Spectrum of Respiratory Viruses in Children With Community-acquired Pneumonia

Background: Community-acquired pneumonia (CAP) remains a significant cause for childhood morbidity worldwide. We designed a study with the objective of describing the frequency of respiratory viruses, especially rhinovirus (RV), human metapneumovirus (HMPV) and human bocavirus (HBoV) in hospitalized children with CAP. Methods: A 6-year prospective study was conducted in children <14 years old admitted to the Pediatrics Department of the Severo Ochoa Hospital (Spain) with CAP. We studied the frequency of 16 respiratory viruses in nasopharyngeal aspirates. Clinical characteristics of respiratory syncytial virus (RSV)-only infections were compared with those of RV, HMPV and HBoV single infections. Results: A viral pathogen was identified in 649 (73.4%) of 884 hospitalized children with CAP. Viral coinfections were detected in 30%. The rate of viral detection was significantly greater in infants <18 months (83%) than in older children (67%) (P < 0.001). The most frequently detected virus was RSV with 41.6% of positive patients followed by RV (26.2%), HBoV (17.8%), adenovirus (17.8%), HMPV (7%) and parainfluenza (7%). RSV was the most frequent virus in children < 18 months, but RV was most common in the eldest group (P < 0.001). After stratifying by age, we found some significant differences among RSV, RV, HBoV and HMPV-associated infections. Conclusions: The high prevalence of viral infections supports the role of respiratory viruses, mainly RSV, RV, HBoV and HMPV in CAP of children requiring hospitalization. These findings help us to understand the etiologic disease burden and to guide research and public health policy.