title: Prevalence and clinical course of viral upper respiratory tract infections in immunocompromised pediatric patients with malignancies or after hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Respiratory tract infections (RTI) in immunosuppressed pediatric patients with malignancies or after hematopoietic stem cell transplantation (HSCT) are associated with significant morbidity and mortality. Prospective data on the incidence and clinical role of infections by respiratory viruses in this population have been lacking.
  
  
  METHODS
  In this prospective study, 191 children between 0 and 18 years of age were investigated by real-time polymerase chain reaction for the presence of 8 common respiratory virus types in transnasal aspirations. The study included 110 children with leukemia, lymphoma, or solid tumors (subgroup 1); 31 children after HSCT (subgroup 2); and 50 immunocompetent control patients.
  
  
  RESULTS
  In comparison with the control group, immunocompromised children showed a significantly higher incidence of positive virus tests (subgroup 1: 53%; subgroup 2: 81%; controls: 24%; P<0.0001), and more frequently experienced ensuing viral infections in the lower respiratory tract (subgroup 1: 74%; subgroup 2: 88%; controls: 25%; P<0.0001). Sixteen percent of these children had coinfections by 2 or more viruses and revealed more severe respiratory illness.
  
  
  CONCLUSIONS
  The present epidemiologic study on viral upper RTI in immunocompromised children revealed a high virus-associated morbidity which was particularly prominent in HSCT recipients. In these children, detection of viral coinfections was identified as a risk factor for a severe course of lower RTI.
authors: Department of Pediatrics, St Anna Children's Hospital, Medical University Vienna, Austria.
authors: Tamas
authors: T
authors: Fazekas
authors: Philipp
authors: P
authors: Eickhoff
authors: Margit
authors: M
authors: Rauch
authors: Maria
authors: M
authors: Verdianz
authors: Andishe
authors: A
authors: Attarbaschi
authors: Michael
authors: M
authors: Dworzak
authors: Christina
authors: C
authors: Peters
authors: Karin
authors: K
authors: Hammer
authors: Andreas
authors: A
authors: Vecsei
authors: Ulrike
authors: U
authors: Pötschger
authors: Thomas
authors: T
authors: Lion
mesh_terms: D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate; D014777:Virus Diseases / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D014780:Viruses / Q000276:immunology*