Abstract
Background
Acute lower respiratory tract infection (ALRI) due to adenovirus infection is a low frequency event but often causes severe outcome. This study was undertaken to uncover the clinical and epidemiological features of adenovirus infection in children.
Methods
Hospitalized children with ALRI were analyzed through continuous monitoring from 2006 to 2012. Nasopharyngeal aspirates were examined by direct immunofluorescence to detect respiratory agents including respiratory syncytial virus, adenovirus, influenza virus types A/B, parainfluenza virus types 1/2/3. Chlamydia pneumonia, Mycoplasma pneumonia and Chlamydia trachomatis were determined by real-time PCR. A retrospective analysis was made of 479 patients with positive infection of adenovirus.
Results
The positive detection rate of adenovirus was 0.63% in patients with ALRI. The incidence rate of adenovirus-associated acute lower respiratory tract infection peaked at the second six months of life. The morbidity was much higher in winter, spring and summer than in autumn. Patients with pneumonia accounted for 73.90% of the patients. More than one-third of the patients developed severe pneumonia, whereas no death was found. Features of severe adenovirus-associated lower respiratory tract infection included persistent high fever with serious infective symptoms, and hepatic dysfunction was one of the most common complications. Mixed infection of atypical pathogens was common (18.58%) in this study.
Conclusions
Adenovirus is a critical pathogen that can cause severe respiratory infections even in immunocompetent children. Coinfection of adenovirus with atypical pathogens is common. Antibiotic treatment with azithromycin or erythromycin is necessary in patients with mixed infection of atypical pathogens.
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References
Schmitz H, Wigand R, Heinrich W. Worldwide epidemiology of human adenovirus infections. Am J Epidemiol 1983;117:455–466.
Kim YJ, Hong JY, Lee HJ, Shin SH, Kim YK, Inada T, et al. Genome type analysis of adenovirus types 3 and 7 isolated during successive outbreaks of lower respiratory tract infections in children. J Clin Microbiol 2003;41:4594–4599.
Guerrier G, Goyet S, Chheng ET, Rammaert B, Borand L, Te V, et al. Acute Viral Lower Respiratory Tract Infections in Cambodian Children Clinical and Epidemiological Characteristics. Pediatr Infect Dis J 2013;32:e8–13.
Nakazawa H, Ito T, Makishima H, Misawa N, Okiyama W, Uehara T, et al. Adenovirus fulminant hepatic failure: disseminated adenovirus disease after unrelated allogeneic stem cell transplantation for acute lymphoblastic leukemia. Intern Med 2006;45:975–980.
Ozbay Hoşnut F, Canan O, Ozçay F, Bilezikçi B. Adenovirus infection as possible cause of acute liver failure in a healthy child: a case report. Turk J Gastroenterol 2008;19:281–283.
Orenstein DM. Acute inflammatory upper airway obstruction. In: ai]Behrman RE, Kliegman RM, eds. Nelson textbook of pediatrics. 16th ed. Philadelphia: Pennsylvania, 2000: 1274–1279.
World Health Organization. A programme for controlling acute respiratory infections in children. Memorandum from a WHO meeting. Bull World Health Organ 1984;62:47–58.
Tang LF, Xu YC, Wang YS, Wang CF, Zhu GH, Bao XE, et al. Airway foreign body removal by flexible bronchoscopy: experience with 1027 children during 2000–2008. World J Pediatr 2009;5:191–195.
Guerrier G, Goyet S, Chheng ET, Rammaert B, Borand L, Te V, et al. Acute viral lower respiratory tract infections in Cambodian children: clinical and epidemiologic characteristics. Pediatr Infect Dis J 2013;32:e8–13.
Khamis FA, Al-Kobaisi MF, Al-Areimi WS, Al-Kindi H, Al-Zakwani I. Epidemiology of respiratory virus infections among infants and young children admitted to hospital in Oman. J Med Virol 2012;84:1323–1329.
Hierholzer JC. Adenoviruses in the immunocompromised host. Clin Microbiol Rev 1992;5:262–274.
Chakrabarti S, Mautner V, Osman H, Collingham KE, Fegan CD, Klapper PE, et al. Adenovirus infection following allogeneic stem cell transplantation: the incidence and outcome in relation to graft manipulation, immunosuppression and immune recovery. Blood 2002;100:1619–1627.
Walls T, Hawrami K, Ushiro-Lumb I, Shingadia D, Saha V, Shankar AG. Adenovirus infection after pediatric bone marrow transplantation: is treatment always necessary? Clin Infect Dis 2005;40:1244–1249.
Siminovich M, Murtagh P. Acute lower respiratory tract infections by adenovirus in children: histopathologic findings in 18 fatal cases. Pediatr Dev Pathol 2011;14:214–217.
Similä S, Linna O, Lanning P, Heikkinen E, Ala-Houhala M. Chronic lung damage caused by adenovirus type 7: a ten-year follow-up study. Chest 1981;80:127–131.
Smyth A. Pneumonia due to viral and atypical organisms and their sequelae. Br Med Bull 2002;61:247–262.
Ruuskanen O, Mertsola J. Childhood community-acquired pneumonia. Semin Respir Infect 1999;14:163–172.
Debiaggi M, Canducci F, Ceresola ER, Clementi M. The role of infections and coinfections with newly identified and emerging respiratory viruses in children. Virol J 2012;9:247.
Peng D, Zhao D, Liu J, Wang X, Yang K, Xicheng H, et al. Multipathogen infections in hospitalized children with acute respiratory infections. Virol J 2009;6:155.
Cimolai N, Wensley D, Seear M et al. Mycoplasma pneumonia as cofactor in severe respiratory infections. Clin Infect Dis 1995;21:1182–1185.
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Lu, MP., Ma, LY., Zheng, Q. et al. Clinical characteristics of adenovirus associated lower respiratory tract infection in children. World J Pediatr 9, 346–349 (2013). https://doi.org/10.1007/s12519-013-0431-3
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DOI: https://doi.org/10.1007/s12519-013-0431-3