title: Association of respiratory picornaviruses with acute bronchiolitis in French infants.
abstract: BACKGROUND
  Human rhinoviruses and enteroviruses (Picornaviridae) are suspected to be major viral etiological causes of bronchiolitis in infants.
  
  
  OBJECTIVE
  In the present study, we assessed the potential role of the respiratory picornaviruses as causative agents of bronchiolitis in French infants.
  
  
  METHODS
  From September 2001 to June 2002, we prospectively selected 192 infants < or =36 months of age and hospitalized for acute bronchiolitis. The detection of common respiratory viruses (respiratory syncytial virus, influenza virus A and B, parainfluenza virus 1, 2, 3 and adenovirus) was performed using classical immunofluorescence antigen and cell-culture detection assays on nasopharyngeal aspirates whereas the detection of human metapneumovirus (HMPV) was performed by a real-time RT-PCR assay. The presence of rhinovirus and/or enterovirus was assessed in respiratory samples by a picornavirus RT-PCR detection assay followed by a differential Southern blotting procedure.
  
  
  RESULTS
  A potential causative virus was detected in 72.5% of the 192 study infants. RSV (30%), rhinovirus (21%), enterovirus (9%), influenza virus A (6%) and human metapneumovirus (4%) were the most frequent causative agents detected. Rhinoviruses or enteroviruses were detected as the only evidence of respiratory viral tract infection in 57 (30%) of 192 infants, whereas rhinovirus or enterovirus occurred in mixed viral infection detected in 25 (13%) of 192 study cases (30% versus 13%, p<10(-3)).
  
  
  CONCLUSIONS
  Our data suggest that respiratory picornaviruses are one of the leading etiological causes of bronchiolitis in French infants. These findings highlight the need to implement a rapid picornavirus RT-PCR detection assay for the clinical diagnosis of respiratory infections in pediatric patients with bronchiolitis.
authors.affiliation: Laboratoire de Virologie, Service de Microbiologie, Hôpital Robert Debré, Avenue du Général Koenig, 51092 REIMS Cedex, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Jacques
authors.forename: Maude
authors.initials: M
authors.lastname: Bouscambert-Duchamp
authors.forename: Hélène
authors.initials: H
authors.lastname: Moret
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Carquin
authors.forename: Véronique
authors.initials: V
authors.lastname: Brodard
authors.forename: Bruno
authors.initials: B
authors.lastname: Lina
authors.forename: Jacques
authors.initials: J
authors.lastname: Motte
authors.forename: Laurent
authors.initials: L
authors.lastname: Andréoletti
mesh_terms: D000208:Acute Disease; D001990:Bronchiolitis, Viral / Q000821:virology*; D002675:Child, Preschool; D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009305:Nasopharynx / Q000821:virology*; D010850:Picornaviridae Infections / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012229:Rhinovirus / Q000302:isolation & purification*
chemical_list: D012367:RNA, Viral