Comparative Clinical Analysis of Respiratory Viruses in Pediatric Community-Acquired Pneumonia
Keywords:
Respiratory Viruses, Community-acquired Pneumonia, Pediatric InfectionsAbstract
Background: Community-acquired pneumonia (CAP) continues to be one of the most significant reasons for hospital admissions and serious health issues for children all over the world. One reason for the rise in detection of respiratory viruses as an important cause of pediatric CAP is the enhancement of molecular diagnostics. Nevertheless, there are only a few local studies from Pakistan that provide information on the prevalence, clinical features, and age-related trends of viral pathogens among children hospitalized with radiographically confirmed CAP. Objective: To determine the prevalence and clinical impact of respiratory viruses in children hospitalized with radiologically confirmed CAP. Methodology: This study was conducted in the Department of Pediatrics at Sahara Medical College, Narowal from January 2022 to June 2023. Patients aged 14 years or younger with radiographic signs of community-acquired pneumonia (CAP) were enrolled in the study. Nasopharyngeal swabs were collected within 24 hours of admission and subsequently analyzed by multiplex RT-PCR for the detection of the following viruses: RSV, rhinovirus (RV), human metapneumovirus (HMPV), human bocavirus (HBoV), adenovirus, influenza, parainfluenza, and seasonal coronaviruses. Results: Out of the total 315 children, the detection rate of respiratory viruses was 72.4%. RSV, which was responsible for 24.8% of the cases, was the leading pathogen and mainly affected infants less than 18 months old, and there were quite high rates of hypoxia (75%) and wheezing (94%) among these children. RV, which accounted for 18.1% of cases, and HBoV, which accounted for 14.9%, were the viruses associated with the strongest inflammatory reactions and the most antibiotic prescriptions. The rate of viral co-infections was 30.3%, which was significantly higher in the younger age group (P = 0.03). Blood cultures showed bacterial growth in 4.4% of the children, with Streptococcus pneumoniae as the most common isolate. Conclusion: Respiratory viruses, particularly RSV, RV, and HBoV, constitute a major burden in pediatric CAP. Age-specific differences and frequent co-infections highlight the need for improved viral diagnostics and targeted management strategies to optimize care and reduce unnecessary antibiotic use.References
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