title: Viral coinfection in childhood respiratory tract infections.
abstract: BACKGROUND
  The introduction of molecular techniques has enabled better understanding of the etiology of respiratory tract infections in children. The objective of the study was to analyze viral coinfection and its relationship to clinical severity.
  
  
  METHODS
  Hospitalized pediatric patients with a clinical diagnosis of respiratory infection were studied during the period between 2009-2010. Clinical and epidemiological data, duration of hospitalization, need for oxygen therapy, bacterial coinfection and need for mechanical ventilation were collected. Etiology was studied by multiplex PCR and low-density microarrays for 19 viruses.
  
  
  RESULTS
  A total of 385 patients were positive, 44.94% under 12 months. The most frequently detected viruses were RSV-B: 139, rhinovirus: 114, RSV-A: 111, influenza A H1N1-2009: 93 and bocavirus: 77. Coinfection was detected in 61.81%, 36.36% with 2 viruses, 16.10% and 9.35% with 3 to 4 or more. Coinfection was higher in 2009 with 69.79 vs. 53.88% in 2010. Rhinovirus/RSV-B on 10 times and RSV-A/RSV-B on 5 times were the most detected coinfections. Hospitalization decreased with greater number of viruses (P<0,001). Oxygen therapy was required by 26.75% (one virus was detected in 55.34% of cases). A larger number of viruses resulted in less need for oxygen (P<0,001). Ten cases required mechanical ventilation, 4 patients with bacterial coinfection and 5 with viral coinfection (P=0,69).
  
  
  CONCLUSIONS
  An inverse relationship was found between the number of viruses detected in nasopharyngeal aspirate, the need for oxygen therapy and hospitalization days. More epidemiological studies and improved quantitative detection techniques are needed to define the role of viral coinfections in respiratory disease and its correlation with the clinical severity.
authors.affiliation: Servicio de Pediatría, Hospital del Mar, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Roig
authors.affiliation: Departamento de Genética y Microbiología, Laboratorio de Referencia de Cataluña, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Salvadó
authors.affiliation: Servicio de Pediatría, Hospital del Mar, Barcelona, España. Electronic address: 97512@hospitaldelmar.cat.
authors.forename: M A
authors.initials: MA
authors.lastname: Caballero-Rabasco
authors.affiliation: Servicio de Pediatría, Hospital del Mar, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez-Buenavida
authors.affiliation: Servicio de Pediatría, Hospital del Mar, Barcelona, España.
authors.forename: N
authors.initials: N
authors.lastname: López-Segura
authors.affiliation: Servicio de Pediatría, Hospital del Mar, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Bonet-Alcaina
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology*; D003131:Combined Modality Therapy; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009305:Nasopharynx / Q000821:virology; D010102:Oxygen Inhalation Therapy; D016133:Polymerase Chain Reaction / Q000379:methods; D012121:Respiration, Artificial; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D013030:Spain / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology*; D014780:Viruses / Q000302:isolation & purification
chemical_list: D000890:Anti-Infective Agents
keywords: Coinfección; Coinfection; Infecciones de vías respiratorias; Respiratory syncytial virus; Respiratory tract infections; Virus respiratorio sincitial