TY - JOUR
T1 - Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe-results from the PED-MERMAIDS multicentre case-control study
AU - Vasconcelos, Malte Kohns
AU - Loens, Katherine
AU - Sigfrid, Louise
AU - Iosifidis, Elias
AU - Epalza, Cristina
AU - Donà, Daniele
AU - Matheeussen, Veerle
AU - Papachristou, Savvas
AU - Roilides, Emmanuel
AU - Gijon, Manuel
AU - Rojo, Pablo
AU - Minotti, Chiara
AU - da Dalt, Liviana
AU - Islam, Samsul
AU - Jarvis, Jessica
AU - Syggelou, Aggeliki
AU - Tsolia, Maria
AU - Nyang'wa, Maggie Nyirenda
AU - Keers, Sophie
AU - Renk, Hanna
AU - Gemmel, Anna-Lena
AU - D'Amore, Carmen
AU - Atti, Marta Ciofi Degli
AU - Sánchez, Carmen Rodríguez-Tenreiro
AU - Martinón-Torres, Federico
AU - Burokiene, Sigita
AU - Goetghebuer, Tessa
AU - Spoulou, Vana
AU - Riordan, Andrew
AU - Calvo, Cristina
AU - Gkentzi, Despoina
AU - Hufnagel, Markus
AU - Openshaw, Peter J.
AU - de Jong, Menno D.
AU - Koopmans, Marion
AU - Goossens, Herman
AU - Ieven, Margareta
AU - Fraaij, Pieter L. A.
AU - Giaquinto, Carlo
AU - Bielicki, Julia A.
AU - Horby, Peter
AU - Sharland, Michael
N1 - Funding Information: Funding This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration (FP7) under grant agreement No. HEALTH-F3-2013-602525. Publisher Copyright: © 2016 Georg Thieme Verlag. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/7/29
Y1 - 2021/7/29
N2 - Background Both pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to estimate the aetiological fractions for ARI hospitalisation in children for respiratory syncytial virus (RSV) and influenza virus and to determine whether detection of specific respiratory pathogens on NP samples was associated with ARI hospitalisation. Methods 349 children up to 5 years of age hospitalised for ARI (following a symptom-based case definition) and 306 hospital controls were prospectively enrolled in 16 centres across seven European Union countries between 2016 and 2019. Admission day NP swabs were analysed by multiplex PCR for 25 targets. Results RSV was the leading single cause of ARI hospitalisations, with an overall population attributable fraction (PAF) of 33.4% and high seasonality as well as preponderance in younger children. Detection of RSV on NP swabs was strongly associated with ARI hospitalisation (OR adjusted for age and season: 20.6, 95% CI: 9.4 to 45.3). Detection of three other viral pathogens showed strong associations with ARI hospitalisation: influenza viruses had an adjusted OR of 6.1 (95% CI: 2.5 to 14.9), parainfluenza viruses (PIVs) an adjusted OR of 4.6 (95% CI: 1.8 to 11.3) and metapneumoviruses an adjusted OR of 4.5 (95% CI: 1.3 to 16.1). Influenza viruses had a PAF of 7.9%, PIVs of 6.5% and metapneumoviruses of 3.0%. In contrast, most other pathogens were found in similar proportions in cases and controls, including Streptococcus pneumoniae, which was weakly associated with case status, and endemic coronaviruses. Conclusion RSV is the predominant cause of ARI hospitalisations in young children in Europe and its detection, as well as detection of influenza virus, PIV or metapneumovirus, on NP swabs can establish aetiology with high probability. PAFs for RSV and influenza virus are highly seasonal and age dependent.
AB - Background Both pathogenic bacteria and viruses are frequently detected in the nasopharynx (NP) of children in the absence of acute respiratory infection (ARI) symptoms. The aim of this study was to estimate the aetiological fractions for ARI hospitalisation in children for respiratory syncytial virus (RSV) and influenza virus and to determine whether detection of specific respiratory pathogens on NP samples was associated with ARI hospitalisation. Methods 349 children up to 5 years of age hospitalised for ARI (following a symptom-based case definition) and 306 hospital controls were prospectively enrolled in 16 centres across seven European Union countries between 2016 and 2019. Admission day NP swabs were analysed by multiplex PCR for 25 targets. Results RSV was the leading single cause of ARI hospitalisations, with an overall population attributable fraction (PAF) of 33.4% and high seasonality as well as preponderance in younger children. Detection of RSV on NP swabs was strongly associated with ARI hospitalisation (OR adjusted for age and season: 20.6, 95% CI: 9.4 to 45.3). Detection of three other viral pathogens showed strong associations with ARI hospitalisation: influenza viruses had an adjusted OR of 6.1 (95% CI: 2.5 to 14.9), parainfluenza viruses (PIVs) an adjusted OR of 4.6 (95% CI: 1.8 to 11.3) and metapneumoviruses an adjusted OR of 4.5 (95% CI: 1.3 to 16.1). Influenza viruses had a PAF of 7.9%, PIVs of 6.5% and metapneumoviruses of 3.0%. In contrast, most other pathogens were found in similar proportions in cases and controls, including Streptococcus pneumoniae, which was weakly associated with case status, and endemic coronaviruses. Conclusion RSV is the predominant cause of ARI hospitalisations in young children in Europe and its detection, as well as detection of influenza virus, PIV or metapneumovirus, on NP swabs can establish aetiology with high probability. PAFs for RSV and influenza virus are highly seasonal and age dependent.
KW - clinical epidemiology
KW - paediatric lung disaese
KW - pneumonia
KW - respiratory infection
KW - viral infection
UR - http://www.scopus.com/inward/record.url?scp=85112630950&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bmjresp-2021-000887
DO - https://doi.org/10.1136/bmjresp-2021-000887
M3 - Article
C2 - 34326154
SN - 2052-4439
VL - 8
JO - BMJ Open Respiratory Research
JF - BMJ Open Respiratory Research
IS - 1
M1 - e000887
ER -