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Respiratory Viral Detection in Children and Adults: Comparing Asymptomatic Controls and Patients With Community-Acquired Pneumonia.

Self WH, Williams DJ, Zhu Y, Ampofo K, Pavia AT, Chappell JD, Hymas WC, Stockmann C, Bramley AM, Schneider E, Erdman D, Finelli L, Jain S, Edwards KM, Grijalva CG
J Infect Dis. 2016 213 (4): 584-91

PMID: 26180044 · PMCID: PMC4721902 · DOI:10.1093/infdis/jiv323

BACKGROUND - The clinical significance of viruses detected in patients with community-acquired pneumonia (CAP) is often unclear.

METHODS - We conducted a prospective study to identify the prevalence of 13 viruses in the upper respiratory tract of patients with CAP and concurrently enrolled asymptomatic controls with real-time reverse-transcriptase polymerase chain reaction. We compared age-stratified prevalence of each virus between patients with CAP and controls and used multivariable logistic regression to calculate attributable fractions (AFs).

RESULTS - We enrolled 1024 patients with CAP and 759 controls. Detections of influenza, respiratory syncytial virus, and human metapneumovirus were substantially more common in patients with CAP of all ages than in controls (AFs near 1.0). Parainfluenza and coronaviruses were also more common among patients with CAP (AF, 0.5-0.75). Rhinovirus was associated with CAP among adults (AF, 0.93) but not children (AF, 0.02). Adenovirus was associated with CAP only among children <2 years old (AF, 0.77).

CONCLUSIONS - The probability that a virus detected with real-time reverse-transcriptase polymerase chain reaction in patients with CAP contributed to symptomatic disease varied by age group and specific virus. Detections of influenza, respiratory syncytial virus, and human metapneumovirus among patients with CAP of all ages probably indicate an etiologic role, whereas detections of parainfluenza, coronaviruses, rhinovirus, and adenovirus, especially in children, require further scrutiny.

© The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

MeSH Terms (20)

Adolescent Adult Aged Age Factors Asymptomatic Diseases Child Child, Preschool Community-Acquired Infections Female Humans Infant Male Middle Aged Pneumonia, Viral Prospective Studies Real-Time Polymerase Chain Reaction Respiratory Syncytial Viruses Respiratory System Reverse Transcriptase Polymerase Chain Reaction Viruses

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