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The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice
Insights
Wheezing-associated respiratory infections (WARI) are common in young children but persist in older children. Respiratory syncytial virus (RSV) is a primary cause in those under five, while Mycoplasma pneumoniae affects school-aged children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Wheezing-associated respiratory infections (WARI) are a significant cause of acute lower respiratory illness (LRI) in children.
- Understanding the epidemiology and causative agents of WARI is crucial for effective diagnosis and management.
Purpose of the Study:
- To investigate the causes and occurrence patterns of WARI in a pediatric population over an 11-year period.
- To identify common pathogens and their association with age in children experiencing wheezing and LRI.
Main Methods:
- Analysis of an 11-year dataset of acute lower respiratory illness in a pediatric practice.
- Identification of pathogens, including viral and bacterial agents, in patients with WARI.
- Assessment of age-specific incidence and pathogen prevalence.
Main Results:
- WARI occurred frequently in children under 2 years old, but wheezing persisted in 19% of children over 9 years old with LRI.
- Males had a higher incidence of LRI and WARI compared to females.
- Nonbacterial pathogens were identified in 21% of WARI cases, with RSV being most common in children under 5 and Mycoplasma pneumoniae in school-aged children.
Conclusions:
- The study provides a comprehensive understanding of WARI causes and patterns in children.
- Findings highlight the age-specific roles of different pathogens in pediatric respiratory infections.
- Data are valuable for clinicians and researchers focused on controlling lower respiratory diseases.
Abstract:
To develop a broad understanding of the causes and patterns of occurrence of wheezing associated respiratory infections, we analyzed data from an 11-year study of acute lower respiratory illness in a pediatric practice. Although half of the WARI occurred in children less than 2 years of age, wheezing continued to be observed in 19% of children greater than 9 years of age who had lower respiratory illness. Males experienced LRI 1.25 times more often than did females; the relative risk of males for WARI was 1.35. A nonbacterial pathogen was recovered from 21% of patients with WARI; respiratory syncytial virus, parainfluenza virus types 1 and 3, adenoviruses, and Mycoplasma pneumoniae accounted for 81% of the isolates. Patient age influenced the pattern of recovery of these agents. The most common cause of WARI in children under 5 years of age was RSV whereas Mycoplasma pneumoniae was the most frequent isolate from school age children with wheezing illness. The data expand our understanding of the causes of WARI and are useful to diagnosticians and to researchers interested in the control of lower respiratory disease.