Respiratory Pathogens in Infants Diagnosed with Acute Lower Respiratory Tract Infection in a Tertiary Care Hospital of Western India Using Multiplex Real Time PCR
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To determine the frequency of respiratory pathogens in infants diagnosed with acute lower respiratory tract infections.
A prospective cross-sectional observational study was conducted in infants hospitalized with a diagnosis of acute lower respiratory tract infection (ALRTI), in a tertiary care hospital in a metropolitan city of Western India. Nasopharyngeal swabs were analyzed by multiplex real time polymerase chain reaction, for 18 viruses and 3 bacteria (H. influenzae type b, C. pneumoniae and M. pneumoniae). The entire data was entered in Microsoft excel sheet and frequencies were determined.
One hundred eligible infants were enrolled. Pathogens were detected in 82 samples, which included Respiratory syncytial viruses (RSV) A / B (35.4%), Human rhinovirus (25.6%), Adenovirus (22%), Human Parainfluenza viruses (11%), Human bocavirus (9.8), Human metapneumovirus A / B (8.5%), Influenza A (H1N1) pdm 09 (6.1%), Parechovirus (3.7%), Human coronaviruses (3.66%), Haemophilus influenzae type b (6.1%), Chlamydia pneumoniae (2.4%) and Mycoplasma pneumoniae (2.4%). Influenza A (other than H1N1), Influenza B, Human Coronavirus 229E and Enterovirus were not detected. The rate of coinfection was 34% and rhinovirus was the most common of the multiple pathogens.
Spectrum of viral etiologies of ALRTI is highlighted. Etiological diagnosis of ALRTI would enable specific antiviral therapy, restrict antibiotic use and help in knowing burden of disease.
KeywordsMultiplex real time PCR Acute lower respiratory tract infection Infants Respiratory viruses RSV Co-infection
The authors’ thank Puritan Medical Products, USA, for providing them flocked swabs with universal transport media (UT – 317).
AAS: Assistance in conceptualization of the research project and developing protocol, conduct of research, data collection, interpretation of results, intellectual inputs in drafting the manuscript and approval of the final draft; JS: Conceptualized the research idea, supervised the conduct of the research, intellectual inputs in drafting the manuscript and approval of the final draft; SSB: Assistance in conceptualization of the research project and developing protocol, interpretation of results, intellectual inputs for improving the research paper and approval of the final draft.
Compliance with Ethical Standards
Conflict of Interest
Source of Funding
Intramural research funds.
- 9.Broor S, Parveen S, Bharaj P, et al. A prospective three-year cohort study of the epidemiology and virology of acute respiratory infections of children in rural India. PLoS One. 2007;2:e491.Google Scholar
- 10.Wright P, Cutt F. Generic protocol to examine the incidence of lower respiratory infection due to respiratory syncytial virus in children less than five years of age [Internet]. Geneva, Switzerland: World Health Organization, Department of Vaccines and Biologicals;2000. Available at:http://apps.who.int/iris/bitstream/handle/10665/66276/WHO_V_and_B_00.08_eng.pdf?sequence=1. Accessed 23 Aug 2018.
- 11.Centre for Disease Control & Prevention, World Food Programme. A Manual: Measuring and Interpreting Malnutrition and Mortality. Rome: CDS & World Food Programme: C; 2005: 17–20.Google Scholar
- 12.World Health Organization. WHO Child Growth Standards. Weight-for-age; girls birth to 2 years (z-scores) [Internet]. WHO; Available at: http://www.who.int/childgrowth/standards/cht_wfa_girls_z_0_2.pdf?ua=1. Accessed 5 Oct 2015.
- 13.World Health Organization. WHO Child Growth Standards. Weight for age; boys birth to 2 years (z scores). Available at: http://www.who.int/childgrowth/standards/cht_wfa_boys_z_0_2.pdf?ua=1. Accessed 5 Oct 2015.
- 18.Pretorius MA, Madhi SA, Cohen C, et al. Respiratory viral coinfections identified by a 10-plex real-time reverse-transcription polymerase chain reaction assay in patients hospitalized with severe acute respiratory illness--South Africa, 2009-2010. J Infect Dis. 2012;206:S159–65.CrossRefGoogle Scholar
- 20.Child Health Programme [Internet]. Minister of Health & Family Welfare; 2015 Available at: https://mohfw.gov.in/sites/default/files/54789632475632147555.pdf. Accessed 4 Oct 2015.
- 22.Proenca-Modena JL, Pereira Valera FC, Jacob M, et al. High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease. PLoS One. 2012;7:e42136.Google Scholar