An investigation on the frequency of viral etiology among the children referred to pediatric emergency service with lower and upper respiratory tract i̇nfection

ABSTRACT An Investigation on the Frequency of Viral Etiology among the Children Referred to Pediatric Emergency Service with Lower and Upper Respiratory Tract İnfection Aim: Respiratory tract infections, mostly caused by viruses, are very common. This study aims to establish the existence, frequency and risk factors in the children referred to pediatric emergency service due to respiratory tract infection, in addition to the characteristics including age, sex, symptoms and findings at referral, treatment options and prognosis for such patients. Materials and Methods: In the scope of this study, nasopharyngeal swab samples were taken from 118 patients, who were referred to Pediatric Emergency Service of Medical Faculty of Cukurova University from November 2014 to April 2015. Then, samples taken were investigated against the existence of Adenovirus, Respiratory syncytial virus (RSV), Human metapneumovirus (hMPV), Parainfluenzavirus (PIV), İnfluenza A and B, İnfluenza H1N1 and Rhinovirus, all of which are respiratory tract viruses, at Virology Laboratory within the body of Department of Medical Microbiology by employing real-time PCR tests. Cases were then recorded in terms of sex, complaints, risk factors and physical examination findings. Clinical diagnoses and treatments applied were also recorded. Findings: In the light of clinical and laboratory findings observed at the time of referral to Pediatric Emergency service, the following diagnoses were made: tonsillopharyngitis in 3 patients (2,5%), croup in 11 patients (9,3%), bronchiolitis in 49 patients (41,5%) and pneumonia in 55 patients (46,6%). The most frequently voiced complaints among the patients included in the study were cough (94,1%), wheezing (95,8%), respiratory distress (80,5%) and tachypnea (81,4%). By using real-time PCR method, 115 (97,4%) of all patients with respiratory tract infection were detected to have respiratory tract virus. Out of all patients, 16 (13,6%) displayed single virus while 99 (83,9%) indicated multiple reproduction. The most frequently isolated virus was H1N1, which was followed by RSV and RV. It was also observed that referrals mostly dispersed among January, February and March. Conclusion: Our study determined a high rate of viral respiratory infections; i.e. 97,4%. Therefore, we are of the opinion that the ability to detect a large number of viruses leading to respiratory tract infections simultaneously, in a short time and at a high sensitivity would be helpful in suitable management of clinical approach and prevention of unnecessary use of antibiotics. Keywords: Child, respiratory tract infections, viruses, real-time PCR.