Comparison of clinical features and diagnosis between the A and B subgroups of respiratory syncytial virus
DOI:
https://doi.org/10.23938/ASSN.0029Keywords:
Respiratory syncytial virus. RSV subgroups. Rapid antigen detection test. Reverse transcription polymerase chain reaction.Abstract
Background. Lower respiratory tract infection by respiratory syncytial virus (RSV) is the most frequent cause of admission in children under 2 years old. The RSV subgroups A and B may circulate simultaneously. We aimed to determine whether clinical differences exist between RSV subgroups A and B. Additionally, we tested the sensitivity of the rapid antigen detection test (RADT) based on immunochromatography in diagnosing subgroups A and B, taking the polymerase chain reaction assay (RT-PCR) as reference.
Methods. A retrospective observational study was performed in a tertiary hospital from October 2013 to March 2014. Clinical records and analytical variables of all children under 5 admitted with lower respiratory tract infection and RT-PCR positive for RSV in nasal lavage were consulted. Previously, the RADT for RSV had been performed from the same sample.
Results. A total of 198 children under 5 were diagnosed with RSV by RT-PCR: 55 (28%) were RSV-A, 132 (67%) RSV-B and 11 (5%) were positive for both subgroups. No differences were observed between subgroups in medical history, symptoms, radiological and analytical findings, and severity. The sensitivity of RADT for RSV was 52%, higher for RSV-A (69%) than for RSV-B (44%, p=0.001).
Conclusions. The two RSV subgroups were indistinguishable in symptoms and prognosis. The sensitivity of RADT compared to RT-PCR was low and limits its usefulness for clinical decision-making.
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References
LANGLEY GF, ANDERSON LJ. Epidemiology and prevention of respiratory syncytial virus infections among infants and young children. Pediatr Infect Dis J 2011; 30: 510-517.
PRETORIUS MA, VAN NIEKERK S, TEMPIA S, MOYES J, COHEN C, MADHI SA et al. SARI Surveillance Group. Replacement and positive evolution of subtype A and B respiratory syncytial virus G-protein genotypes from 1997-2012 in South Africa. J Infect Dis 2013; 208 (Suppl 3): S227-237.
ESPOSITO S, PIRALLA A, ZAMPIERO A, BIANCHINI S, DI PIETRO G, SCALA A et al. Characteristics and their clinical relevance of respiratory syncytial virus types and genotypes circulating in Northern Italy in five consecutive winter seasons. PLoS One 2015; 10: e0129369.
GILCA R, DE SERRES G, TREMBLAY M, VACHON ML, LEBLANC E, BERGERON MG et al. Distribution and clinical impact of human respiratory syncytial virus genotypes in hospitalized children over 2 winter seasons. J Infect Dis 2006; 193: 54-58.
PANAYIOTOU C, RICHTER J, KOLIOU M, KALOGIROU N, GEORGIOU E, CHRISTODOULOU C. Epidemiology of respiratory syncytial virus in children in Cyprus during three consecutive winter seasons (2010-2013): age distribution, seasonality and association between prevalent genotypes and disease severity. Epidemiol Infect 2014; 142: 2406-2411.
BAMBERGER E, SRUGO I, ABU RAYA B, SEGAL E, CHAIM B, KASSIS I et al. What is the clinical relevance of respiratory syncytial virus bronchiolitis?: findings from a multi-center, prospective study. Eur J Clin Microbiol Infect Dis 2012; 31: 3323-3330.
MAZUR NI, MARTINÓN-TORRES F, BARALDI E, FAUROUX B, GREENOUGH A, HEIKKINEN T et al. Respiratory Syncytial Virus Network (ReSViNET). Lower respiratory tract infection caused by respiratory syncytial virus: current management and new therapeutics. Lancet Respir Med 2015; 3: 888-900.
SOMERVILLE LK, RATNAMOHAN VM, DWYER DE, KOK J. Molecular diagnosis of respiratory viruses. Pathology 2015; 47: 243-249.
PFEIL J, TABATABAI J, SANDER A, RIES M, GRULICH-HENN J, SCHNITZLER P. Screening for respiratory syncytial virus and isolation strategies in children hospitalized with acute respiratory tract infection. Medicine (Baltimore) 2014; 93: e144.
PRINCIPI N, ESPOSITO S. Antigen-based assays for the identification of influenza virus and respiratory syncytial virus: why and how to use them in pediatric practice. Clin Lab Med 2009; 29: 649-660.
BYINGTON CL, CASTILLO H, GERBER K, DALY JA, BRIMLEY LA, ADAMS S et al. The effect of rapid respiratory viral diagnostic testing on antibiotic use in a children's hospital. Arch Pediatr Adolesc Med 2002; 156: 1230-1234.
KRISTENSEN K, HJULER T, RAVN H, SIMÕES EA, STENSBALLE LG. Chronic diseases, chromosomal abnormalities, and congenital malformations as risk factors for respiratory syncytial virus hospitalization: a population-based cohort study. Clin Infect Dis 2012; 54: 810-817.
FARAH MM, PADGETT LB, MCLARIO DJ, SULLIVAN KM, SIMON HK. First-time wheezing in infants during respiratory syncytial virus season: chest radiograph findings. Pediatr Emerg Care 2002; 18: 333-336.
BAER G, BAUMANN P, BUETTCHER M, HEININGER U, BERTHET G, SCHÄFER J et al. Procalcitonin guidance to reduce antibiotic treatment of lower respiratory tract infection in children and adolescents (ProPAED): a randomized controlled trial. PLoS One 2013; 8: e68419.
ELEMRAID MA, RUSHTON SP, THOMAS MF, SPENCER DA, GENNERY AR, CLARK JE. Utility of inflammatory markers in predicting the aetiology of pneumonia in children. Diagn Microbiol Infect Dis 2014; 79: 458-462.
GUÍA PRÁCTICA CLÍNICA SOBRE BRONQUIOLITIS AGUDA. Guías de práctica clínica en el SNS. Ministerio de Sanidad y Política Social. http://www.guiasalud.es/GPC/GPC_475_Bronquiolitis_AIAQS_compl.pdf. Consultado el 12 de noviembre de 2016.
ZLATEVA KT, VIJGEN L, DEKEERSMAEKER N, NARANJO C, VAN RANST M. Subgroup prevalence and genotype circulation patterns of human respiratory syncytial virus in Belgium during ten successive epidemic seasons. J Clin Microbiol 2007; 45: 3022-3030.
GIMFERRER L, CAMPINS M, CODINA MG, MARTÍN MDEL C, FUENTES F, ESPERALBA J et al. Molecular epidemiology and molecular characterization of respiratory syncytial viruses at a tertiary care university hospital in Catalonia (Spain) during the 2013-2014 season. J Clin Virol 2015; 66: 27-32.
JIMÉNEZ-JORGE S, DELGADO-SANZ C, DE MATEO S, POZO F, CASAS I, LARRAURI A, en representación del Sistema de Vigilancia de la Gripe en España (SVGE). Vigilancia del virus respiratorio sincitial en el marco del sistema de vigilancia de la gripe en España, 2006-2014. Enferm Infecc Microbiol Clin 2015; 34: 117-120.
REINA J, FERRÉS F, RUBIO R, ROJO-MOLINERO E. Análisis de las coinfecciones detectadas entre los subtipos del virus respiratorio sincitial y otros virus respiratorios. An Pediatr (Barc) 2015; 82: e255-e256.
DE-PARIS F, BECK C, DE SOUZA NUNES L, MACHADO AB, PAIVA RM, DA SILVA MENEZES D et al. Evaluation of respiratory syncytial virus group A and B genotypes among nosocomial and community-acquired pediatric infections in Southern Brazil. Virol J 2014; 11: 36.
MEERHOFF TJ, FLEMING D, SMITH A, MOSNIER A, VAN GAGELDONK-LAFEBER AB, PAGET WJ; EISS RSV TASK GROUP. Surveillance recommendations based on an exploratory analysis of respiratory syncytial virus reports derived from the European Influenza Surveillance System. BMC Infect Dis 2006; 6: 128.
FODHA I, VABRET A, GHEDIRA L, SEBOUI H, CHOUCHANE S, DEWAR J et al. Respiratory syncytial virus infections in hospitalized infants: association between viral load, virus subgroup, and disease severity. J Med Virol 2007; 79: 1951-1958.
GOKA E, VALLELY P, MUTTON K, KLAPPER P. Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respir Viruses 2013; 7: 1079-1087.
CALVO C, GARCÍA-GARCÍA ML, POZO F, PAULA G, MOLINERO M, CALDERÓN A, GONZÁLEZ-ESGUEVILLAS M, CASAS I. Respiratory syncytial virus coinfections with rhinovirus and human bocavirus in hospitalized children. Medicine (Baltimore) 2015; 94: e1788.
HALL CB, WEINBERG GA, BLUMKIN AK, EDWARDS KM, STAAT MA, SCHULTZ AF et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 2013; 132: e 341-348.
PIÑERO FERNÁNDEZ JA, ALFAYATE MIGUELÉZ S, MENASALVAS RUIZ A, SALVADOR GARCÍA C, MORENO DOCÓN A, SÁNCHEZ-SOLÍS DE QUEROL M. Características epidemiológicas, clínicas y terapéuticas de lactantes hospitalizados por bronquiolitis. An Pediatr (Barc) 2012; 77: 391-396.
CHARTRAND C, TREMBLAY N, RENAUD C, PAPENBURG J. Diagnostic accuracy of rapid antigen detection tests for respiratory syncytial virus infection: systematic review and meta-analysis. J Clin Microbiol 2015; 53: 3738-3749.
PAPENBURG J, BUCKERIDGE DL, DE SERRES G, BOIVIN G. Host and viral factors affecting clinical performance of a rapid diagnostic test for respiratory syncytial virus in hospitalized children. J Pediatr 2013; 163: 911-913.
HAYNES AK, PRILL MM, IWANE MK, GERBER SI; Centers for Disease Control and Prevention (CDC). Respiratory syncytial virus--United States, July 2012-June 2014. MMWR Morb Mortal Wkly Rep 2014; 63: 1133-1136.
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