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Does the Presence of Multiple Respiratory Pathogens Indicate more Severe Illness in Hospitalized Children?

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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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Keywords: Bronchiolitis; antibiotic; co-infection; polymerase chain reaction; respiratory pathogen panel

Document Type: Research Article

Publication date: August 1, 2016

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  • Anti-Infective Agents publishes original research, expert reviews, drug clinical trial studies and guest edited issues on all the latest and outstanding developments on the medicinal chemistry, biology, pharmacology and use of anti-infective and anti-parasitic agents. The scope of the journal covers all pre-clinical and clinical research on antimicrobials, antibacterials, antiviral, antifungal, and antiparasitic agents. Anti-Infective Agents is an essential journal for all infectious disease researchers in industry, academia and the health services.
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