Molecular epidemiology of human rhinovirus infections in the pediatric emergency department

Emily K. Martin, Jane Kuypers, Helen Y. Chu, Kirsten Lacombe, Xuan Qin, Bonnie Strelitz, Miranda Bradford, Charla Jones, Eileen J. Klein, Janet A. Englund

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background: Human rhinovirus (HRV) infections are highly prevalent, genetically diverse, and associated with both mild upper respiratory tract and more severe lower tract illnesses (LRTI). Objective: To characterize the molecular epidemiology of HRV infections in young children seeking acute medical care. Study design: Nasal swabs collected from symptomatic children <3 years of age receiving care in the Emergency and Urgent Care Departments at Seattle Children's Hospital were analyzed by a rapid polymerase chain reaction (PCR) system (FilmArray®) for multiple viruses including HRV/enterovirus. HRV-positive results were confirmed by laboratory-developed real-time reverse transcription PCR (LD-PCR). Clinical data were collected by chart review. A subset of samples was selected for sequencing using the 5' noncoding region. Associations between LRTI and HRV species and genotypes were estimated using logistic regression analysis. Results: Of 595 samples with HRV/enterovirus detected by FilmArray, 474 (80%) were confirmed as HRV by LD-PCR. 211 (96%) of 218 selected samples were sequenced; HRV species A, B, and C were identified in 133 (63%), 6 (3%), and 72 (34%), respectively. LRTI was more common in HRV-C than HRV-A illness episodes (adjusted OR [95% CI] 2.35[1.03-5.35). Specific HRV-A and HRV-C genotypes detected in multiple patients were associated with a greater proportion of LRTI episodes. In 18 patients with >1 HRV-positive illness episodes, a distinct genotype was detected in each. Conclusion: Diverse HRV genotypes circulated among symptomatic children during the study period. We found an association between HRV-C infections and LRTI in this patient population and evidence of association between specific HRV genotypes and LRTI.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalJournal of Clinical Virology
Volume62
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Keywords

  • Emergency department
  • Genotyping
  • HRV-C
  • Human rhinovirus
  • Lower respiratory tract infection

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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