Respiratory Pathogen Detection in Pediatric Asthma Exacerbations Using the FilmArray Respiratory Panel 2.1

Viral infections, particularly rhinoviruses (RVs) and respiratory syncytial virus (RSV), are major causes of pediatric acute asthma exacerbations. The FilmArray Respiratory Panel 2.1 (FARP2.1) is an automated multiplex PCR tool that is being increasingly used in clinical settings; however, its application in asthma exacerbations has not been studied yet. From April 2022 to March 2025, children aged between 6 months and 5 years who had been hospitalized for asthma exacerbations were enrolled ("asthma group," n = 67), alongside children with respiratory infections without wheezing within the same age range ("non-asthma group," n = 207). Nasopharyngeal swabs were performed in all, tested with FARP2.1, and all detected pathogens and clinical features were compared between the two groups. RV/enterovirus (EV) prevalence was significantly higher in the asthma group (82.1%) than in the non-asthma group (28.5%). RSV prevalence was similar in both groups (19.4% vs. 30.0%), while parainfluenza virus was more frequent in the non-asthma group (11.9% vs. 24.2%). The peaks in asthma hospitalizations coincided with RV/EV detection peaks during the autumn. These results highlight that RV/EV was significantly associated with pediatric asthma exacerbations, frequently occurring. Although typically a cause of the common cold, RV/EV may represent an important trigger of asthma exacerbation in children.