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Published on: August 7, 2017
Analysis of Pathogens in Respiratory Tract Infections and Their Effect on Disease Severity: Retrospective Data from a
Petros Strempas1,2, Heidi Weberruss1,2, Thomas Bollinger1,3
1Medizincampus Oberfranken (MCO), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Insights
Co-infections with multiple respiratory viruses in children, excluding common epidemic strains, do not worsen hospital stay or severity. This suggests that strict isolation for several viral co-infections may not be necessary in pediatric care.
Area of Science:
- Pediatric infectious diseases
- Respiratory virology
- Hospital epidemiology
Background:
- Respiratory tract infections (RTIs) are a significant cause of pediatric hospitalizations, particularly during colder months, straining healthcare resources.
- Understanding pathogen distribution and severity predictors like age, season, inflammatory markers, and oxygen demand is crucial for managing pediatric RTIs.
Purpose of the Study:
- To investigate the clinical impact of viral co-infections in pediatric respiratory tract infections.
- To determine if multiple pathogen detection influences hospitalization duration, inflammatory markers, or oxygen requirements.
Main Methods:
- A retrospective cohort study of pediatric inpatients with RTIs between 2021-2023.
- Analysis of nasopharyngeal swab results, age, CRP values, hospitalization length, oxygen demand, and comorbidities.
- Statistical analysis included chi-square tests, paired t-tests, and regression analysis.
Main Results:
- Co-detection of multiple respiratory pathogens (excluding SARS-CoV-2, influenza, RSV) did not correlate with longer hospital stays, higher CRP, or increased oxygen demand compared to single infections.
- Detection of any pathogen was associated with higher rates of oxygen demand and elevated CRP values.
Conclusions:
- Viral co-infections, excluding those with high epidemic potential, do not appear to lead to more severe RTIs in hospitalized children.
- The findings suggest that strict isolation protocols may be dispensable for several viral co-infections in pediatric settings.
Background:
Respiratory tract infections (RTIs) represent a frequent cause of inpatient admission in children's hospitals, especially in the fall and winter seasons, resulting in major healthcare problems due to a lack of beds. The age and seasonal distribution of each pathogen seem to be multifactorial features that influence the course of infection. Other severity predictors appear to be the length of hospital stay, the presence or absence of oxygen demand, and the value of inflammatory markers.
Methods:
All inpatients from our children's hospital between 2021 and 2023 who had a nasopharyngeal swab and presented with RTI symptoms were recruited for this retrospective cohort study. The parameters of interest were age, swab result, month of detection, CRP values, duration of hospitalization, presence of oxygen demand, and comorbidities. The data were analyzed using chi-square tests, paired t-tests and regression analysis to determine the associations of differences between the groups.
Results:
Detection of more than one respiratory pathogen in the same swab, apart from combinations with SARA-CoV-2, influenza, or RS-virus, was not associated with longer hospital stay, higher mean maximal CRP values, or oxygen demand compared to mono-infection with the same pathogens. In contrast, the detection of a pathogen versus no detection could be related to higher rates of oxygen demand and higher CRP values.
Conclusions:
Since co-infection with more than one virus, excluding those with epidemic potential, was not associated with a more severe course of RTIs, strict patient isolation seems to be dispensable for several viruses, as well as isolation of infected or colonized patients.
