Identification and analysis of the impact of co-infections in pediatric patients hospitalized with lower tract acute respiratory infections

Abstract

Respiratory infections are a well-established child morbidity and mortality cause, which are estimated to cause 75% of all acute illness and are the leading cause of hospitalization for infants and young children worldwide. There are no methods of treatment or prevention through vaccination, except for specific agents (seasonal flu and H1N1) and in specific children with risk factors. However, the majority of respiratory infections occur in apparently healthy children without identifiable medical history, in which also the susceptibility, clinical course and prognosis vary widely even being affected by the same virus. Within this spectrum, respiratory syncytial virus (RSV) specifically is one of the paradigms of pediatric respiratory infection, frequency, morbidity and the absence of demonstrably effective preventive or therapeutic measures. While the clinical features of ARIs are easily recognized, the etiological agent responsible for disease is often not detected, as typically it is used direct immunofluorescence to detect RSV, influenza virus, parainfluenza virus and adenovirus. In this regard, the etiology of most lower respiratory tract infection is thought to be viral, but a virus is identified in approximately 40% of cases with this approach. Since the introduction of molecular diagnostic techniques, the identification of pathogens that escape from conventional modalities has increased. These molecular techniques frequently reveal the presence of more than one microorganism in the samples. The importance of these co-infections in the pathogenesis, severity or course of these respiratory infections is not well established. In the other hand, bacteremia risk is considered low in children with acute bronchiolitis and fever.