The Journal of Pediatrics
Volume 154, Issue 3 , Pages 396-400.e1, March 2009

Respiratory Pathogens in Children with and without Respiratory Symptoms

  • Marieke M. van der Zalm, MD

      Affiliations

    • Division of Respiratory Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
    • Corresponding Author InformationReprint requests: Marieke M. van der Zalm, MD, Department of Pediatrics, Respiratory Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, PO Box 85090, Office KH 01.419.0, 3508 AB Utrecht, The Netherlands
  • ,
  • Bart E. van Ewijk, MD, PhD

      Affiliations

    • Division of Respiratory Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
  • ,
  • Berry Wilbrink, PhD

      Affiliations

    • Laboratory of Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
  • ,
  • Cuno S.P.M. Uiterwaal, MD, PhD

      Affiliations

    • Department of Pediatrics, Wilhelmina Children's Hospital, and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  • ,
  • Tom F.W. Wolfs, MD, PhD

      Affiliations

    • Division of Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
  • ,
  • Cornelis K. van der Ent, MD, PhD

      Affiliations

    • Division of Respiratory Diseases, University Medical Center Utrecht, Utrecht, The Netherlands

Received 18 February 2008; received in revised form 22 July 2008; accepted 18 August 2008. published online 29 September 2008.

Objectives

To investigate the occurrence of respiratory pathogens in samples from children with and without respiratory symptoms and to identify whether age and/ or coinfections modify the impact of respiratory pathogens on symptoms.

Study design

In a prospective longitudinal study, 18 children were sampled biweekly for respiratory pathogens, irrespective of respiratory symptoms. Polymerase chain reaction was performed for 13 respiratory pathogens. Episodes were defined “asymptomatic” if no symptoms of any respiratory tract illness were present between 1 week before and 1 week after sampling.

Results

A total of 230 samples were collected. In 56% of the symptomatic episodes, a pathogen was detected, compared with 40% of the asymptomatic episodes (P = .03). Rhinovirus and coronaviruses were most prevalent in both symptomatic and asymptomatic episodes. In the youngest children, 9% of the pathogen-positive episodes were asymptomatic, compared with 36% in the oldest children (P = .01). Multiple pathogens were found in 17% of the symptomatic episodes and in 3% of the asymptomatic episodes (P = .02).

Conclusions

Respiratory pathogens are frequently detected in samples from children with no respiratory symptoms. Symptomatic cases occurred more often in younger children and with detections of more than 1 respiratory pathogen.

Abbreviations: PCR, Polymerase chain reaction, RSV, Respiratory syncytial virus

 

 Supported by a MD/PhD grant from the University Medical Center Utrecht, The Netherlands (to M.vdZ.) and a fellowship from the Wilhelmina Children's Hospital Research Fund (to B.vE.). None of the authors reports any conflict of interest.

PII: S0022-3476(08)00719-1

doi:10.1016/j.jpeds.2008.08.036

The Journal of Pediatrics
Volume 154, Issue 3 , Pages 396-400.e1, March 2009