1764. Rhinovirus is an important pathogen in lower and upper respiratory tract infections in Mexican children. A multicenter study
Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background:

There is limited data on the viral etiology of respiratory tract infections (RTI) in Mexico. The aims of the study were to determine the viral etiology and to investigate the frequency and genotype of rhinovirus associated with LRTI and upper RTI (URTI) in children in the country.

Methods:

Prospective surveillance of children with a clinical diagnosis suggestive of viral pneumonia (LRTI) from 9 hospitals in various regions of Mexico and children attending the pediatric consult with URTI in 5 cities of the state of Veracruz were included. Nasal washings in the LRTI patients and nasal swabs in the URTI patients were obtained, transported in viral medium and sent to the laboratories for storage at -70°C until processing. Samples were processed by the RT-PCR multiplex technique for 19 respiratory viruses. In some samples positive for rhinovirus the non translated 5´ region of the virus genome was amplified by RT-PCR and sequenced by the Sanger method.

Results:

1323 children with respiratory tract infections were included, 831 children with LRTI and 492 children with URTI. The positive viral detection by RT-PCR multiplex technique was 79% for both the LRTI and URTI. In LRTI the 5 most frequent pathogens detected were:  23.2% RSV A, 20% rhinovirus, 8.2% metapneumovirus, 2.6% parainfluenza 3, 1.7% adenovirus, there was coinfection in 16% and 20.7% were negative. In the URTI the 5 most frequent pathogens detected were: 16.5% RSV A, 11.1% rhinovirus, 7.1% influenza A, 3.3% metapneumovirus, 3.3% adenovirus, there was coinfection in 12.6% and 20.9% were negative.

In 43 children with rhinovirus associated LRTI 47% were genotype A, 6% genotype B, and 47% genotype C, whereas in 60 children with rhinovirus associated URTI, 60% were genotype A and 40% genotype C (p=ns). 

Conclusion:

Although RSV A was the most frequent viral pathogen found in children with LRTI and URTI (23% & 16%), rhinovirus is also a frequent respiratory pathogen in Mexican children with LRTI and URTI (20% & 11%). Rhinovirus C has been associated with severe RTI, in this study it was a very frequent genotype: 47% of children with rhinovirus associated pneumonia and 40% of children with rhinovirus associated URTI; allowing us to conclude that rhinovirus, and particularly rhinovirus C, is an important respiratory pathogen in Mexican children.

Rosa Maria Wong Chew, MD DSc1, Miguel Leonardo Garcia Leon, MSc2, Fernando Aponte Sanchez, BSc3, Veronica Firo Reyes, MD4, Carlos Nicolas Del Rio Almendarez, MD5, Jesus Gaitan Meza, MD6, Alberto Villaseñor Sierra, MD DSc7, Celia Mercedes Alpuche Aranda, MD DSc8, Irma Lopez Martinez, MSc9, Teresa Hernandez Andrade, BSc9, Oscar Alberto Newton Sanchez, MD, MSc.10, Gerardo Martinez Aguilar, MD, MSc.11, Daniel Noyola12, Luis Fernando Perez Gonzalez, MD13, Carmen Gorety Soria Rodriguez, MD14, Enrique Rafael Ortiz Garcia, MD15, Susana Navarrete Navarro, MD16, Marco A. Espinoza, MSc.3, Maria Antonieta Arias Ortiz, MD17, Jesus Monge Martinez, MD18, Ruben Rodriguez Vazquez, MD19, Fidel Diaz Hernandez, MD20, Fernando Zarate Vidal, MD21, Norberto Luna Lopez, MD21, Rafael Vazquez Salinas, MD22, Carlos F Arias, PhD23 and Jose Ignacio Santos Preciado, MD2, (1)Experimental Medicine Department, Universidad Nacional Autonoma De Mexico, DF, Mexico, (2)Experimental Medicine Department, Universidad Nacional Autonoma de Mexico, DF, Mexico, (3)Instituto de Biotecnologia, Universidad Nacional Autonoma de Mexico, Cuernavaca, Morelos, Mexico, (4)Pediatrics, Hospital General de Mexico, DF, Mexico, (5)Infectious Diseases, Hospital Pediatrico de Coyoacan, DF, Mexico, (6)Infectious Diseases, Nuevo Hospital Civil de Guadalajara, Guadalajara, Mexico, (7)CIBO. CMNO, IMSS Guadalajara, Guadalajara, Mexico, (8)Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico, (9)Instituto Nacional de Diagnostico y referencia epidemiologica, DF, Mexico, (10)Pediatrics, Hospital Regional Universitario de los Servicios de Salud del Estado de Colima, Colima, Colima, Mexico, (11)IMSS Durango, Durango, Mexico, (12)Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico, (13)Pediatric Infecrious Diseases, Hospital Central Ignacio Morones Prieto, San Luis Potosi, Mexico, (14)Research and Education department, Hospital General de Mexicali, Baja California , Mexicali, Baja California, Mexico, (15)Hospital para el Niño del Instituto Materno Infantil del Estado de México, Toluca, Estado de México. , Mexico, (16)Pediatrics, Unidad Medica de Alta Especialidad, Hospital de Pediatría, CMNO IMSS, Guadalajara, Mexico, (17)Colegio de Pediatria de Veracruz, A. C., TIERRA BLANCA, VERACRUZ, Mexico, (18)Colegio de Pediatría de Veracruz, A. C., Poza Rica, Veracruz, Mexico, (19)Colegio de Pediatria de Veracruz, A. C., Orizaba, Veracruz, Mexico, (20)Colegio de Pediatria de Veracruz, A. C., Veracruz, Veracruz, Mexico, (21)Colegio de Pediatria de Veracruz, A. C., Minatitlan, Veracruz, Mexico, (22)Colegio de Pediatria de Veracruz, A. C., Jalapa, Veracruz, Mexico, (23)Instituto de Biotecnologia, Universidad Nacional Autonoma de Mexico, Cuernavaca, Mexico

Disclosures:

R. M. Wong Chew, None

M. L. Garcia Leon, None

F. Aponte Sanchez, None

V. Firo Reyes, None

C. N. Del Rio Almendarez, None

J. Gaitan Meza, None

A. Villaseñor Sierra, None

C. M. Alpuche Aranda, None

I. Lopez Martinez, None

T. Hernandez Andrade, None

O. A. Newton Sanchez, None

G. Martinez Aguilar, None

D. Noyola, None

L. F. Perez Gonzalez, None

C. G. Soria Rodriguez, None

E. R. Ortiz Garcia, None

S. Navarrete Navarro, None

M. A. Espinoza, None

M. A. Arias Ortiz, None

J. Monge Martinez, None

R. Rodriguez Vazquez, None

F. Diaz Hernandez, None

F. Zarate Vidal, None

N. Luna Lopez, None

R. Vazquez Salinas, None

C. F. Arias, None

J. I. Santos Preciado, None

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