Does the presence of multiple respiratory pathogens indicate more severe illness in hospitalized children?

Research output: Contribution to journalArticle

Abstract

Background: There is new information regarding respiratory infection etiologies in Pediatrics. With the ability to test for 20 pathogens with a single nasal swab, we aimed to: 1. Study the relevance of respiratory pathogen testing in the con-text of hospitalized children and the incidence of multiple pathogens or “co-infection.” 2. Determine whether patients with multiple pathogens have a longer length of stay (LOS) than those children with a single pathogen. 3. Determine whether children with multiple pathogens have more severe illness—as indicated by oxygen use, antibiotic use, or requirement of critical care—compared to those chil-dren with one pathogen identified. Methods: Electronic medical records of patients who had respiratory pathogen panel (RPP) polymerase chain reaction (PCR) testing during the winter of 2011-2012 at a tertiary care chil-dren’s hospital were reviewed. RPP results, LOS, oxygen use, antibiotic use, and critical care interven-tions were noted. Data were analyzed with Pearson chi-square and Cox proportional hazard regression. Results: 93 RPPs (83%) tested positive for a single pathogen, and 19 RPPs (17%) were positive for multiple pathogens. Patients with co-infections had more severe disease as defined by the requirement of intensive care (p=0.02, OR 3.51, 1.2-9.8). There was no significant difference in oxygen use or antibiotic use between patients with one or more than one pathogen. The co-infection group was hospitalized for a median of 67 hours versus 41 hours for the single pathogen group (p= 0.01). This increased hospital LOS for the co-infection group was also seen in Cox regression analysis (p=0.007). Conclusions: Hospitalized children with multiple pathogens on RPP testing have statistically longer LOS and more severe illness.

Original languageEnglish (US)
Pages (from-to)106-109
Number of pages4
JournalAnti-Infective Agents
Volume14
Issue number2
DOIs
StatePublished - Aug 1 2016

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Hospitalized Child
Length of Stay
Coinfection
Critical Care
Oxygen
Anti-Bacterial Agents
Electronic Health Records
Tertiary Healthcare
Nose
Respiratory Tract Infections
Regression Analysis
Pediatrics
Polymerase Chain Reaction
Incidence

Keywords

  • Antibiotic
  • Bronchiolitis
  • Co-infection
  • Polymerase chain reaction
  • Respiratory pathogen panel

ASJC Scopus subject areas

  • Pharmacology
  • Infectious Diseases

Cite this

Does the presence of multiple respiratory pathogens indicate more severe illness in hospitalized children? / Mahoney, Kathleen E.; Murray, Dennis L.; Sharma, Nirupma.

In: Anti-Infective Agents, Vol. 14, No. 2, 01.08.2016, p. 106-109.

Research output: Contribution to journalArticle

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abstract = "Background: There is new information regarding respiratory infection etiologies in Pediatrics. With the ability to test for 20 pathogens with a single nasal swab, we aimed to: 1. Study the relevance of respiratory pathogen testing in the con-text of hospitalized children and the incidence of multiple pathogens or “co-infection.” 2. Determine whether patients with multiple pathogens have a longer length of stay (LOS) than those children with a single pathogen. 3. Determine whether children with multiple pathogens have more severe illness—as indicated by oxygen use, antibiotic use, or requirement of critical care—compared to those chil-dren with one pathogen identified. Methods: Electronic medical records of patients who had respiratory pathogen panel (RPP) polymerase chain reaction (PCR) testing during the winter of 2011-2012 at a tertiary care chil-dren’s hospital were reviewed. RPP results, LOS, oxygen use, antibiotic use, and critical care interven-tions were noted. Data were analyzed with Pearson chi-square and Cox proportional hazard regression. Results: 93 RPPs (83{\%}) tested positive for a single pathogen, and 19 RPPs (17{\%}) were positive for multiple pathogens. Patients with co-infections had more severe disease as defined by the requirement of intensive care (p=0.02, OR 3.51, 1.2-9.8). There was no significant difference in oxygen use or antibiotic use between patients with one or more than one pathogen. The co-infection group was hospitalized for a median of 67 hours versus 41 hours for the single pathogen group (p= 0.01). This increased hospital LOS for the co-infection group was also seen in Cox regression analysis (p=0.007). Conclusions: Hospitalized children with multiple pathogens on RPP testing have statistically longer LOS and more severe illness.",
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