Two-year prospective study of single infections and co-infections by respiratory syncytial virus and viruses identified recently in infants with acute respiratory disease

Authors

  • Filippo Canducci,

    Corresponding author
    1. Laboratorio di Microbiologia e Virologia, Università “Vita-Salute” San Raffaele, and Istituto Scientifico San Raffaele, Milan, Italy
    • Laboratorio di Microbiologia e Virologia, Università “Vita-Salute” San Raffaele, Milan, Italy.
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  • Maurizia Debiaggi,

    1. Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia, Pavia, Italy
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  • Michela Sampaolo,

    1. Laboratorio di Microbiologia e Virologia, Università “Vita-Salute” San Raffaele, and Istituto Scientifico San Raffaele, Milan, Italy
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  • Maria Chiara Marinozzi,

    1. Laboratorio di Microbiologia e Virologia, Università “Vita-Salute” San Raffaele, and Istituto Scientifico San Raffaele, Milan, Italy
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  • Stefano Berrè,

    1. Laboratorio di Microbiologia e Virologia, Università “Vita-Salute” San Raffaele, and Istituto Scientifico San Raffaele, Milan, Italy
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  • Cristina Terulla,

    1. Servizio Analisi Microbiologiche, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, Pavia, Italy
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  • Gianluigi Gargantini,

    1. Unità Operativa di Pediatria e, Azienda Ospedaliera di Melegnano, Presidio di Vizzolo Predabissi, Melegnano, Italy
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  • Patrizia Cambieri,

    1. Servizio Analisi Chimico Cliniche e Microbiologiche, Azienda Ospedaliera di Melegnano, Presidio di Vizzolo Predabissi, Melegnano, Italy
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  • Egidio Romero,

    1. Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia, Pavia, Italy
    2. Servizio Analisi Microbiologiche, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Matteo, Pavia, Italy
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  • Massimo Clementi

    1. Laboratorio di Microbiologia e Virologia, Università “Vita-Salute” San Raffaele, and Istituto Scientifico San Raffaele, Milan, Italy
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Abstract

A prospective 2-year analysis including 322 infant patients with acute respiratory disease (ARD) hospitalized in a pediatric department in northern Italy was carried out to evaluate the role as respiratory pathogens or co-pathogens of recently identified viruses. The presence of respiratory syncitial virus (RSV), human Metapneumoviruses (hMPVs), human Bocaviruses (hBoVs), and human Coronaviruses (hCoVs) was assayed by molecular detection and clinical symptoms evaluated. Nasopharyngeal aspirates from 150 of the 322 infants (46.6%) tested positive for at least one pathogen. Ninety samples (28.0%) tested positive for RSV RNA (61.5% genotype A and 38.5% genotype B), 46 (14.3%) for hMPV RNA (71.7% subtype A and 28.3% subtype B), 28 (8.7%) for hCoV RNA (39.3% hCoV-OC43, 35.7% hCoV-NL63, 21.4% hCoV-HKU1, and 3.6% hCoV-229E), and 7 (2.2%) for hBoV DNA (of the 6 typed, 50% subtype 1 and 50% subtype 2); 21/150 samples revealed the presence of 2 or more viruses. Co-infection rates were higher for hMPVs, hCoVs, and hBoV (38.3%, 46.4%, and 57.1%,) and lower for RSV (23.3%). RSV was associated with the presence of complications (P < 0.001) and hypoxia (P < 0.015). When the presence of RSV alone and the RSV-hMPV co-infections were considered, RSV mono-infected patients resulted to have longer hospitalization and higher hypoxia (P < 0.001). The data highlight that (i) RSV has a central role as a respiratory pathogen of infants, (ii) the wide circulation of recently identified viruses does not reduce the clinical and epidemiological importance of RSV, and that (iii) recently identified agents (hMPVs, hBoVs, and hCoVs) act as primary pathogens or co-pathogens. J. Med. Virol. 80:716–723, 2008. © 2008 Wiley-Liss, Inc.

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