Methods: Multiplex PCR testing detected >1 virus in 2375 patients (1290 HRV/enterovirus (EV)). Excluding nosocomial HRV, confirmed EV, NICU/immunocompromised patients, and charts with missing data, 617 charts were reviewed. Chest X-rays (CXR) were interpreted by a blinded pediatric radiologist. Admission groups and definition: 1. Bacterial N= 72 (11.7%): confirmed serious bacterial infection (SBI); 2. Equivocal N=37 (5.6%): pneumonia unconfirmed as bacterial or viral; 3. Nonbacterial N=509 (82.6%). Pre-existing co-morbidities were noted in 154/617.Results: HRV was the sole virus in 85%. Peak HRV detection was Mar-May and Sept-Nov. Male/female ratio was 329/288; 76% were <3 yrs old. There were 55 PICU stays (15 bacterial and 35 nonbacterial). HRV results were available at Mn 1.54d (0-8.5) post admit but returned after hospital discharge (D/C) for 177/617.
For all 509 nonbacterial admits, the D/C rate by 48hr after HRV results were available was 46% and Mn length of stay (LOS) was 8.1d (range 0-402d, St Dev
Conclusion: Almost 90% of non-SBI admits had HRV as the sole detected pathogen (70%of PICU cases). 3/4 of HRV occurred in children <3 years old. Molecularly detected HRV was associated with early D/C for previously healthy children. During admission, CXR patterns in almost 2/3 HRV patients were inconsistent with a bacterial process. HRV seems an important pathogen in hospitalized, even previously healthy, children. Our data may allow less antibiotic use and early discharge.
Regeneron: Investigator , Research support
GSK: Investigator , Research grant
Roche: Investigator , Research support
CDC: Investigator , Research grant
A. Dahl, None
R. Selvarangan, None
See more of: Poster Abstract Session