Human respiratory syncytial virus in children with lower respiratory tract infections or influenza-like illness and its co-infection characteristics with viruses and atypical bacteria in Hangzhou, China

J Clin Virol. 2015 Aug:69:1-6. doi: 10.1016/j.jcv.2015.05.015. Epub 2015 May 21.

Abstract

Background: Human respiratory syncytial virus (RSV) is the most important viral pathogen in children. However, its epidemic patterns and co-infection characteristics are not fully understood.

Objectives: We attempted to determine the level of genetic variation of RSV, and describe the prevalence and co-infection characteristics of RSV in Hangzhou during two epidemic seasons.

Study design: Single respiratory samples from 1820 pediatric patients were screened for RSV and genotyped by RT-PCR and sequencing. In all RSV positive specimens, we screened for viruses and atypical bacteria. Demographic and clinical information was recorded and analyzed.

Results: A total of 34.5% and 3.8% of samples from acute lower respiratory tract infections (ALRI) and influenza-like illness (ILI) were positive for RSV, respectively. Phylogenetic analysis revealed that 61.1% of the selected 167 RSV strains were NA1, 31.1% were BA, 3.6% were ON1, 2.4% were CB1, and 1.8% were NA3. A new genotype, BA11 was identified, which comprised 98.1% of BA strains in this study, while the rest were BA10. A total of 36.4% and 9.1% of RSV-positive children with ALRI and ILI respectively were found to be co-infected. Rhinovirus was the most common additional respiratory virus, followed by human metapneumovirus. Except for fever, no significant differences in other clinical presentation between the RSV mono-infection and co-infection groups were observed.

Conclusions: The circulating RSV strains had high genetic variability with RSV-B showing a more local pattern. In ALRI cases, co-infection of RSV with other viruses or atypical bacteria has no significant effect on the clinical presentation except fever.

Keywords: Children; Co-infection; Epidemic pattern; Genotype; Human respiratory syncytial virus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Bacteria / isolation & purification
  • Bacterial Infections / complications
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology
  • Child
  • Child, Preschool
  • China / epidemiology
  • Coinfection / virology
  • Female
  • Genetic Variation
  • Humans
  • Infant
  • Influenza, Human / epidemiology
  • Male
  • Phylogeny
  • Real-Time Polymerase Chain Reaction
  • Respiratory Syncytial Virus Infections / complications
  • Respiratory Syncytial Virus Infections / epidemiology*
  • Respiratory Syncytial Virus Infections / virology*
  • Respiratory Syncytial Virus, Human / classification
  • Respiratory Syncytial Virus, Human / genetics*
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / virology
  • Seasons
  • Sequence Analysis, DNA