47. CLINICAL, SUBCLINICAL CHARACTERISTICS OF CHILDREN WITH PNEUMONIA CAUSED BY RESPIRATORY SYNCYTIAL VIRUS BACTERIAL CO-INFECTIONS
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Abstract
Objective: To describe the clinical, subclinical characteristics of children with pneumonia caused by respiratory syncytial virus, bacterial co-infection.
Subjects and methods: A descriptive study was conducted on 283 children aged 1-24 months with respiratory syncytial virus pneumonia who were hospitalized at the Center for Pulmonology and Respiratory Care, Vietnam National Children’s Hospital, from August 2022 to November 2023.
Results: The rate of bacterial co-infection in children with respiratory syncytial virus pneumonia was 57.2%, with a higher prevalence in the 6-11 months age group (p < 0.05). Children with bacterial co-infection were 3.66 times more likely to have fever compared to those without co-infection, with fever rates of 74.7% and 44.6%, respectively (p < 0.05). The bacterial co-infection group also showed a significantly higher prevalence of both dry rales and moist rales (p < 0.05). In terms of subclinical findings, white blood cell count, neutrophil count, and CRP levels were significantly elevated in the co-infection group (p < 0.01). Notably, the risk of elevated CRP levels (≥ 6 mg/dl) was 4.3 folds higher in the bacterial co-infection group compared to the non-co-infection group (95%CI: 2.6-7.2; p < 0.0001).
Conclusion: Bacterial co-infection is common in children with respiratory syncytial virus pneumonia and is associated with more severe clinical manifestations, including fever, dry rales and moist rales, as well as elevated white blood cell counts and CRP levels
Article Details
Keywords
Pneumonia, RSV, CRP, children
References
[2] Hishiki H et al, Incidence of bacterial coinfection with respiratory syncytial virus bronchopulmonary infection in pediatric inpatients, J Infect Chemother, 2011, 17 (1): 87-90.
[3] Lin H.C et al, RSV pneumonia with or without bacterial co-infection among healthy children, J Formos Med Assoc, 2022, 121 (3): 687-693.
[4] World Health Organization, Guidelines for the Management of common childhood illness, In: Poket book of Hospital care for children, 2013.
[5] Jung J, Seo E, Yoo R.N, Sung H, Lee J, Clinical significance of viral-bacterial codetection among young children with respiratory tract infections: findings of RSV, influenza, adenoviral infections, Medicine, 2020, 99 (2): e18504.
[6] Trần Quang Khải, Nguyễn Thị Diệu Thúy, Trần Đỗ Hùng, Phạm Hùng Vân, Nguyễn Vũ Trung và cộng sự, Phát hiện đồng nhiễm vi sinh vật ở trẻ viêm phổi nặng mắc phải tại cộng đồng bằng Real-time PCR, Tạp chí Y Dược học Cần Thơ, 2023, 54: 17-24.
[7] Elmore D et al, Is fever a red flag for bacterial pneumonia in children with viral bronchiolitis? Glob Pediatr Health, 2019, 6: 2333794X19868660.
[8] Esposito S et al, Measurement of lipocalin-2 and syndecan-4 levels to differentiate bacterial from viral infection in children with community-acquired pneumonia, BMC Pulm Med, 2016, 16 (1): 103.
[9] Higdon M.M et al, Association of C-reactive protein with bacterial and respiratory syncytial virus-associated pneumonia among children aged < 5 years in the perch study, Clin Infect Dis, 2017, 64 (3): S378-S386.
[10] Flood R.G, Badik J, Aronoff S.C, The utility of serum C-reactive protein in differentiating bacterial from nonbacterial pneumonia in children: a meta-analysis of 1230 children, Pediatr Infect Dis J, 2008, 27 (2): 95-99.