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Published on: November 10, 2023
Frequency of detection of picornaviruses and seven other respiratory pathogens in infants
Julian P Legg1, Jill A Warner, Sebastian L Johnston
1Allergy and Inflammation Sciences, School of Medicine, Southampton General Hospital, Southampton, United Kingdom. julianlegg@yahoo.co.uk
Insights
Picornaviruses are the most common cause of respiratory infections in infants. This study found they were present in 46% of illness episodes, often alongside other viruses like RSV.
Area of Science:
- Pediatric infectious diseases
- Virology
- Respiratory medicine
Background:
- Previous research focused on hospitalized children.
- This study examines community-acquired respiratory illness in infants.
Purpose of the Study:
- Determine the frequency of 8 common respiratory pathogens in infants.
- Describe the clinical presentation of community-acquired respiratory illness in infancy.
Main Methods:
- Prospective monitoring of 88 infants during their first winter.
- Nasal lavage specimen collection during respiratory illness.
- Reverse transcription-polymerase chain reaction (RT-PCR) for pathogen detection.
Main Results:
- Picornaviruses were most frequent (46%), followed by RSV (27%).
- Dual infections occurred in 20% of episodes, often involving picornaviruses.
- RSV infection was linked to bronchiolitis; no other pathogen-clinical diagnosis links were found.
Conclusions:
- Picornaviruses are the leading cause of infant respiratory infections.
- Further community-based studies are needed to understand picornavirus roles in infant respiratory syndromes.
Background:
Previous studies in which molecular-based techniques have been used to identify the causative pathogens of respiratory tract infection have investigated hospitalized children only. We report a prospective study designed to determine the frequency and clinical presentation of community-acquired respiratory illness in infancy associated with 8 common respiratory pathogens.
Methods:
Eighty-eight infants were monitored through their first winter. With each respiratory illness, infants were examined, and a nasal lavage specimen was collected. Individual reverse transcription-polymerase chain reactions were performed to detect infection with picornaviruses (rhinoviruses and enteroviruses), coronaviruses (serotypes OC43 and 229E), adenoviruses, parainfluenza viruses 1-3, influenza viruses (types A and B), respiratory syncytial virus (RSV), Chlamydia pneumoniae and Mycoplasma pneumoniae.
Results:
Picornaviruses were the most frequently detected pathogen identified in 46% (56 of 123) of episodes, followed by RSV (27%), parainfluenza viruses (13%) and coronaviruses (9%). Dual pathogen infections were identified in 20% of episodes, predominantly caused by picornaviruses together with either RSV or parainfluenza viruses. RSV infection was significantly associated with a diagnosis of bronchiolitis. No other associations were found between pathogen and clinical diagnosis. Dual infection did not predispose infants to a more severe clinical course.
Conclusions:
Picornaviruses are the predominant cause of community-acquired respiratory tract infection in the first year of life. Large prospective community-based studies will be needed to fully evaluate the contribution of picornaviruses, both in isolation and in combination with other respiratory pathogens, to the various clinical syndromes of respiratory infection observed during infancy.
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