title: Sole infection by human metapneumovirus among children with radiographically diagnosed community-acquired pneumonia in a tropical region.
abstract: BACKGROUND
  Limited information is available on the role of human metapneumovirus (HMPV) as the unique pathogen among children hospitalized for community-acquired pneumonia (CAP) in a tropical region.
  
  
  OBJECTIVE
  We aimed to describe HMPV infection among children with CAP investigating bacterial and viral co-infections.
  
  
  METHODS
  A prospective study was carried out in Salvador, North-East Brazil. Overall, 268 children aged <5 years hospitalized for CAP were enrolled. Human metapneumovirus RNA was detected in nasopharyngeal aspirates (NPA) by reverse transcription polymerase chain reaction. Sixteen other bacterial and viral pathogens were investigated by an expanded panel of laboratory methods. Chest X-ray taken on admission was read by an independent paediatric radiologist unaware of clinical information or the established aetiology.
  
  
  RESULTS
  Human metapneumovirus RNA was detected in NPAs of 11 (4.1%) children, of which 4 (36%) had sole HMPV infection. The disease was significantly shorter among patients with sole HMPV infection in comparison with patients with mixed infection (4 ± 1 versus 7 ± 2 days, P = 0.03). Three of those four patients had alveolar infiltrates.
  
  
  CONCLUSIONS
  Sole HMPV infection was detected in children with CAP in Salvador, North-East Brazil. HMPV may play a role in the childhood CAP burden.
authors.affiliation: Department of Paediatrics, School of Medicine, Federal University of Bahia, Salvador, Brazil. nascimentocarvalho@hotmail.com
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Nascimento-Carvalho
authors.forename: Maria-Regina A
authors.initials: MR
authors.lastname: Cardoso
authors.forename: Olli
authors.initials: O
authors.lastname: Ruuskanen
authors.forename: Maija
authors.initials: M
authors.lastname: Lappalainen
mesh_terms: D001938:Brazil; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification*; D009305:Nasopharynx / Q000821:virology; D018184:Paramyxoviridae Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D015995:Prevalence; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D013902:Radiography, Thoracic; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014329:Tropical Climate
chemical_list: D012367:RNA, Viral