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Clinical significance of codetection of the causative agents for acute respiratory tract infection in hospitalized children

Korean Journal of Pediatrics 2009;52(6):661-666.
Published online June 15, 2009.
Clinical significance of codetection of the causative agents for acute respiratory tract infection in hospitalized children
Eui Jung Roh1, Young Pyo Chang1, Jae Kyung Kim2, In Soo Rheem2, Kwi Sung Park3, Eun Hee Chung1
1Departments of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
2Departments of Laboratory Medicine, College of Medicine, Dankook University, Cheonan,
3Chungcheongnam-Do Health and Environment Research Institute, Daejeon, Korea
급성 호흡기 감염으로 입원한 소아에서 호흡기 감염의 원인 : 중복검출의 임상적 의미
노의정1, 장영표1, 김재경2, 임인수2, 박귀성3, 정은희1
1단국대학교 의과대학 소아과학교실
2단국대학교 의과대학 진단검사의학과교실
3충남보건환경연구원
Abstract
Purpose
: To determine the prevalence and clinical features of codetected respiratory etiological agents for acute respiratory infection in hospitalized children.
Methods
: Nasopharyngeal aspirates were obtained from hospitalized children with acute respiratory infection at Dankook University Hospital from September 2003 through June 2005. Immunofluorescent staining and culture were used for the detection of respiratory viruses (influenza virus [IFV] types A, B; parainfluenza virus [PIV] types 1, 2, 3; respiratory syncytial virus [RSV]; adenovirus [AdV]). Polymerase chain reaction (PCR) assays were used for Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT) detection, and PCR and culture were performed for enterovirus detection. Acid-fast staining and culture were performed for tuberculosis detection. The demographic and clinical characteristics were reviewed retrospectively from the patients medical records.
Results
: Evidence of two or more microbes was found in 28 children: RSV was detected in 14, PIV 3 in 10, AdV in 10, MP in 8, PIV 2 in 8, CT in 4, and PIV 1 in 3. Codetected agents were found as follows: RSV+PIV 2, 6 patients; AdV+MP, 4 patients; AdV+PIV, 3 patients; RSV+MP, 3 patients; PIV 1+PIV 3, 3 patients. Distinct peaks of codetected agents were found in epidemics of MP and each respiratory virus.
Conclusion
: The codetected infectious agents were RSV, PIV, AdV, and MP, with distinct peaks found in epidemics of MP and each respiratory virus. Although advances in diagnostic methods have increased the prevalence of codetection, its clinical significance should be interpreted cautiously.
Key Words: Codetection, Respiratory tract infection, Virus, Mycoplasma pneumoniae, Child


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