title: Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies.
abstract: BACKGROUND
  Children who suffer a viral lower respiratory infection early in life are prone to subsequent wheezing and asthma: RSV and rhinovirus are thought to be the primary causative pathogens. Epidemiologic and long-term data on these pathogens in Thailand are limited.
  
  
  OBJECTIVE
  To detect the causative pathogens in children hospitalized with a first episode of acute wheezing and to compare the respective impact on the recurrence of wheezing and development of asthma.
  
  
  METHODS
  We conducted a 5-year cohort study of children under 2 hospitalized with acute bronchiolitis at two tertiary hospitals. Nasopharyngeal secretions were collected at admission to determine the causative pathogens by RT-PCR.
  
  
  RESULTS
  145/170 samples (85%) were positive for pathogens. RSV, rhinovirus, influenza, bacteria and hMPV was found in 64.7%, 18.2%, 17.6%, 12.9% and 3.5% of children respectively. The majority (94/152; 62%) of participants reported having recurrent wheezing within the first year of follow-up (mean duration 5.5 ± 7.2 months). Only 16% still had wheezing episodes after 5 years. Asthma was diagnosed in 41 children (45%), most of whom were treated with inhaled corticosteroid. There were no statistically significant differences among the various etiologies.
  
  
  CONCLUSIONS
  Rhinovirus ranked second after RSV as the cause of hospitalizations of children with acute bronchiolitis. More than half of these children had recurrent wheezing which mostly disappeared before the age of 6. Nearly half were subsequently diagnosed with asthma at the 5th year of follow-up. The specific pathogens did not account for a statistically significant difference in subsequent wheezing or asthma development.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Khon Kaen University.
authors.forename: Jamaree
authors.initials: J
authors.lastname: Teeratakulpisarn
authors.forename: Chamsai
authors.initials: C
authors.lastname: Pientong
authors.forename: Tipaya
authors.initials: T
authors.lastname: Ekalaksananan
authors.forename: Hunsa
authors.initials: H
authors.lastname: Ruangsiripiyakul
authors.forename: Rattapon
authors.initials: R
authors.lastname: Uppala
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001249:Asthma / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D001990:Bronchiolitis, Viral / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D010850:Picornaviridae Infections / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000503:physiopathology*; D012189:Retrospective Studies; D012229:Rhinovirus