Program Schedule

773
Viral Etiology in Hospitalized Children Less than Two Years of Age with Lower Respiratory Infections in Amman, Jordan

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Acute lower respiratory infections (ALRI) are a leading cause of death in children, but the role that viruses play in their etiology in Jordan and the Middle East is poorly characterized.   

 

Methods:

A prospective 3-year, year-round viral surveillance in children <2 years of age admitted with respiratory symptoms and/or fever at the Al-Bashir government hospital from 3/16/10 to 3/31/13 was conducted. Clinical and demographic data were collected. Nasal/throat swabs were obtained and were tested by real-time RT-PCR for respiratory syncytial virus (RSV), metapneumovirus (MPV), rhinovirus (HRV), influenza, and parainfluenza viruses 1, 2, and 3 (PIV1-3) and MERs-CoV.

 

Results:  3169 children were enrolled, virus detected in 81%.  Mean age 3.5 months, 60% male.  Most common ALRI diagnoses were bronchopneumonia (32%), bronchiolitis (17%), and pneumonia (12%).  284 (9%) were admitted to the ICU and only 31 (1%) died. Table 1 describes clinical presentation and viruses by these diagnoses. MERS-CoV was not detected. Figures 1 and 2 display the frequency of viruses and diagnoses over time, respectively. 

Table 1.

 

Pneumonia

N=394

Broncho-pneumonia

N=1020

Bronchiolitis

N=547

Total Cohort

N=3169

Age (mean)

2.4 months

7.9 months

3.4 months

3.5 months

Sex (male)

220 (56%)

604 (59%)

362 (66%)

1913 (60%)

Vitamin D level (median)

11.7 ng/mL

20.6ng/mL

17.9ng/mL

16.5 ng/mL

No PMH

342 (87%)

863 (85%)

519 (95%)

2848 (90%)

Cough

358 (91%)

945 (93%)

526 (96%)

2366 (75%)

Wheezing

250 (63%)

735 (72%)

483 (88%)

1757 (55%)

Fever

201 (51%)

716 (70%)

173 (32%)

1763 (56%)

Abnormal chest x-ray

381/390 (98%)

980/1009

(97%)

512/540 (95%)

2077/2963

(70%)

Oxygen Use

209 (53%)

279 (28%)

215 (40%)

1013 (32%)

MV

26 (7%)

37 (4%)

21 (4%)

111 (4%)

ICU

80 (20%)

53 (5%)

32 (6%)

284 (9%)

Death

10 (3%)

4 (0.003%)

1 (0.002%)

31 (1%)

Virus

RSV

225 (57%)

476 (47%)

374 (68%)

1397 (44%)

HRV

153 (39%)

374 (37%)

215 (39%)

1238 (39%)

MPV

37 (9%)

123(12%)

56 (10%)

273 (9%)

Influenza

14 (4%)

50 (5%)

14 (3%)

123 (4%)

PIV

17 (4%)

68 (7%)

23 (4%)

175 (6%)

Adenovirus

68 (17%)

175 (15%)

62 (11%)

475 (15%)

Conclusion: Viruses play a major role in ALRI in Jordanian children. Pneumonia was associated with higher morbidity and mortality; those children were younger, had lower vitamin D levels, and were more likely to require oxygen.

 

Figures 1. 

Figure 2. 

Natasha Halasa, MD, MPH1, Samir Faouri, MD2, Asem Shehabi, DSC3, Li Wang4, John Williams, MD1, Chris Fonnesbeck4 and Najwa Khuri-Bulos, MD, FIDSA5, (1)Pediatrics, Vanderbilt University, Nashville, TN, (2)Al-Basheer, Amman, Jordan, (3)Jordan University, Amman, Jordan, (4)Vanderbilt University, Nashville, TN, (5)Division of Infectious Disease, Jordan University Hospital, Amman, Jordan

Disclosures:

N. Halasa, None

S. Faouri, None

A. Shehabi, None

L. Wang, None

J. Williams, None

C. Fonnesbeck, None

N. Khuri-Bulos, None

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