Etiology and clinical features of repeatedly hospitalized children with respiratory virus infection / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the causative factors of children with respiratory tract infection and their clinical features.Methods Nasopharyngeal aspirate (NPA) was collected from 1746 children with acute respiratory infections (ARIs),aged from 37 days to 3 years,who were admitted to Children's Hospital of Chongqing Medical University between Jun.2009 and May 2011.Fourteen respiratory viruses in NPA were investigated using polymerase chain reactions (PCR) after nucleic acids extracted from the samples and then synthesized cDNA.Sequence analysis was performed to verify the results of each virus from random positive samples.A total of 23 cases were identified with twice or more admissions to hospital.Individual factors,virus detection and clinical characte-ristics were compared between patients with and without repeated hospitalization.Risk factors for repeated hospitalization were investigated.Then these factors were compared in patients with repeated hospitalization between first time and second time.Results The median age was 7 months in patients with repeated hospitalization and 8 months in patients without repeated hospitalization,there were significantly different difference (P ＜ 0.0001).There was no significant difference in virus detection including influenza type A,parainfluenza,respiratory syncytial virus (RSV),adenovirus and human bocavirus between patients with and without repeated hospitalization in the same age group.By comparing clinical features between patients with and without repeated hospitalizatin in the same age group,(69.6％ vs 47.4％,P =O.037) and diarrhea (52.2％vs 29.0％,P =0.017) were found more often in patients with repeated hospitalization.There was no connection between respiratory virus detection and presence of fever,wheeze,cough and diarrhea in patients with repeated hospitalization for the first time of hospitalization.RSV was the most frequently appeared virus in twice hospitalizations,presenting 52.2％ and 30.4％,respectively.One case had twice positive for RSV.In the first hospitalization,there were 16 viruspositive cases and 16 wheeze cases,while in the second hospitalization,there were 12 virus-positive cases (75.0％)and 11 wheeze cases (68.8％),respectively.Conclusions Children with respiratory tract infections suffered repeated hospitalization,mainly occur in children less than 3 years old.Wheeze is an important clinical feature in children with repeated hospitalization.Although causative viruses for patients in each infection are different,RSV is the most common detected viral agent.Virus-positive cases in the first hospitalization present higher viral detection rate during the second hospitalization,with similar trend for wheeze.