Clinical characteristics of the lower respiratory tract infection caused by a single infection or coinfection of the human parainfluenza virus in children

• Published in: Journal of medical virology 2019-09, Vol.91 (9), p.1625-1632
• Main Authors: Zhong, Peipei, Zhang, Hailin, Chen, Xiaofang, Lv, Fangfang
• Format: Article
• Language: English
• Subjects: Bacteria; Children; clinical characteristics; coinfection; Etiology; human parainfluenza virus; Infections; lower respiratory tract infection; Nose; Parainfluenza; Pathogens; Patients; Polymerase chain reaction; Respiratory diseases; Respiratory syncytial virus; Respiratory tract; Respiratory tract diseases; Respiratory tract infection; Rhinovirus; Secretions; Viral infections; Virology; Viruses; Vitamin E
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.25499

Background Human parainfluenza virus (HPIV), usually combined with other pathogens, causes lower respiratory tract infection (LRTI) in children. However, clinical characteristics of HPIV coinfection with other pathogens were unclear. This study aimed to investigate the viral and atypical bacterial etiology of LRTI in children and compare the clinical characteristics of HPIV single infection with those of coinfection. Methods This study included 1335 patients, aged between 1 to 71 months, diagnosed with LRTI in Yuying Children's Hospital, Zhejiang, China, from December 2013 to June 2015. Nasopharyngeal secretions were collected, and respiratory pathogens were detected using Multiplex polymerase chain reaction. The clinical data of patients were collected and analyzed. Results At least 1 pathogen was detected in 1181/1335 (88.5%) patients. The pathogens identified most frequently were respiratory syncytial virus, human rhinovirus, HPIV, adenovirus, and human metapneumovirus. The coinfection rate was 24.8%. HPIV coinfection with other viruses was more associated with running nose, shortness of breath, and oxygen support compared with HPIV single infection. Moreover, HPIV coinfection with atypical bacteria was more related to running nose, moist rales, and longer hospital duration compared with HPIV single infection, and also to longer hospital duration compared with coinfection with other viruses. Conclusions This study demonstrated that viral infections were highly associated with LRTI and the rate of coinfection was high. HPIV single infection was milder than coinfection with other viruses. Moreover, HPIV coinfection with atypical bacteria was more serious than HPIV single infection and coinfection with other viruses. Highlights Viral infections are highly associated with lower respiratory tract infection and the rate of coinfection is high. HPIV single infection was milder than coinfection with other viruses. HPIV coinfection with atypical bacteria was more serious than HPIV single infection and coinfection with other viruses.