Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients.

BACKGROUND: Pediatric cancer patients have a higher risk of morbidity and mortality due to respiratory viral infections than do other patient populations.

OBJECTIVES: To investigate the causative viruses of respiratory infections and their burden among pediatric cancer patients in Lebanon.

STUDY DESIGN: Nasopharyngeal swabs along with clinical and demographic data were collected from pediatric cancer patients presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by real-time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections.

RESULTS: We obtained 89 nasopharyngeal swabs from pediatric cancer patients (mean age, 5.8 ± 4.2 years). Real-time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV, 26%), influenza type B (Flu B, 26%), human metapneumovirus (24.6%), and human coronavirus (HCoV, 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission.

CONCLUSION: Pediatric cancer patients have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use. This article is protected by copyright. All rights reserved.