title: Two-year prospective study of single infections and co-infections by respiratory syncytial virus and viruses identified recently in infants with acute respiratory disease.
abstract: A prospective 2-year analysis including 322 infant patients with acute respiratory disease (ARD) hospitalized in a pediatric department in northern Italy was carried out to evaluate the role as respiratory pathogens or co-pathogens of recently identified viruses. The presence of respiratory syncitial virus (RSV), human Metapneumoviruses (hMPVs), human Bocaviruses (hBoVs), and human Coronaviruses (hCoVs) was assayed by molecular detection and clinical symptoms evaluated. Nasopharyngeal aspirates from 150 of the 322 infants (46.6%) tested positive for at least one pathogen. Ninety samples (28.0%) tested positive for RSV RNA (61.5% genotype A and 38.5% genotype B), 46 (14.3%) for hMPV RNA (71.7% subtype A and 28.3% subtype B), 28 (8.7%) for hCoV RNA (39.3% hCoV-OC43, 35.7% hCoV-NL63, 21.4% hCoV-HKU1, and 3.6% hCoV-229E), and 7 (2.2%) for hBoV DNA (of the 6 typed, 50% subtype 1 and 50% subtype 2); 21/150 samples revealed the presence of 2 or more viruses. Co-infection rates were higher for hMPVs, hCoVs, and hBoV (38.3%, 46.4%, and 57.1%,) and lower for RSV (23.3%). RSV was associated with the presence of complications (P < 0.001) and hypoxia (P < 0.015). When the presence of RSV alone and the RSV-hMPV co-infections were considered, RSV mono-infected patients resulted to have longer hospitalization and higher hypoxia (P < 0.001). The data highlight that (i) RSV has a central role as a respiratory pathogen of infants, (ii) the wide circulation of recently identified viruses does not reduce the clinical and epidemiological importance of RSV, and that (iii) recently identified agents (hMPVs, hBoVs, and hCoVs) act as primary pathogens or co-pathogens.
authors.affiliation: Laboratorio di Microbiologia e Virologia, Università Vita-Salute San Raffaele, and Istituto Scientifico San Raffaele, Milan, Italy. canducci.filippo@hsr.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Canducci
authors.forename: Maurizia
authors.initials: M
authors.lastname: Debiaggi
authors.forename: Michela
authors.initials: M
authors.lastname: Sampaolo
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Marinozzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Berrè
authors.forename: Cristina
authors.initials: C
authors.lastname: Terulla
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Gargantini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cambieri
authors.forename: Egidio
authors.initials: E
authors.lastname: Romero
authors.forename: Massimo
authors.initials: M
authors.lastname: Clementi
mesh_terms: D052660:Bocavirus / Q000235:genetics / Q000302:isolation & purification; D002675:Child, Preschool; D015897:Comorbidity; D017934:Coronavirus / Q000235:genetics / Q000302:isolation & purification; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D029121:Metapneumovirus / Q000235:genetics / Q000302:isolation & purification; D008969:Molecular Sequence Data; D018184:Paramyxoviridae Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D010322:Parvoviridae Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D010614:Pharynx / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology*; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D017422:Sequence Analysis, DNA
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral