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Adenovirus species C common in children with protracted bacterial bronchitis, bronchiectasis
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In the lower airways of children with protracted bacterial bronchitis and bronchiectasis, adenovirus C was the major adenovirus species detected regardless of season, according to recent study findings published in Clinical Infectious Diseases.
Danielle F. Wurzel, FRACP, of the Queensland Children’s Medical Research Institute in Australia, and colleagues evaluated 245 children (median age, 30 months) with protracted bacterial bronchitis or bronchiectasis to determine the prevalence of adenovirus, the different genotypes/species, and if the presence of adenovirus increased chances of a bacterial coinfection.
Patients were divided to either adenovirus-positive or adenovirus-negative groups. Ninety-six percent of 24 typeable adenovirus isolates were adenovirus species C; 57% were adenovirus-1 and 43% were adenovirus-2.
Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae were the most common bacterial pathogens detected in adenovirus-positive and adenovirus-negative patients. There was a significant association of adenovirus detection and a lower airway infection with one or more of the three major bacterial pathogens (OR=3.27; 95% CI, 1.38-7.75). Compared with adenovirus-negative patients, adenovirus-positive patients were more likely to have a lower airway infection with multiple bacterial pathogens (OR=2.47; 95% CI, 1.23-4.97).
Similar detection rates were found among adenovirus-positive and adenovirus-negative patients for Mycoplasma pneumoniae (P=.58) as well as standard panel respiratory viruses. There were no detections of human influenza virus among adenovirus-positive patients compared with 1.5% of adenovirus-negative patients. Human parainfluenza virus was detected in 4.9% of adenovirus-negative patients and 5% of adenovirus-positive patients. Respiratory syncytial virus was detected in 5.4% of adenovirus-negative patients and human metapneumovirus was detected in 2.4%; neither of these viruses were detected in adenovirus-positive patients.
Extended viral panel testing of bronchoalveolar lavage was performed in 41 adenovirus-negative patients and 11 adenovirus-positive patients. On bronchoalveolar lavage, human rhinovirus was found in 54.5% of the adenovirus-positive patients compared with 24.4% of adenovirus-negative patients. Human bocavirus also was detected more among adenovirus-positive patients (27.3%) compared with adenovirus-negative patients (2.4%). Human coronavirus was not detected in any adenovirus-positive patients and just one adenovirus-negative patient.
“We conclude that adenovirus-negative-Cs (genotypes 1 and 2) are the dominant adenovirus species infection the lower airways of young children with chronic endobronchial suppuration,” the researchers wrote. “The significant association between adenovirus and lower airway bacterial infection suggests a possible role of adenovirus-negative-C in the pathogenesis of chronic suppurative lung diseases in young children. Our findings may have implications for targets in the prevention of chronic suppurative lung diseases, however further research, to definitely establish causality, would be required.”
Disclosure: See the study for a full list of financial disclosures.
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