Program Schedule

781
Rhinovirus in Children Hospitalized with Community Acquired Pneumonia: Insights from the Centers for Disease Control and Prevention (CDC) Etiology of Pneumonia in the Community (EPIC) Study

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • IDSA 2014 Poster 10-1-2014 (HRV).pdf (1017.0 kB)
  • Background: Human rhinoviruses (HRV) are frequently detected in both children with respiratory symptoms and asymptomatic children. Thus, the relevance of HRV detection in children with pneumonia remains unclear. Some data suggest that HRV-C is associated with severe disease. We studied the association between HRV species and viral load among children hospitalized with radiographically-confirmed pneumonia and asymptomatic children (controls).

    Methods: Molecular testing for HRV and 12 other respiratory viruses was performed on naso-/oro-pharyngeal swabs from children <18 years hospitalized with pneumonia (1/2010-6/2012) and a convenience sample of children without pneumonia (2/2011-6/2012) enrolled at the Utah site of the CDC's EPIC study. HRV speciation was by amplifying and sequencing the VP4/VP2 regions of the HRV genome and comparing sequences to HRV strains in GenBank. HRV load (RNA copies/mL) was determined using standard curves from quantified HRV RNA transcripts normalized with human RNase P gene (specimen control).

    Results: HRV detection was similar among children with pneumonia and controls, (166/853, 20% vs. 38/226, 18%; p=0.18). The majority of HRV detections were single detections, however co-detection with another respiratory virus was more frequent among children with pneumonia than controls (41% vs. 11%; p<0.01). HRV-C was more commonly detected in children with pneumonia than controls (Table).  HRV viral load was significantly higher among children with pneumonia compared with controls (median 6.9 vs. 5.9 log10 copies/mL; p<0.001). However, while median viral loads for HRV-B (7.0 vs 6.1 log10 copies/mL; p=0.5) and HRV-C (6.8 vs 6.4 log10 copies/mL; p=0.4) were similar in children with pneumonia compared with controls, HRV-A viral load was higher in children with pneumonia (7.0 vs 5.9 log10 copies/mL; p<0.001).

    Conclusion: HRV was commonly detected among children with pneumonia and controls, though children with pneumonia had higher viral loads. HRV-C, but not other species, was associated with pneumonia. These data suggest that HRV species and viral load may play a role in the development of pneumonia in children.

     

     

    Children with pneumonia

    (n=166)

    Asymptomatic children

    (n=38)

    P

         HRV-A

         HRV-B

         HRV-C

         Non-typeable

    60 (36%)

    13 (8%)

    84 (51%)

    9 (5%)

    19 (50%)

    6 (16%)

    9 (24%)

    4 (10%)

    NS

    NS

    0.003

    NS

     

     

     

    Krow Ampofo, MD1, Chris Stockmann, MSc1, Weston Hymas, MS, MB(ASCP)2, Anna M. Bramley, MPH3, Derek J. Williams, MD, MPH4, Kathryn Edwards, MD, FIDSA5, Evan Anderson, MD6, Sandra Arnold, MD7, Jonathan a. Mccullers, MD8, Xiaoyan Lu, MS9, Dean Erdman, Dr PH10, David Hillyard, MD11, Carrie L. Byington, MD12, Seema Jain, MD, MPH13 and Andrew Pavia, MD, FIDSA, FSHEA1, (1)Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, (2)ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, (3)Centers for Disease Control and Prevention (CDC), Atlanta, GA, (4)Vanderbilt University School of Medicine, Nashville, TN, (5)Division of Pediatric Infectious Disease, Vanderbilt University Medical Center, Nashville, TN, (6)Children's Memorial Hospital and Northwestern Memorial Hospital, Chicago, IL, (7)University of Tennessee, Memphis, TN, (8)St. Jude Children's Research Hospital, Memphis, TN, (9)CDC, Atlanta, IL, (10)Division of Viral Diseases, Ncird, CDC, Atlanta, GA, (11)Associated Regional and University Pathologists, Salt Lake City, UT, (12)Pediatrics, University of Utah, Salt Lake City, UT, (13)Centers for Disease Control and Prevention, Atlanta, GA

    Disclosures:

    K. Ampofo, None

    C. Stockmann, None

    W. Hymas, None

    A. M. Bramley, None

    D. J. Williams, None

    K. Edwards, Novartis: Grant Investigator and Scientific Advisor, Research grant

    E. Anderson, None

    S. Arnold, None

    J. A. Mccullers, None

    X. Lu, None

    D. Erdman, None

    D. Hillyard, None

    C. L. Byington, None

    S. Jain, None

    A. Pavia, None

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