741. Impact of Adenovirus Co-detections on Illness Severity.
Session: Poster Abstract Session: Respiratory Infections: Viral
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • IDweek AdV _04.30.2018 for poster presentation.pdf (119.9 kB)
  • Background: Human adenovirus(AdV) is a common pathogen among children with acute respiratory illnesses(ARI) and is often associated with co-detection with other respiratory viral pathogens. We sought to compare demographic and clinical characteristics in children with ARI who had single-AdV vs. AdV-co-detection with other viruses.

    Methods: Children <18 yrs with fever and/or ARI were enrolled in Vanderbilt Children’s Hospital inpatient setting from 2015–2018 and emergency department from 2016–2018. Interviews were conducted using standardized case report forms. Nose and throat swab specimens were collected and tested by RT-qPCR for common respiratory pathogens (AdV, RSV, HRV, hMPV, PIV1–4 and Influenza).

    Results: Of 2740 ARI cases, 174 were positive for AdV [88 (51%) single detection], with 53% male, 47% White, 36% Black, 30% Hispanic and median age of 17.2 months. Co-detected pathogens in AdV-positive specimens were RSV(15%), HRV(14%), influenza(5%), PIV1(1%), PIV2(0.6%), PIV3(1.7%), and PIV4(0.6%), hMPV(3%), >1 co-pathogens(9%). Subjects with single-AdV detection were more likely to have an underlying medical condition (42% vs 24%, p<0.05).Table 1 compares clinical presentation and severity of single-AdV and AdV-co-detection cases.

    Table 1

    AdV-Single n=88 (%)

    AdV-co-detection n=86 (%)

    p-value*

    Fever

    78(89)

    71(83)

    0.25

    Cough

    63(72)

    79(92)

    <0.01

    Dyspnea

    38(43)

    57(66)

    <0.01

    Wheezing

    36(41)

    50(58)

    <0.05

    Chest In-drawing

    8(9)

    29(34)

    <0.01

    Nasal Congestion/Runny Nose

    71(81)

    79(92)

    <0.05

    Diarrhea

    13(15)

    27(31)

    <0.01

    Supplemental Oxygen

    5/88(6)

    23/84(27)

    <0.01

    Admitted (2015-16)

    6/6(100)

    20/20(100)

    -

    ICU Admission (2015-16)

    1/69(16.7)

    4/20(20.0)

    0.86

    Admitted (2016-18)

    15/82(18)

    20/66(30)

    0.09

    ICU Admission (2016-18)

    1/15(6.7)

    2/20(10.0)

    0.72

    Conclusion: Patients with single-AdV detection were less likely to present with ARI symptoms and require oxygen, but were more likely to have underlying medical conditions compared to AdV-co-detection. Further studies to type AdV isolates will help elucidate the role of specific adenovirus types associated with co-detections and illness severity and inform epidemiological information for future vaccine initiatives.

    Varvara Probst, MD1, Bhinnata Piya, MPH2, Laura Stewart, PhD2, Susan Gerber, MD3, Brian Rha, MD, MSPH4, Joana Yu, MPH5, Suman Das, PhD2, Angela P. Campbell, MD, MPH, FPIDS, FIDSA6, John V. Williams, MD7 and Natasha B. Halasa, MD, MPH, FPIDS8, (1)Pediatric Infectious Disease, Vanderbilt University Medical Center, Nashville, TN, (2)Vanderbilt University Medical Center, Nashville, TN, (3)Centers for Disease Control and Prevention, Atlanta GA, GA, (4)Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, (5)Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (6)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (7)Children's Hospital of Pittsburgh, Pittsburgh, PA, (8)Vanderbilt University School of Medicine, Nashville, TN

    Disclosures:

    V. Probst, None

    B. Piya, None

    L. Stewart, None

    S. Gerber, None

    B. Rha, None

    J. Yu, None

    S. Das, None

    A. P. Campbell, None

    J. V. Williams, Quidel: Board Member , Consulting fee . GlaxoSmithKline: Consultant , Consulting fee .

    N. B. Halasa, Sanofi Pasteur: Investigator , Research support . GSK: Consultant , Consulting fee . Moderna: Consultant , Consulting fee .

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