VIRAL LOWER RESPIRATORY TRACT INFECTION IN HOSPITALIZED INFANTS AND CHILDREN IN GERMANY

I. Kambeck, M. Posselt, A. Rohwedder, G. Ihorst, G. Petersen, J. Forster and the PRI.DE study group

University Children's Hospital Freiburg; St. Josefskrankenhaus Freiburg; Institute for Medical Microbiology and Virology, Ruhr-University Bochum; Institute for Medical Biometry and Statistic, University Freiburg,;Wyeth Pharma GmbH Muenster, Germany., St. Josefskrankenhaus Freiburg, Germany

Study design: Prospective multicenter hospital based study, winter 1999/2000.

Setting: Five primary to tertiary care hospitals in 4 cities in Germany.

Cases: Infants and children (0-3 years) admitted for lower airways disease or apnea (0-6 months) and those nosocomially affected.

Methods: Standardized recording of history, biometry, clinical examination, x-ray, course of hospitalization. Multiplex-PCR from nasopharyngeal secretions (NPS) (Prodesse, Waukesha, USA).

Results: From November 99 – October 00 1433 patients were recruited, 72.7% thereof participated in the study. Diagnoses of 572 analyzed patients were: laryngotracheitis 5.6%, bronchiolitis/wheezing bronchitis 59.8%, bronchitis 12.8%, pneumonia 35.5% and apnea 4%. Viruses found in NPS (n=564): Respiratory Syncytial Virus (RSV) A/B (37.2%), Parainfluenzavirus (PIV) 1-3 (6.5%) and Influenzavirus (IV) A (4.9%). No IV B could be detected. PIV were the most important pathogens in laryngotracheitis, whereas RSV was the dominating virus in wheezing bronchitis, bronchiolitis, pneumonia and apnea, equirecal amounts of all viruses were found in bronchitis. Hospital stay (median) was 5.8 days in bronchiolitis and 5.2 in pneumonia. As additional diagnoses at admission were found: acute otitis media (7.7%), otitis media with discharge (3%), and gastroenteritis (8.6%).

Conclusion: Typical virus/diagnosis constellations were found. RSV caused the highest burden of disease and, thus, must be the first target of prevention.