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Bacterial involvement in parainfluenza virus infection in children
M Korppi1, M Leinonen, P H Mäkelä
1Department of Paediatrics, Kuopio University Central Hospital, Finland.
Insights
Secondary bacterial infections are rare in children with parainfluenza virus (PV) related croup. However, bacterial involvement is common in lower respiratory tract infections caused by PV.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Parainfluenza virus (PV) is a common cause of respiratory illness in children.
- Concomitant bacterial infections can complicate viral respiratory illnesses, impacting treatment and outcomes.
- Distinguishing viral from bacterial etiologies is crucial for appropriate management.
Purpose of the Study:
- To investigate the prevalence of secondary bacterial infections in children with parainfluenza virus (PV) infection.
- To differentiate the occurrence of bacterial co-infections in croup versus lower respiratory tract infections (LRTI) associated with PV.
Main Methods:
- Serological methods were employed to detect evidence of bacterial infection in 37 children with confirmed PV.
- Patients were categorized based on clinical presentation: croup (24 children) or LRTI (13 children).
- Specific bacterial pathogens, including Streptococcus pneumoniae and Haemophilus influenzae, were assessed.
Main Results:
- Overall, 11% (4/37) of children showed serological evidence of bacterial involvement.
- No bacterial co-infections were detected in children with PV-associated croup.
- A significant proportion (31%) of children with PV-associated LRTI had evidence of bacterial co-infection (p < 0.05).
- Streptococcus pneumoniae was identified in 3 cases, and Haemophilus influenzae in 1 case.
Conclusions:
- Secondary bacterial infections appear uncommon in pediatric croup caused by parainfluenza virus.
- Bacterial co-infections are frequently observed in children with parainfluenza virus-induced lower respiratory tract infections.
- These findings highlight the importance of considering bacterial co-infection in pediatric LRTI, particularly when caused by PV.
Abstract:
37 children with serologically confirmed parainfluenza virus (PV) infection were studied by new serological methods for evidence of concomitant bacterial infection. 24 of the children were hospitalized because of croup and 13 because of lower respiratory tract infection. Serological evidence of bacterial involvement was found in 4 (11%) of the 37 children, in none of the 24 children with croup but in 31% of the 13 children with PV infection of the lower airways (p less than 0.05). Streptococcus pneumoniae was implicated in 3 cases and Haemophilus influenzae in 1. Serological evidence of staphylococcal involvement was not seen in any case. The 3 patients with pneumococcal involvement had pneumococcal antigen in the acute serum. In all of them pneumonia was associated with PV type 1 or 3, and in 2 serum C-reactive protein was elevated. The data presented support the view, that secondary bacterial infection is rare in children with croup, but common in lower respiratory tract infection caused by PV.