Wheezing independently predicts viral infection in children with community-acquired pneumonia.

Authors:
Olli Ruuskanen
Olli Ruuskanen
Turku University Hospital
Finland
Cristiana M Nascimento-Carvalho
Cristiana M Nascimento-Carvalho
Federal University of Bahia
Brazil

Pediatr Pulmonol 2019 Apr 19. Epub 2019 Apr 19.

Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Brazil.

Aim: To assess whether there was a difference in the frequency of symptoms and signs among children with community-acquired pneumonia (CAP) with viral or bacterial infection.

Methods: A prospective cross-sectional study was conducted in Salvador, Brazil. Children less than 5-years-old hospitalized with CAP were recruited. Viral or only bacterial infection was diagnosed by an investigation of 11 viruses and 8 bacteria. Bacterial infection was diagnosed by blood culture, detection of pneumococcal DNA in acute buffy coat, and serological tests. Viral infection was diagnosed by detection of respiratory virus in nasopharyngeal aspirate and serological tests. Viral infection comprised only viral or mixed viral-bacterial infection subgroups.

Results: One hundred and eighty-eight patients had a probable etiology established as only viral (51.6%), mixed viral-bacterial (30.9%), and only bacterial infection (17.5%). Asthma was registered for 21.4%. Report of wheezing (47.4% vs 21.2%; P = 0.006), rhonchi (38.0% vs 15.2%; P = 0.01), and wheezing detected on physical examination (51.0% vs 9.1%; P < 0.001) were the differences found. Among children with asthma, detected wheezing was the only different finding when children with viral infection were compared with those with only bacterial infection (75.0% vs 0%; P = 0.008). By multivariable analysis, viral infection (AdjOR [95% CI]: 9.6; 95%CI: 2.7-34.0), asthma (AdjOR [95% CI]: 4.6; 95%CI: 1.9-11.0), and age (AdjOR [95% CI]: 0.95; 95%CI: 0.92-0.97) were independently associated with wheezing on physical examination. The positive predictive value of detected wheezing for viral infection was 96.3% (95% CI: 90.4-99.1%).

Conclusion: Wheezing detected on physical examination is an independent predictor of viral infection.

Download full-text PDF

Source
https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.24339
Publisher Site
http://dx.doi.org/10.1002/ppul.24339DOI Listing
April 2019
7 Reads

Publication Analysis

Top Keywords

infection diagnosed
12
viral infection
12
bacterial infection
12
mixed viral-bacterial
8
community-acquired pneumonia
8
serological tests
8
tests viral
8
viral bacterial
8
children community-acquired
8
viral
7
infection
7
infection subgroupsresults
4
aspirate serological
4
nasopharyngeal aspirate
4
infection comprised
4
viral mixed
4
virus nasopharyngeal
4
eighty-eight patients
4
subgroupsresults eighty-eight
4
viral-bacterial infection
4

References

(Supplied by CrossRef)
Mycoplasma pneumoniae infections in childhood
Atkinson TP et al.
Pediatr Infect Dis J 2014
Molecular diagnosis of human rhinovirus infection: comparison with virus isolation
Hyypiä T et al.
J Clin Microbiol 1998
Viruses and bacteria in the etiology of the common cold
Mäkelä MJ et al.
J Clin Microbiol 1998

Similar Publications