Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases
REN Kang-Yi, REN Luo, DENG Yu, XIE Xiao-Hong, ZANG Na, XIE Jun, LUO Zheng-Xiu, LUO Jian, FU Zhou, LIU EnMei, LI Qu-Bei
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China
Abstract Objective To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI). Methods Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed. Results A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (P=0.030). A total of 298 samples were detected with single RSV, 148 were detected with RSV mixed with other viruses, 389 were detected with other viruses, and 241 were detected negative for viruses. Compared with the other viruses and negative virus groups, the single RSV group had a significantly younger age and significantly higher incidence rates of dyspnea, respiratory failure, and severe lower respiratory tract infection (P < 0.0083). The RSV-A positive group had a significantly higher proportion of boys than the RSV-B positive group (P=0.004), but there were no significant differences in clinical manifestations between the two groups. Conclusions In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.
REN Kang-Yi,REN Luo,DENG Yu et al. Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases[J]. CJCP, 2021, 23(1): 67-73.
REN Kang-Yi,REN Luo,DENG Yu et al. Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases[J]. CJCP, 2021, 23(1): 67-73.
Shi T, McAllister DA, O'Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015:a systematic review and modelling study[J]. Lancet, 2017, 390(10098):946-958.
[2]
Anderson EJ, Carbonell-Estrany X, Blanken M, et al. Burden of severe respiratory syncytial virus disease among 33-35 weeks' gestational age infants born during multiple respiratory syncytial virus seasons[J]. Pediatr Infect Dis J, 2017, 36(2):160-167.
[3]
Pangesti KNA, Abd El Ghany M, Walsh MG, et al. Molecular epidemiology of respiratory syncytial virus[J]. Rev Med Virol, 2018, 28(2):e1968.
[4]
Griffiths C, Drews SJ, Marchant DJ. Respiratory syncytial virus:infection, detection, and new options for prevention and treatment[J]. Clin Microbiol Rev, 2017, 30(1):277-319.
Coiras MT, Pérez-Breña P, García ML, et al. Simultaneous detection of influenza A, B, and C viruses, respiratory syncytial virus, and adenoviruses in clinical samples by multiplex reverse transcription nested-PCR assay[J]. J Med Virol, 2003, 69(1):132-144.
[7]
Zheng SY, Wang LL, Ren L, et al. Epidemiological analysis and follow-up of human rhinovirus infection in children with asthma exacerbation[J]. J Med Virol, 2018, 90(2):219-228.
Bont L, Checchia PA, Fauroux B, et al. Defining the epidemiology and burden of severe respiratory syncytial virus infection among infants and children in western countries[J]. Infect Dis Ther, 2016, 5(3):271-298.
[10]
Anderson LJ, Dormitzer PR, Nokes DJ, et al. Strategic priorities for respiratory syncytial virus (RSV) vaccine development[J]. Vaccine, 2013, 31(Suppl 2):B209-B215.
Pretorius MA, van Niekerk S, Tempia S, et al. Replacement and positive evolution of subtype A and B respiratory syncytial virus G-protein genotypes from 1997-2012 in South Africa[J]. J Infect Dis, 2013, 208(Suppl 3):S227-S237.
[13]
Houspie L, Lemey P, Keyaerts E, et al. Circulation of HRSV in Belgium:from multiple genotype circulation to prolonged circulation of predominant genotypes[J]. PLoS One, 2013, 8(4):e60416.
Liu J, Mu YL, Dong W, et al. Genetic variation of human respiratory syncytial virus among children with fever and respiratory symptoms in Shanghai, China, from 2009 to 2012[J]. Infect Genet Evol, 2014, 27:131-136.
Petrarca L, Nenna R, Frassanito A, et al. Acute bronchiolitis:influence of viral co-infection in infants hospitalized over 12 consecutive epidemic seasons[J]. J Med Virol, 2018, 90(4):631-638.
[20]
Richard N, Komurian-Pradel F, Javouhey E, et al. The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis[J]. Pediatr Infect Dis J, 2008, 27(3):213-217.
[21]
Papenburg J, Hamelin MÈ, Ouhoummane N, et al. Comparison of risk factors for human metapneumovirus and respiratory syncytial virus disease severity in young children[J]. J Infect Dis, 2012, 206(2):178-189.
[22]
Yoshihara K, Le MN, Okamoto M, et al. Association of RSV-A ON1 genotype with increased pediatric acute lower respiratory tract infection in Vietnam[J]. Sci Rep, 2016, 6:27856.
[23]
Vandini S, Biagi C, Lanari M. Respiratory syncytial virus:the influence of serotype and genotype variability on clinical course of infection[J]. Int J Mol Sci, 2017, 18(8):1717.
[24]
Wu W, Macdonald A, Hiscox JA, et al. Different NF-κB activation characteristics of human respiratory syncytial virus subgroups A and B[J]. Microb Pathog, 2012, 52(3):184-191.
[25]
Fonseca W, Lukacs NW, Ptaschinski C. Factors affecting the immunity to respiratory syncytial virus:from epigenetics to microbiome[J]. Front Immunol, 2018, 9:226.
[26]
Hornsleth A, Klug B, Nir M, et al. Severity of respiratory syncytial virus disease related to type and genotype of virus and to cytokine values in nasopharyngeal secretions[J]. Pediatr Infect Dis J, 1998, 17(12):1114-1121.
[27]
Fodha I, Vabret A, Ghedira L, et al. Respiratory syncytial virus infections in hospitalized infants:association between viral load, virus subgroup, and disease severity[J]. J Med Virol, 2007, 79(12):1951-1958.
[28]
Midulla F, Nenna R, Scagnolari C, et al. How respiratory syncytial virus genotypes influence the clinical course in infants hospitalized for bronchiolitis[J]. J Infect Dis, 2019, 219(4):526-534.
[29]
Papadopoulos NG, Gourgiotis D, Javadyan A, et al. Does respiratory syncytial virus subtype influences the severity of acute bronchiolitis in hospitalized infants?[J]. Respir Med, 2004, 98(9):879-882.
[30]
Tse SM, Coull BA, Sordillo JE, et al. Gender-and age-specific risk factors for wheeze from birth through adolescence[J]. Pediatr Pulmonol, 2015, 50(10):955-962.
LI Lei, ZHANG Zhi-Quan, ZHENG Cheng-Zhong, SHI Yuan, Pediatric Disaster Branch of Chinese Pediatric Society of Chinese Medical Association, Pediatric Branch of Chinese People's Liberation Army. Expert consensus on the prevention and treatment of drowning in children[J]. CJCP, 2021, 23(1): 12-17.
