title: Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom.
abstract: Most studies exploring the role of upper airway viruses and bacteria in paediatric acute respiratory infections (ARI) focus on specific clinical diagnoses and/or do not account for virus-bacteria interactions. We aimed to describe the frequency and predictors of virus and bacteria codetection in children with ARI and cough, irrespective of clinical diagnosis. Bilateral nasal swabs, demographic, clinical and risk factor data were collected at enrollment in children aged <15 years presenting to an emergency department with an ARI and where cough was a symptom. Swabs were tested by polymerase chain reaction for 17 respiratory viruses and seven respiratory bacteria. Logistic regression was used to investigate associations between child characteristics and codetection of the organisms of interest. Between December 2011 and August 2014, swabs were collected from 817 (93.3%) of 876 enrolled children, median age 27.7 months (interquartile range 13.9-60.3 months). Overall, 740 (90.6%) of 817 specimens were positive for any organism. Both viruses and bacteria were detected in 423 specimens (51.8%). Factors associated with codetection were age (adjusted odds ratio (aOR) for age <12 months = 4.9, 95% confidence interval (CI) 3.0, 7.9; age 12 to <24 months = 6.0, 95% CI 3.7, 9.8; age 24 to <60 months = 2.4, 95% CI 1.5, 3.9), male gender (aOR 1.46; 95% CI 1.1, 2.0), child care attendance (aOR 2.0; 95% CI 1.4, 2.8) and winter enrollment (aOR 2.0; 95% CI 1.3, 3.0). Haemophilus influenzae dominated the virus-bacteria pairs. Virus-H. influenzae interactions in ARI should be investigated further, especially as the contribution of nontypeable H. influenzae to acute and chronic respiratory diseases is being increasingly recognized.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, South Brisbane, Australia. Electronic address: kerryann.ogrady@qut.edu.au.
authors.forename: K F
authors.initials: KF
authors.lastname: O'Grady
authors.affiliation: Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Southport, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Grimwood
authors.affiliation: Queensland Paediatric Infectious Diseases Laboratory, Children's Health Queensland, South Brisbane, Australia.
authors.forename: T P
authors.initials: TP
authors.lastname: Sloots
authors.affiliation: UQ Centre for Clinical Research, The University of Queensland, Herston, Australia.
authors.forename: D M
authors.initials: DM
authors.lastname: Whiley
authors.affiliation: Department of Emergency Medicine, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia.
authors.forename: J P
authors.initials: JP
authors.lastname: Acworth
authors.affiliation: Department of Emergency Medicine, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Phillips
authors.affiliation: Queensland Children's Respiratory Centre, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia; Children's Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Goyal
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, South Brisbane, Australia; Queensland Children's Respiratory Centre, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia; Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
authors.forename: A B
authors.initials: AB
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000821:virology; D003371:Cough / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009297:Nasal Mucosa / Q000382:microbiology / Q000821:virology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000821:virology; D012621:Seasons; D012737:Sex Factors; D014780:Viruses / Q000145:classification / Q000302:isolation & purification*
keywords: Acute respiratory illness; bacteria; children; cough; viruses