Detection of human metapneumovirus in hospitalized children with acute respiratory tract infection using real-time RT-PCR in a hospital in northern Taiwan.
OBJECTIVE
Human metapneumovirus (hMPV) is a newly discovered respiratory pathogen. This prospective hospital-based study investigated the clinical role and features of hMPV in Taiwan.


METHODS
Respiratory specimens collected from hospitalized children with acute respiratory tract infection between September 1, 2003 and April 10, 2005 were screened for metapneumovirus using real-time reverse transcription-polymerase chain reaction (RT-PCR).


RESULTS
During the study period, 930 specimens were obtained from 926 hospitalized children. After exclusion of 200 cases due to lack of clinical evidence of airway infection or diseases with known etiology, 726 were included in the analysis. Among these, 33 children had a positive result for hMPV infection. The majority of these patients were admitted during spring and early summer. Twenty-one (63.6%) were younger than 2 years of age. hMPV accounted for 13.3% of respiratory infections occurring between the ages of 18 and 24 months and was as common a respiratory pathogen as respiratory syncytial virus (RSV) in that age group. The 11 patients (33.3%) with underlying diseases had a similar disease course to those without underlying diseases. A co-pathogen was found in 11 patients (33.3%). Infected children between 2 and 5 years of age had significantly higher titers of hMPV in their respiratory specimens (103.88 copies/microL) than children younger than 2 years (102.26 copies/microL) (p = 0.013) and children older than 5 years (102.25 copies/microL) (p = 0.005). hMPV positive cases were significantly older than those with RSV infection (p = 0.002) and had a shorter duration of hospitalization (p = 0.001), fewer days of oxygen use (p = 0.001) and higher levels of C-reactive protein (p = 0.004).


CONCLUSIONS
Metapneumovirus circulates in children in northern Taiwan during spring and early summer. hMPV was the most common respiratory pathogen in children aged between 18 and 24 months hospitalized with acute respiratory tract infection. Real-time RT-PCR is a sensitive method for investigating the epidemiology and diseases associated with hMPV.
Chan
Pei-Chun
PC
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Wang
Chung-Yi
CY
Wu
Ping-Sheng
PS
Chang
Po-Young
PY
Yang
Tsao-Ton
TT
Chiang
Yu-Ping
YP
Kao
Chuan-Liang
CL
Chang
Luan-Yin
LY
Lu
Chun-Yi
CY
Lee
Ping-Ing
PI
Chen
Jung-Min
JM
Shao
Pei-Lan
PL
Huang
Fu-Yuan
FY
Lee
Chin-Yun
CY
Huang
Li-Min
LM
D000208:Acute Disease; D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification*; D018184:Paramyxoviridae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013624:Taiwan / Q000453:epidemiology