title: Prevalence and Characteristics of Human Metapneumovirus Infection Among Hospitalized Children at High Risk for Severe Lower Respiratory Tract Infection.
abstract: BACKGROUND
  Human metapneumovirus (HMPV) is a significant cause of respiratory tract infections. Little is known about HMPV in children who are at high risk for lower respiratory tract infection (LRTI).
  
  
  METHODS
  To determine the prevalence of HMPV in high-risk children and to identify HMPV risk factors, children ≤24 months with prematurity, chronic lung disease, and/or congenital cardiac disease who were hospitalized with LRTI were prospectively enrolled. Nasopharyngeal aspirates were tested for HMPV, respiratory syncytial virus (RSV), influenza A and B, and parainfluenza types 1-3. Demographics, medical history, and outcomes for those with HMPV and RSV were compared. A multivariate analysis was performed to determine HMPV risk factors.
  
  
  RESULTS
  Over 4 years, 1126 eligible children were enrolled. Pathogens were identified in 61% of subjects. HMPV was identified in 9.0%, second to RSV (45%). Coinfection with HMPV and RSV occurred in <1% of subjects. Subjects infected with HMPV were older (8.2 vs 4.0 months, P < .001), were born more prematurely (27 vs 33 weeks, P < .001), and more commonly had chronic lung disease (59.3% vs 21.8%, P < .001) compared with subjects infected with RSV. In a multivariate analysis that compared children infected with HMPV to all others, increasing age and household exposure to children ages 6-12 were associated with an increased risk, whereas birth at older gestational age and exposure to children age >12 were associated with a decreased risk.
  
  
  CONCLUSIONS
  HMPV was detected in 9% of high-risk children who were hospitalized with lower respiratory tract disease, representing the second most common virus in this population. Compared with all other subjects (including RSV-infected), subjects infected with HMPV were older but were born more prematurely.
authors.affiliation: Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ilinois.
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Anderson
authors.affiliation: The University of Colorado School of Medicine, Children's Hospital Colorado, Aurora.
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simões
authors.affiliation: Royal Children's and Monash Children's Hospitals, Murdoch Children's Research Institute, Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Jim P
authors.initials: JP
authors.lastname: Buttery
authors.affiliation: Hasbro Children's Hospital and The Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Penelope H
authors.initials: PH
authors.lastname: Dennehy
authors.affiliation: SUNY Upstate Medical University, Department of Pediatrics, Syracuse, New York.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Domachowske
authors.affiliation: Clinical Development, MedImmune, LLC, Gaithersburg, Maryland.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Jensen
authors.affiliation: Miller Children's Hospital, Long Beach, California.
authors.forename: Jay M
authors.initials: JM
authors.lastname: Lieberman
authors.affiliation: Clinical Development, MedImmune, LLC, Gaithersburg, Maryland.
authors.forename: Genevieve A
authors.initials: GA
authors.lastname: Losonsky
authors.affiliation: Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ilinois.
authors.forename: Ram
authors.initials: R
authors.lastname: Yogev