Analysis of Pathogens Detected Using Multiplex PCR in Children After the COVID-19 Pandemic

Area of Science:

• Pediatric Infectious Diseases
• Respiratory Virology
• Clinical Microbiology

Background:

• The 2023 surge of respiratory illnesses in Japan presented a significant challenge in pediatric healthcare.
• Understanding the specific pathogens driving these infections is crucial for effective management and public health strategies.

Purpose of the Study:

• To identify the primary viral and bacterial pathogens responsible for pediatric airway infections during the 2023 respiratory illness surge in Japan.
• To correlate specific pathogen identification with clinical manifestations and outcomes in hospitalized children.

Main Methods:

• A retrospective, single-centered cohort study design was employed.
• Data were extracted from electronic medical records of hospitalized children who underwent BioFire® Respiratory Panel testing.
• Pathogen identification and association with clinical symptoms like labored breathing, wheezing, rhonchi, crackles, and transcutaneous oxygen saturation were analyzed.

Main Results:

• Out of 228 hospitalized children, 188 (82.45%) had 306 identified pathogens.
• Rhinovirus/enterovirus (RV/EV) was the most prevalent (36.93%), followed by respiratory syncytial virus (RSV; 12.75%), adenovirus (12.42%), and parainfluenza virus type 3 (PIV3; 9.48%).
• RV/EV positivity correlated with increased labored breathing and wheezing. RSV positivity was linked to rhonchi and crackles. RSV and PIV3 infections were associated with lower oxygen saturation.

Conclusions:

• RV/EV were the predominant pathogens identified in pediatric airway infections during the 2023 surge.
• Specific viruses like RV/EV and RSV are significantly associated with distinct clinical symptoms and hypoxemia in children.
• Enhanced surveillance and timely diagnosis of these common respiratory pathogens are essential for managing pediatric respiratory distress and hypoxemia.