Why the study?
Acute lower respiratory infections are a major burden and predominantly viral in children; molecular biology detection enables broader virological diagnosis to describe patient characteristics and factors linked to disease severity.
What are the virological profiles and factors associated with severity in children hospitalized with acute respiratory infections?
What are the virological profiles and factors associated with severity in children hospitalized with acute respiratory infections?
RSV is the predominant viral cause of acute respiratory infections in hospitalized children during winter in this Moroccan cohort, and multiplex PCR can rapidly identify the etiology to potentially reduce unnecessary antibiotic use.
Younger age, elevated CRP, and abnormal radiographs flag higher oxygen need in pediatric ALRI; leaves open whether routine multiplex PCR alters management or antibiotic use.
Background: Acute Lower Respiratory Infections are a heavy burden on the Heath system. The viral cause is the most prevalent in children. The techniques of detection by molecular biology have made it possible to broaden the virological diagnosis and to optimize the therapeutic management. The aim of our work is to describe the epidemiological and virological characteristics of our patients and to specify the factors associated with the severity of the disease by evaluating the need for oxygen and the duration of hospitalization in the patients. Patients and Methods: this is a cross-sectional prospective study carried out from January 1 to February 28, 2021 in the pediatrics department at Cheikh Khalifa Hospital in Casablanca. The epidemiological, clinical and paraclinical data of the patients were collected on an admission form. The virological diagnosis was carried out on nasopharyngeal swabs by the multiplex Polymerase Chain Reaction (PCR) test. Results: A total of 85 cases were included with a median age of 9 months. Children under 12 months of age accounted for 55.3% of cases. The predominant clinical picture was wheezing dyspnea (45.9%). The median length of hospital stay was 5 days [3 - 6]. RSV, rhinovirus, influenza A and H1N1 influenza are detected in 50.8%, 17.5%, 17.5% and 5.2% respectively. Co-infection with 2 viruses is noted in 3 cases. By comparing the patients who required oxygen therapy with those who did not have this need, a statistically significant difference according to age (p <0.001), length of stay (p = 0.019), CRP level (p = 0.02) and whether or not the chest x-ray was pathological (p = 0.005) was found. Conclusion: This study made it possible to determine the virological agents most implicated in ARI during the winter period in our patients. The multiplex PCR detection technique, although expensive, is rapid and efficient. Its routine use should reduce the number of unnecessary paraclinical examinations and the overuse of antibiotics.
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Chekhlabi et al. (2024) studied this question.
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