Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 8, August, p. 971–977

doi: 10.17219/acem/121520

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Comparative analysis of clinical features and risk factors of severe pneumonia development in pediatric patients hospitalized with seasonal influenza or swine-origin influenza infection

Ling Jin1,B,C,D,E,F, En-Mei Liu2,B,C,E,F, Xiao-Hong Xie2,C,E,F, Ying Hu1,C,F, Wei Liao1,A,C,E,F

1 Department of Pediatrics, First Affiliated Hospital (Southwest Hospital) of The Third Military Medical University, Chongqing, China

2 Respiratory Center of the Affiliated Children’s Hospital of Chongqing Medical University, China

Abstract

Background. The influenza A virus is the most important human pathogen affecting respiratory tract in children and has been prevalent for more than a century.
Objectives. To describe epidemiological and clinical features in hospitalized children with acute respiratory infection caused by a novel swine-origin influenza virus (S-OIV) and seasonal influenza virus A (IVA).
Material and Methods. A total of 1,074 nasopharyngeal aspirate (NPA) samples were collected from children hospitalized with acute respiratory tract infections. The RNAs of S-OIV and seasonal IVA in the samples were examined using real-time polymerase chain reaction (RT-PCR).
Results. The presence of IVA was detected in 105 samples (9.8%), including S-OIV in 15 samples (1.4%) and seasonal IVA in the remaining samples (8.4%). The incidence of both viral infections was lower in autumn and winter. The rates of severe pneumonia in patients with S-OIV and seasonal IVA were 6.7% and 15.6%, respectively. In total, 14 out of 90 seasonal IVA-positive cases were categorized as severe pneumonia and 1 out of 15 S-OIV-positive cases as severe bronchiolitis. Five samples were found to have single S-OIV infection among 15 S-OIV-positive cases, while other respiratory viruses were detected in the other 9 samples. Twenty-one samples were found to be single seasonal-IVA-positive among the 90 seasonal-IVA-positive cases. Underlying heart conditions (odds ratio (OR) = 13.60), wheezing (OR = 6.82) and co-infection with adenovirus (OR = 6.21) were risk factors for developing severe pneumonia in seasonal IVA patients.
Conclusion. Children younger than 2 years appeared to be susceptible to both kinds of viral infection. Diagnoses of non-severe respiratory tract infection were mainly made for patients with S-OIV and IVA infection. Underlying heart conditions, wheezing and co-infection with adenovirus increase the risk of developing severe pneumonia in seasonal IVA patients.

Key words

children, swine-origin influenza virus, seasonal influenza virus A, acute respiratory tract infection

References (26)

  1. Fouchier RA, Munster V, Wallesten A, et al. Characterization of a novel influenza A virus hemagglutinin subtype (H16) obtained from black-headed gulls. J Virol. 2005;79(5):2814–2822.
  2. Piyarat S, Kano KS, Pranee S, et al. Clinical and epidemiological characteristics of respiratory syncytial virus and influenza virus associated hospitalization in urban Thai infants. J Med Assoc Thai. 2011;94(Suppl 3):S164–S171.
  3. Taubenberger JK, Huhin JV, Morens DM. Discovery and characterization of the 1918 pandemic influenza virus in historical context. Antivir Ther. 2007;12(4 Pt B):581–591.
  4. Peiris JS, Poon LL, Guan Y. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. J Clin Virol. 2009;45(3):169–173.
  5. Muhammad Ismail HI, Tan KK, Lee YL, et al. Characteristics of children hospitalized for pandemic (H1N1) 2009 in Malaysia. Emerg Infect Dis. 2011;17(4):708–710.
  6. Falagas ME, Kiriaze IJ. Reaction to the threat of influenza pandemic: The mass media and the public. Crit Care. 2006;10(1):408.
  7. Piekarska K, Zacharczuk K, Wolkowicz T, et al. Distribution of 16S rRNA methylases among different species of aminoglycoside-resistant Enterobacteriaceae in a tertiary care hospital Poland. Adv Clin Exp Med. 2017;25(3):539–544.
  8. Halasa NB. Update on the 2009 pandemic influenza A H1N1 in children. Curr Opin Pediatr. 2010;22(1):83–87.
  9. Wang C, Liu Y, Wang Y, et al. Adenovirus-mediated siRNA targeting CXCR2 attenuates titanium particle-induced osteolysis by suppressing osteoclast formation. Med Sci Monit. 2016;22(1):727–735.
  10. Xu W, McDonough MC, Erdman DD. Species-specific identification of human adenoviruses by a multiplex PCR assay. J Clin Microbiol. 2000;38(11):4114–4120.
  11. Allander T, Jartti T, Gupta S, et al. Human bocavirus and acute wheezing in children. Clin Infect Dis. 2007;44(7):904–910.
  12. Call SA, Vollenweider MA, Hornung CA, Simel DL, McKinney WP. Does this patient have influenza? JAMA. 2005;293(8):987–997.
  13. Cox NJ, Subbarao K. Influenza. Lancet. 1999;354(9186):1277–1282.
  14. Fiore AE, Shay DK, Broder K, et al; Centers for Disease Control and Prevention. Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009;58(RR-8):1–52.
  15. Thompson WW, Shay DK, Weintraub E, et al. Influenza associated hospitalizations in the United States. JAMA. 2004;292(11):1333–1340.
  16. Monies M, Vicente D, Perez-Yarza E, Cilla G, Pérez-Trallero E. Influenza-related hospitalizations among children aged less than 5 years old in the Basque country, Spain: A 3-year study (July 2001–June 2004). Vaccine. 2005;23(34):4302–4306.
  17. Neuzil K, Zhu Y, Griffin M, et al. Burden of inter-pandemic influenza in children younger than 5 years: A 25-year prospective study. Infect Dis. 2002;185(1):147–152.
  18. Neumann G, Noda T, Kawaoka Y. Emergence and pandemic potential of swine-origin H1N1 influenza virus. Nature. 2009;459(7249):931–939.
  19. Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: Implications for pandemic influenza preparedness. J Infect Dis. 2008;198(7):962–970.
  20. Brundage JF, Shanks GD. Deaths from bacterial pneumonia during the 1918–1919 influenza pandemic. Emerg Infect Dis. 2008;14(8):1193–1199.
  21. Wunderink RG. Influenza and bacterial pneumonia, constant companions. Crit Care. 2010;14(3):150.
  22. Chertow DS, Memoli MJ. Bacterial coinfection in influenza: A grand rounds review. JAMA. 2013;309(3):275–282.
  23. McCullers JA, Jerold ER. Lethal synergism between influenza virus and Streptococcus pneumoniae: Characterization of a mouse model and the role of platelet-activating factor receptor. J Infect Dis. 2002;186(3):341–350.
  24. Shigeki N, Kimberly MD, Jeffrey NW. Synergistic stimulation of type I interferons during influenza virus coinfection promotes Streptococcus pneumoniae colonization in mice. J Clin Microbiol. 2011;121(9):3657–3665.
  25. Lai CC, Lee PL, Tan CK, et al. Pneumonia due to pandemic (H1N1) 2009 influenza virus and Klebsiella pneumoniae capsular serotype K16 in a patient with nasopharyngeal cancer. J Microbiol Immunol Infect. 2011;45(5):382–384.
  26. Radzikowska E, Rozy A, Jagus P, et al. Clarithromycin decreases IL-6 concentration in serum and BAL fluid in patients with cryptogenic organizing pneumonia. Adv Clin Exp Med. 2016;25(5):871–878.
© Wroclaw Medical University