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Respiratory viruses in exacerbations of non-cystic fibrosis bronchiectasis in children

Kapur, Nitin, Mackay, Ian M., Sloots, Theo P., Masters, Ian B. and Chang, Anne B. (2014). Respiratory viruses in exacerbations of non-cystic fibrosis bronchiectasis in children. Archives of Disease in Childhood,99(8):749-753.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 5
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IRMA ID cmartelxPUB178
Title Respiratory viruses in exacerbations of non-cystic fibrosis bronchiectasis in children
Author Kapur, Nitin
Mackay, Ian M.
Sloots, Theo P.
Masters, Ian B.
Chang, Anne B.
Journal Name Archives of Disease in Childhood
Publication Date 2014
Volume Number 99
Issue Number 8
ISSN 1468-2044   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84905163383
Start Page 749
End Page 753
Total Pages 5
Place of Publication United Kingdom
Publisher B M J Group
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Respiratory viral infections precipitate exacerbations of chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease though similar data in non-cystic fibrosis (CF) bronchiectasis are missing. Our study aimed to determine the point prevalence of viruses associated with exacerbations and evaluate clinical and investigational differences between virus-positive and -negative exacerbations in children with bronchiectasis.

Methods
A cohort of 69 children (median age 7 years) with non-CF bronchiectasis was prospectively followed for 900 child-months. PCR for 16 respiratory viruses was performed on nasopharyngeal aspirates collected during 77 paediatric pulmonologist-defined exacerbations. Clinical data, systemic (C reactive protein (CRP), IL-6, procalcitonin, amyloid-A, fibrinogen) and lung function parameters were also collected.

Findings
Respiratory viruses were detected during 37 (48%) exacerbations: human rhinovirus (HRV) in 20; an enterovirus or bocavirus in four each; adenoviruses, metapneumovirus, influenza A virus, respiratory syncytial virus, parainfluenza virus 3 or 4 in two each; coronavirus or parainfluenza virus 1 and 2 in one each. Viral codetections occurred in 6 (8%) exacerbations. HRV-As (n=9) were more likely to be present than HRV-Cs (n=2). Children with virus-positive exacerbations were more likely to require hospitalisation (59% vs 32.5% (p=0.02)) and have fever (OR 3.1, 95% CI 1.2 to 11.1), hypoxia (OR 25.5, 95% CI 2.0 to 322.6), chest signs (OR 3.3, 95% CI 1.1 to 10.2) and raised CRP (OR 4.7, 95% CI 1.7 to 13.1) when compared with virus-negative exacerbations.

Interpretation
Respiratory viruses are commonly detected during pulmonary exacerbations of children with bronchiectasis. HRV-As were the most frequently detected viruses with viral codetection being rare. Time-sequenced cohort studies are needed to determine the role of viral–bacterial interactions in exacerbations of bronchiectasis.

DOI http://dx.doi.org/10.1136/archdischild-2013-305147   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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