Upper airway viruses and bacteria and clinical outcomes in children with cough

Abstract

Background: Cough is symptomatic of a broad range of acute and chronic pediatric respiratory illnesses. No studies in children have tested for an extended panel of upper airway respiratory viruses and bacteria to identify whether they predict cough outcomes, irrespective of clinical diagnosis at the time of acute respiratory illness (ARI). We therefore determined whether upper airway microbes independently predicted hospitalization and persistent cough 28-days later in children presenting with an ARI, including cough as a symptom.; Methods: A cohort study of children aged <15-years were followed for 28-days after presenting to a pediatric emergency department with an ARI where cough was also a symptom. Socio-demographic factors, presenting clinical features and a bilateral anterior nasal swab were collected at enrolment. Polymerase chain reaction assays tested for seven respiratory bacteria and 17 viruses. Predictors of hospitalization and persistent cough at day-28 were evaluated in logistic regression models.; Results: Eight hundred and seventeen children were included in the analysis; median age 27.7-months. 116 (14.2%, 95%CI 11.8, 16.6) children were hospitalized and 163 (20.0%, 95%CI 17.2, 22.7) had persistent cough at day-28. Hospitalized children were more likely to have RSV A or B detected on nasal swab than those not admitted (adjusted relative risk (aRR) 1.8, 95%CI 1.0, 3.3). M. catarrhalis was the only microbial difference between children with and without cough persistence (aRR for those with cough at day 28: 2.1, 95%CI 1.3, 3.1).; Discussion: An etiologic role for M. catarrhalis in the pathogenesis of persistent cough post-ARI is worth exploring, especially given the burden of chronic cough in children and its relationship with chronic lung disease. Pediatr Pulmonol. 2017;52:373-381. © 2016 Wiley Periodicals, Inc. (© 2016 Wiley Periodicals, Inc.)BMJ. 2010 Oct 04;341:c4978. (PMID: 20921080); PLoS One. 2014 Aug 01;9(8):e103293. (PMID: 25084351); Fam Pract. 2000 Apr;17(2):150-5. (PMID: 10758078); Arch Dis Child. 2011 Mar;96(3):221-6. (PMID: 20880940); Rev Med Virol. 2012 Jan;22(1):46-64. (PMID: 22038931); J Glob Health. 2013 Jun;3(1):010401. (PMID: 23826505); Scand J Infect Dis. 1993;25(3):323-9. (PMID: 8362228); Cell Host Microbe. 2015 May 13;17(5):704-15. (PMID: 25865368); BMJ. 2013 Dec 11;347:f7027. (PMID: 24335668); Pediatrics. 2012 Feb;129(2):e364-9. (PMID: 22232311); Lancet. 2010 May 1;375(9725):1545-55. (PMID: 20399493); Med J Aust. 2015 Dec 14;203(11):440. (PMID: 26654612); J Pediatr. 2010 Dec;157(6):1001-5. (PMID: 20656297); Eur Respir J. 1998 Feb;11(2):462-6. (PMID: 9551755); Clin Microbiol Infect. 2011 Jun;17(6):907-14. (PMID: 20977542); PLoS One. 2015 Jun 05;10(6):e0129369. (PMID: 26047100); Chest. 2012 Oct;142(4):943-950. (PMID: 22459773); JAMA Pediatr. 2016 Mar;170(3):267-87. (PMID: 26810619); Pediatr Pulmonol. 2014 Jun;49(6):561-8. (PMID: 23788413); Pediatr Infect Dis J. 2006 Feb;25(2):108-12. (PMID: 16462285); Pediatr Pulmonol. 2012 Mar;47(3):300-7. (PMID: 21901858); Pediatr Pulmonol. 2008 Jun;43(6):519-31. (PMID: 18435475); Pediatr Pulmonol. 2003 Dec;36(6):457-61. (PMID: 14618635); J Infect. 2015 Oct;71(4):458-69. (PMID: 26149186); Chest. 2008 Aug;134(2):303-309. (PMID: 18641100); Pediatr Infect Dis J. 2009 Apr;28(4):290-4. (PMID: 19258918); Pediatr Pulmonol. 2003 Dec;36(6):469-74. (PMID: 14618637); Hum Vaccin Immunother. 2016;12(2):375-82. (PMID: 26367344); Chest. 2006 Jan;129(1 Suppl):260S-283S. (PMID: 16428719); J Clin Virol. 2014 Jun;60(2):133-40. (PMID: 24686044); Curr Opin Infect Dis. 2015 Jun;28(3):259-66. (PMID: 25887611); Int Arch Allergy Immunol. 2005 Jul;137(3):249-57. (PMID: 15961954); Pediatr Infect Dis J. 2015 Oct;34(10):1056-62. (PMID: 26164848); Pediatr Infect Dis J. 2009 Aug;28(8):697-701. (PMID: 19461554); Med J Aust. 2006 Apr 17;184(8):398-403. (PMID: 16618239); PLoS One. 2012;7(10):e47711. (PMID: 23082199); PLoS One. 2014 Sep 26;9(9):e108523. (PMID: 25259619); Pediatr Infect Dis J. 2011 Jun;30(6):480-5. (PMID: 21593705); J Infect Dis. 2015 May 15;211(10):1550-9. (PMID: 25425699); Clin Exp Allergy. 2008 Jun;38(6):968-76. (PMID: 18355370); Clin Microbiol Infect. 2016 Jun;22(6):527-34. (PMID: 26916343); Scand J Infect Dis. 1994;26(5):545-51. (PMID: 7710536). Linking ISSN: 10990496. Subset: MEDLINE; Date of Electronic Publication: 2016 Jul 26. Current Imprints: Publication: <2005-> : Hoboken, NJ : Wiley-Liss; Original Imprints: Publication: [Philadelphia, PA] : W.B. Saunders, [c1985- <br />