Rose, Katie (2010) Acute respiratory infection in pre-school children. Masters thesis, University of Liverpool.
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Introduction: Acute respiratory infection (ARI) is a major cause of morbidity and mortality worldwide, being responsible for 3.5 million deaths annually. Despite this the precise aetiology of ARI is often unclear, and the pathogenesis remains poorly understood. The aims of this study were i) to investigate the viral and atypical bacterial causes of ARI in a clinically and demographically well defined population of children less than five years of age and ii) to investigate host immunological response to ARI caused by different pathogens and in different severities of disease. Methods: Clinical and demographic data, along with nasopharyngeal aspirate samples were collected from 407 pre-school children who presented with ARI to the IMIP Children’s Hospital, Recife, Brazil over a 12 month period. Multiplex PCR was used to detect 17 different respiratory pathogens. The concentrations of nine cytokines were determined in a selection of samples from children with ARI caused by different pathogens and in differing severities of human respiratory syncytial virus (hRSV) disease. Results: At least one pathogen was detected in 85.5% of samples. The pathogens detected most frequently were hRSV (in 37.3% of samples), adenovirus (AdV; 24.8%), human rhinovirus (hRV; 18.9%), human bocavirus (hBoV; 18.7%), human metapneumovirus (hMPV; 10.3%) and Mycoplasma pneumoniae (Mpp; 9.8%). Co-infection with multiple pathogens was detected in 39.6% of samples, with the pathogens most frequently detected in co-infection being AdV (in 52.8% of co-infections), hRSV (44.1%), hBoV (41.6%) and hRV (26.7%). Infection with Mpp or hRSV was associated with hospital admission and more severe disease. Cytokine profiles were similar in ARI caused by different pathogens and in different severities of disease. Conclusions: We have described high rates of pathogen detection and co-infection, with particularly high rates of Mpp, AdV and hBoV infection. Our results may reflect the type of samples collected, the number of pathogens tested for, and/or the population demographics. The high prevalence of Mpp is more commonly associated with ARI in older children, and our findings may have implications for antibiotic use in this age group. Differing pathogens and differing severities of disease were not associated with particular patterns of cytokine production in the upper respiratory tract. This may reflect the type of sample or the particular cytokines investigated.
|Item Type:||Thesis (Masters)|
|Uncontrolled Keywords:||Acute respiratory infection; Respiratory syncytial virus; Mycoplasma pneumoniae|
|Subjects:||R Medicine > R Medicine (General)|
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
|Departments, Research Centres and Related Units:||Academic Faculties, Institutes and Research Centres > Faculty of Medicine > School of Reproductive & Developmental Medicine|
|Deposited On:||13 Sep 2011 15:24|
|Last Modified:||13 Sep 2011 15:24|
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