
Authors: Wen Kuan Liu; Qian Liu; De Hui Chen; Huan Xi Liang; Xiao Kai Chen; Mei Xin Chen; Shu Yan Qiu; Zi Yeng Yang; Rong Zhou Journal: PLoS One Date: 2014-05-05 Impact factor: 3.240
Authors: Natalie I Mazur; Federico Martinón-Torres; Eugenio Baraldi; Brigitte Fauroux; Anne Greenough; Terho Heikkinen; Paolo Manzoni; Asuncion Mejias; Harish Nair; Nikolaos G Papadopoulos; Fernando P Polack; Octavio Ramilo; Mike Sharland; Renato Stein; Shabir A Madhi; Louis Bont Journal: Lancet Respir Med Date: 2015-09-25 Impact factor: 30.700
Authors: Sandra A Asner; Michelle E Science; Dat Tran; Marek Smieja; Arnaud Merglen; Dominik Mertz Journal: PLoS One Date: 2014-06-16 Impact factor: 3.240
Authors: Ayodeji E Ogunbayo; Milton T Mogotsi; Hlengiwe Sondlane; Kelebogile R Nkwadipo; Saheed Sabiu; Martin M Nyaga Journal: Int J Environ Res Public Health Date: 2022-08-21 Impact factor: 4.614