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Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
Published on: January 30, 2017
A tNGS-based comparative study on clinical features and co-detection profiles of hospitalized children with influenza
Chunyun Fu1, Qiang Huang1, Xiaoying Chen1
1Medical Science Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Insights
In hospitalized children, influenza B virus (IBV) infection independently predicts a higher need for respiratory support compared to influenza A virus (IAV). Younger age and female sex are key risk factors for respiratory support needs in pediatric IBV cases.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Respiratory Medicine
Background:
- Influenza B virus (IBV) and influenza A virus (IAV) are common causes of pediatric respiratory infections.
- Understanding the distinct clinical and epidemiological features of IBV in hospitalized children is crucial for effective management.
Purpose of the Study:
- To characterize the clinical and epidemiological features of hospitalized children with IBV.
- To compare these features with those of children hospitalized with IAV.
- To identify predictors for respiratory support requirements in pediatric patients with acute respiratory infections (ARI).
Main Methods:
- A cohort of 10,143 pediatric inpatients with ARI was studied between April 2021 and December 2024.
- Pathogen screening was performed using targeted next-generation sequencing.
- Multivariable logistic regression identified independent predictors for respiratory support needs.
Main Results:
- IBV was detected in 2.0% of patients. IBV and IAV groups showed similar age distributions and high polymicrobial detection rates.
- While initial analysis suggested less respiratory support for IBV, multivariable analysis revealed IBV independently predicted higher respiratory support needs (aOR=1.882).
- Younger age and female sex were independent risk factors for respiratory support. IBV cases had complications but favorable outcomes with no mortality.
Conclusions:
- IBV and IAV share similar epidemiological characteristics in hospitalized children.
- IBV infection independently predicts a higher risk of requiring respiratory support than IAV, particularly in younger children and females.
- Clinicians must remain vigilant for respiratory deterioration in pediatric IBV patients.
Objectives:
This study aimed to characterize the clinical and epidemiological features of hospitalized children with IBV and compare them with those of influenza A virus (IAV).
Methods:
We enrolled 10,143 pediatric inpatients with ARI between April 2021 and December 2024. Pathogen screening was conducted using targeted next-generation sequencing. Multivariable logistic regression was performed to identify independent predictors for respiratory support requirements.
Results:
IBV was detected in 198 children (2.0%). Compared to children with IAV (n = 325), IBV-positive children showed similar age distribution (median: 38 vs. 42 months, p = 0.464) and similarly high polymicrobial detection rates (96.0% vs. 97.2%, p = 0.365). The most frequently co-detected microbes were Haemophilus influenzae, Streptococcus pneumoniae, and Mycoplasma pneumoniae, similar between groups, though the prevalence of H. influenzae was higher in the IBV group than in the IAV group (p = 0.017). Children with IBV required less frequent respiratory support than those with IAV (12.6% vs. 20.6%, p = 0.020). However, multivariable analysis reversed this trend: IBV infection independently predicted a higher risk for respiratory support than IAV (aOR = 1.882, 95% CI: 1.134-3.123, p = 0.014). Younger age (aOR = 0.990, p = 0.009) and female sex (aOR for males = 0.503, p = 0.009) were also independent risk factors. Among IBV cases, 31.3% developed respiratory complications and 46.0% presented with extrapulmonary manifestations. Outcomes were favorable with a median hospitalization of 6 days, low ICU admission rate (4.0%), and no mortality.
Conclusion:
IBV and IAV show similar age distributions and comparably high polymicrobial detection rates in hospitalized children. Importantly, multivariable analysis unmasked that IBV infection independently predicted a higher requirement for respiratory support than IAV, with younger age and female sex identifying particularly vulnerable cohorts. Clinicians should maintain high vigilance for respiratory progression in pediatric IBV inpatients.
