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September 20-22, 2017 | Toronto, Canada
10
TH
AMERICAN PEDIATRICS HEALTHCARE &
PEDIATRIC INFECTIOUS DISEASES CONGRESS
Pediatric Healthcare & Pediatric Infections 2017
A
cute respiratory infections (ARI) leading to pneumonia,
bronchiolitis or reactive airway disease are the leading
cause of death and ill health among children under 5 years
in developing countries. With introduction of molecular
diagnostic methods like real time based multiplex PCR tests,
polymicrobial infection is being increasingly detected in
both hospitalized and OPD cases of ARIs, but their clinical
significance is poorly documented. In a recent study in 2016-
17, we screened 618 under 5 years children with ARI for
21 different viral and bacterial respiratory pathogens in a
tertiary hospital in northeast India using real time taqman
probe based multiplex assay. The most common respiratory
pathogen in indoor cases vs OPD was RSV (27.3% vs 11.5%,
p-value: 0.0001) followed by
Streptococcus pneumoniae
(SP) (16.4% vs 28%) and Rhinovirus (RV) (13.5% vs 9.6%)
respectively. Co-infection of 3 or more pathogen was
common and was observed in 25% of indoor cases (76/304)
and 32.1% of OPD cases (101/314). Co-infection rate was
similar in both indoor and OPD cases, however coinfection
of RSV, RV & SP was significantly higher in indoor cases
compared to OPD cases. RSV, RV and SP infection were
significantly associated with breathlessness/respiratory
distress (p-value=0.0001). It was seen that U5 children
presenting RSV with bacterial superinfection specially
Streptococcus pneumoniae
was significantly associated with
severe breathlessness/respiratory distress (OR:10.2; 95%
CI: 5.3 to 19.6% p-value=0.0001). Moreover, 23 different
RV serotypes was found to be circulating in the region.
Rhinovirus C was found to be significantly associated
with breathlessness/respiratory distress than RV A or RV
B infection. In developing country like India, where U5
mortality due to ARIs is very high, pneumococcal conjugate
vaccine has now recently been introduced from May 2017
in the UIP. Furthermore, development of an effective low
cost RSV vaccine is necessary to lower the morbidity and
mortality associated with ARIs in developing countries.
e:
biswaborkakoty@gmail.comCo-infection of respiratory pathogens influencing severity of acute respiratory infection in children
under 5 years
Biswajyoti Borkakoty
Indian Council of Medical Research, India