title: Multiple viral respiratory pathogens in children with bronchiolitis.
abstract: OBJECTIVE
  The aim of the study was to describe the frequency of viral pathogens and relative frequency of co-infections in nasal specimens obtained from young children with bronchiolitis receiving care at a children's hospital.
  
  
  METHODS
  We conducted a study of nasal wash specimens using real-time PCR and fluorescent-antibody assay results from children less than two with an ICD-9-CM code for bronchiolitis. All specimens were collected for clinical care at Children's Hospital in Seattle, WA, USA, during the respiratory season from October 2003 to April 2004.
  
  
  RESULTS
  Viruses were detected in 168 (93%) of the 180 children with bronchiolitis. A single virus was identified in 127 (71%) children and multiple viruses in 41 (23%). Respiratory syncytial virus (RSV) was the most common virus detected (77%), followed by adenovirus (15%), human metapneumovirus (11%), coronavirus (8%), parainfluenza (6%) and influenza (1%). Of the 139 samples with RSV detected, 34 (24%) were co-infected with another viral pathogen.
  
  
  CONCLUSIONS
  Molecular diagnostic techniques identified a high frequency of viruses and viral co-infections among children evaluated for bronchiolitis. Further study of the role of viral pathogens other than RSV and co-infections with RSV in children with bronchiolitis appears warranted.
authors.affiliation: Seattle Children's Hospital Research Institute, University of Washington, Seattle, WA, USA.
authors.forename: Hilary E
authors.initials: HE
authors.lastname: Stempel
authors.forename: Emily T
authors.initials: ET
authors.lastname: Martin
authors.forename: Jane
authors.initials: J
authors.lastname: Kuypers
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Zerr
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification; D001990:Bronchiolitis, Viral / Q000175:diagnosis* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D029121:Metapneumovirus; D016133:Polymerase Chain Reaction; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000382:microbiology; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification*; D012137:Respiratory System / Q000382:microbiology* / Q000821:virology; D012189:Retrospective Studies
references.citation: Pediatrics. 2007 Oct;120(4):893-4
references.pmid: 17908775
references.citation: JAMA. 1999 Oct 20;282(15):1440-6
references.pmid: 10535434
references.citation: J Hosp Infect. 2001 Oct;49(2):122-8
references.pmid: 11567557
references.citation: Pediatr Infect Dis J. 2005 Jul;24(7):605-10
references.pmid: 15999001
references.citation: Emerg Infect Dis. 2004 Jun;10(6):1095-101
references.pmid: 15207063
references.citation: Pediatrics. 2007 Oct;120(4):890-2
references.pmid: 17908774
references.citation: Am J Respir Crit Care Med. 2002 May 1;165(9):1285-9
references.pmid: 11991880
references.citation: Arch Pediatr Adolesc Med. 2004 Feb;158(2):119-26
references.pmid: 14757603
references.citation: Pediatrics. 2008 Feb;121(2):244-52
references.pmid: 18245414
references.citation: J Clin Microbiol. 2006 Jul;44(7):2382-8
references.pmid: 16825353
references.citation: Emerg Infect Dis. 2003 Mar;9(3):372-5
references.pmid: 12643835
references.citation: Pediatrics. 2006 Oct;118(4):1774-93
references.pmid: 17015575
references.citation: J Clin Virol. 2004 Oct;31(2):123-9
references.pmid: 15364268
references.citation: J Med Virol. 2006 Nov;78(11):1498-504
references.pmid: 16998894
references.citation: J Pediatr. 1979 Aug;95(2):183-90
references.pmid: 448557
references.citation: Emerg Infect Dis. 2003 Jun;9(6):634-40
references.pmid: 12781001
references.citation: Pediatrics. 2007 Jan;119(1):e70-6
references.pmid: 17130280
references.citation: Acad Emerg Med. 2008 Feb;15(2):111-8
references.pmid: 18275439