PP8 -Viral and atypical bacterial Etiology of community-acquired respiratory infections in children at two tertiary care hospitals in Peradeniya

Abstract

Introduction

Acute respiratory tract infections (ARTIs) in children impose a significant healthcare burden worldwide. Despite the availability of international data on the etiology of pediatric ARTIs, there is a lack of information on the pathogens causing these conditions in Sri Lanka, necessitating this study.

Objective

To analyze viral and atypical bacterial etiology of ARTIs among pediatric patients in two tertiary care hospitals in Peradeniya.

Design, setting, and methods

A prospective descriptive study was conducted in two tertiary care hospitals in Peradeniya. Multiplex PCR testing was conducted on nasopharyngeal swabs (NPS) from 75 randomly selected subjects with acute respiratory tract infections to detect 20 viruses and four atypical bacteria. Additionally, all 75 NPS were processed utilizing SARS-CoV-2 RT-PCR assay. Data analysis was performed using IBM SPSS Statistics 25.0. Descriptive statistics summarized the dataset, with mean ± SD for normally distributed continuous variables. Categorical variables were compared using the Pearson Chi-squared test, with statistical significance set at p < 0.05.

Results

To analyze the viral and atypical bacterial pathogens as the etiology of ARTIs, a cohort of 523 patients admitted to the hospital was studied. Among them, 445 (85%) presented with respiratory symptoms, and 73.4% (384/523) of those with symptoms were diagnosed with ARTIs. Of the 75 samples tested systematically, 82.6% (62/75) were positive for at least one viral pathogen. Of these, 85.4% (53/62) exhibited the presence of a single viral pathogen, while 14.5% (9/62) demonstrated the presence of dual viral pathogens. None of the samples tested positive for the atypical bacterial pathogens. The most commonly detected viral group was influenza (19/62, 30.6%), followed by the human parainfluenza virus (HPIV) group (14/62, 22.5%) and Respiratory syncytial virus (RSV) group (12/62, 19.3%). Among pneumonia patients, influenza viruses were the most commonly detected (12 out of 25, 48%). RSV was frequently detected among patients diagnosed with bronchiolitis, followed by HPIV. The study revealed no significant differences in PCR positivity and the number of viruses detected, regardless of demographic and clinical parameters.

Conclusion

Acute respiratory infections, predominantly viral, accounted for the majority of admissions.