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Prospective detection of respiratory pathogens in symptomatic children with cancer

Ashok Srinivasan1, Zhengming Gu, Teresa Smith

  • 1Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN 38105, USA. ashok.srinivasan@stjude.org

The Pediatric Infectious Disease Journal
|November 30, 2012
PubMed

Insights

Human rhinovirus is the most frequent respiratory virus in children with cancer experiencing acute respiratory illness. This common virus did not increase illness severity in these vulnerable patients.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Limited data exists on respiratory infections in pediatric cancer patients.
  • Common respiratory pathogens include human rhinovirus, coronavirus, bocavirus, and others.

Purpose of the Study:

  • To determine the prevalence of respiratory pathogens in children with cancer.
  • To investigate the association of specific viruses with lower respiratory tract infections (LRTI).

Main Methods:

  • Prospective study of 253 children with respiratory infections over one year.
  • Multiplexed-polymerase chain reaction (PCR) used for pathogen detection.
  • Analysis of underlying diagnoses including leukemia, lymphoma, solid tumors, and post-stem cell transplant.

Main Results:

  • Respiratory viruses detected in 76% of patients; human rhinovirus was most common (62% of upper respiratory, 65% of LRTI).
  • Human bocavirus was significantly associated with LRTI (OR 4.52, P=0.008).
  • Coinfections occurred in 24% but did not increase LRTI risk; two deaths occurred.

Conclusions:

  • Human rhinovirus is the most prevalent virus in hospitalized children with cancer and acute respiratory illness.
  • Human rhinovirus infection was not linked to increased morbidity in this cohort.
  • Further research with viral load and asymptomatic controls is needed for emerging viruses.
Abstract

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