Rhinovirus Viremia in Patients Hospitalized With Community-Acquired Pneumonia

• Type of Material: Article
• Authors: Xiaoyan Lu, Centers for Disease Control and Prevention; Eileen Schneider, Centers for Disease Control and Prevention; Seema Jain, Centers for Disease Control and Prevention; Anna M. Bramley, Centers for Disease Control and Prevention; Weston Hymas, University of Utah; Chris Stockmann, University of Utah; Krow Ampofo, University of Utah; Sandra R. Arnold, Le Bonheur Children’s Hospital; Derek J. Williams, Vanderbilt University; Wesley H. Self, Vanderbilt University; Anami Patel, Le Bonheur Children’s Hospital; James D. Chappell, Vanderbilt University; Carlos G. Grijalva, Vanderbilt University; Evan Anderson, Emory University; Richard G. Wunderink, Northwestern University; Jonathan A. McCullers, Le Bonheur Children’s Hospital; Kathryn M. Edwards, Vanderbilt University; Andrew T. Pavia, University of Utah; Dean D. Erdman, Centers for Disease Control and Prevention
• Language: English
• Date: 2017-11-01
• Publisher: Oxford University Press
• Publication Version: Final Published Version
• Copyright Statement: Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
• Final Published Version (URL): http://dx.doi.org/10.1093/infdis/jix455
• Title of Journal or Parent Work: Journal of Infectious Diseases
• ISSN: 0022-1899
• Volume: 216
• Issue: 9
• Start Page: 1104
• End Page: 1111
• Grant/Funding Information: This work was supported by funds from the CDC.
• Keywords: viremia; REQUIRING HOSPITALIZATION; US CHILDREN; community-acquired pneumonia; TRACT; Science & Technology; RNA; ASTHMA; TISSUE; RESPIRATORY-INFECTIONS; SEVERITY; CHILDHOOD; Life Sciences & Biomedicine; Infectious Diseases; Microbiology; Immunology; rhinovirus; REPLICATION
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background: Rhinoviruses (RVs) are ubiquitous respiratory pathogens that often cause mild or subclinical infections. Molecular detection of RVs from the upper respiratory tract can be prolonged, complicating etiologic association in persons with severe lower respiratory tract infections. Little is known about RV viremia and its value as a diagnostic indicator in persons hospitalized with community-acquired pneumonia (CAP). Methods: Sera from RV-positive children and adults hospitalized with CAP were tested for RV by real-time reverse-transcription polymerase chain reaction. Rhinovirus species and type were determined by partial genome sequencing. Results: Overall, 57 of 570 (10%) RV-positive patients were viremic, and all were children aged < 10 years (n = 57/375; 15.2%). Although RV-A was the most common RV species detected from respiratory specimens (48.8%), almost all viremias were RV-C (98.2%). Viremic patients had fewer codetected pathogens and were more likely to have chest retractions, wheezing, and a history of underlying asthma/reactive airway disease than patients without viremia. Conclusions: More than 1 out of 7 RV-infected children aged < 10 years hospitalized with CAP were viremic. In contrast with other RV species, RV-C infections were highly associated with viremia and were usually the only respiratory pathogen identified, suggesting that RV-C viremia may be an important diagnostic indicator in pediatric pneumonia.