Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis.
The association between severe bronchiolitis and dual infection by human metapneumovirus (hMPV) and human respiratory syncytial virus (hRSV) was investigated in <2-year-old infants with bronchiolitis who were admitted to the hospital during the 2001-2002 winter season. hMPV in nasopharyngeal aspirate and/or cells and fluid collected by nonbronchoscopic bronchoalveolar lavage was detected by reverse transcriptase-polymerase chain reaction (RT-PCR). hRSV was detected in nasopharyngeal aspirate and/or cells and fluid collected by nonbronchoscopic bronchoalveolar lavage by enzyme immunoassay, tissue culture, and RT-PCR. Dual infection with hMPV and hRSV confers a 10-fold increase in relative risk (RR) of admission to a pediatric intensive-care unit for mechanical ventilation (RR, 10.99 [95% confidence interval, 5.0-24.12]; P<.001, by Fisher exact test). Dual infection by hMPV and hRSV is associated with severe bronchiolitis.
Semple
Malcolm G
MG
Department of Child Health, University of Liverpool, Liverpool, United Kingdom. m.g.semple@liv.ac.uk
Cowell
Angela
A
Dove
Winfred
W
Greensill
Julie
J
McNamara
Paul S
PS
Halfhide
Claire
C
Shears
Paul
P
Smyth
Rosalind L
RL
Hart
C Anthony
CA
D001990:Bronchiolitis, Viral / Q000503:physiopathology / Q000821:virology*; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D002675:Child, Preschool; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007231:Infant, Newborn; D029121:Metapneumovirus / Q000235:genetics / Q000302:isolation & purification*; D009305:Nasopharynx / Q000821:virology; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000821:virology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012720:Severity of Illness Index