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Profile of respiratory pathogens causing acute respiratory infections in hospitalised children at Rajasthan a 4
M Anjaneya Swamy1, Bharti Malhotra2, P V Janardhan Reddy3
1Department of Microbiology and Immunology, Sawai Man Singh Medical College, Jaipur; Department of Microbiology, Ananta Institute of Medical Sciences and Research Center, Rajsamand, Rajasthan, India.
Insights
Respiratory syncytial virus (RSV) and Streptococcus pneumoniae are the most common causes of respiratory infections in young children. This study identified key pathogens and developed a diagnostic algorithm to improve care.
Area of Science:
- Pediatric infectious diseases
- Molecular diagnostics
- Microbiology
Background:
- Acute respiratory tract infections (ARTIs) in children under 5 years old lead to significant morbidity and mortality.
- The spectrum of causative pathogens for pediatric ARTIs varies geographically.
Purpose of the Study:
- To identify the profile and trends of respiratory pathogens in children with ARTIs.
- To develop a diagnostic algorithm for pediatric respiratory infections using multiplex real-time PCR.
Main Methods:
- Conducted a study on 997 children with respiratory infection symptoms.
- Utilized multiplex real-time PCR on nasopharyngeal aspirate and throat swab samples to detect 18 viruses and 6 bacteria.
Main Results:
- Identified respiratory pathogens in 76.73% of samples.
- Respiratory syncytial virus (RSV) A/B and Streptococcus pneumoniae were the most prevalent pathogens, particularly in children under 1 year.
- Detected viruses in 59.98% and bacteria in 41.85% of samples, with co-infections present in 22.24%.
Conclusions:
- RSV and S. pneumoniae are key pathogens in pediatric respiratory infections, with higher prevalence in infants.
- Developed a diagnostic algorithm to potentially reduce healthcare costs.
- Further research is needed to differentiate bystander viruses from true pathogens and expand the diagnostic panel.
Introduction:
Various pathogens cause respiratory tract infections in children of <5 years of age causing severe morbidity and mortality. The profile of causative agents varies from place to place.
Aims:
The objectives of our study were to detect the profile and trends of respiratory pathogens causing acute respiratory tract infection in children using a custom multiplex real-time polymerase chain reaction (RT-PCR) and to develop a diagnostic algorithm.
Materials And Methods:
A total of 997 children with clinical manifestations of respiratory infections were included in the study. Their nasopharyngeal aspirate and throat swab samples were subjected to nucleic acid extraction followed by multiplex RT-PCR for eighteen viruses and six bacteria.
Statistical Analysis Used:
Chi-square test was employed to study the P value of different viruses and bacteria.
Results:
A total of 765 (76.73%) samples were found to be positive for one of the respiratory pathogens. Viruses were detected in 598 (59.98%) and bacteria in 167 (41.85%) samples, respectively. The prevalence of single and co-infections among viruses and bacteria were 77.76% and 22.24%, 81.44% and 18.56% each, respectively. Respiratory syncytial virus (RSV) A/B and Streptococcus pneumoniae were the most predominant pathogens detected in the study and were associated with lower respiratory tract infections.
Conclusion:
RSV and S. pneumoniae were the most common pathogens detected, higher prevalence was observed in children <1 year of age. Viruses were predominant during winter months. The study helped to prepare diagnostic algorithm which will help in reducing diagnostic costs. However, further studies are required to assess whether viruses are bystander or real pathogens and include larger panel of bacteria and viruses for diagnosis.