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. 2018 Feb 8;18(1):72.
doi: 10.1186/s12879-018-2982-3.

Comparison of the prevalence of respiratory viruses in patients with acute respiratory infections at different hospital settings in North China, 2012-2015

Jianxing Yu  1 , Zhengde Xie  2 , Tiegang Zhang  3 , Yanqin Lu  4 , Hongwei Fan  5 , Donghong Yang  6 , Thomas Bénet  7   8 , Philippe Vanhems  7   8   9 , Kunling Shen  2 , Fang Huang  3 , Jinxiang Han  4 , Taisheng Li  5 , Zhancheng Gao  6 , Lili Ren  10 , Jianwei Wang  11
Affiliations

Comparison of the prevalence of respiratory viruses in patients with acute respiratory infections at different hospital settings in North China, 2012-2015

Jianxing Yu et al. BMC Infect Dis. .

Abstract

Background: Acute respiratory infections (ARIs) are a great public health challenge globally. The prevalence of respiratory viruses in patients with ARIs attending at different hospital settings is fully undetermined.

Methods: Laboratory-based surveillance for ARIs was conducted at inpatient and outpatient settings of 11 hospitals in North China. The first 2-5 patients with ARIs were recruited in each hospital weekly from 2012 through 2015. The presence of respiratory viruses was screened by PCR assays. The prevalence of respiratory viruses was determined and compared between patients at different hospital settings.

Results: A total of 3487 hospitalized cases and 6437 outpatients/Emergency Department (ED) patients were enrolled. The most commonly detected viruses in the hospitalized cases were respiratory syncytial virus (RSV, 33.3%) in children less than two years old, adenoviruses (13.0%) in patients 15-34 years old, and influenza viruses (IFVs, 9.6%) in patients ≥65 years. IFVs were the most common virus in outpatient/ED patients across all age groups (22.7%). After controlling for the confounders caused by other viruses and covariates, adenoviruses (adjusted odds ratio [aOR]: 3.97, 99% confidence interval [99% CI]: 2.19-7.20) and RSV (aOR: 2.04, 99% CI: 1.34-3.11) were independently associated with increased hospitalization in children, as well as adenoviruses in adults (aOR: 2.14, 99% CI: 1.19-3.85). Additionally, co-infection of RSV with IFVs was associated with increased hospitalization in children (aOR: 12.20, 99% CI: 2.65-56.18).

Conclusions: A substantial proportion of ARIs was associated with respiratory viruses in North China. RSV, adenoviruses, and co-infection of RSV and IFVs were more frequent in hospitalized children (or adenoviruses in adults), which might predict the severity of ARIs. Attending clinicians should be more vigilant of these infections.

Keywords: Hospitalization; Respiratory tract infections; Risk factors; Sentinel surveillance; Viruses.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the ethical review committee at the Institute of Pathogen Biology, Chinese Academy of Medical Sciences (IPB, Beijing, China [Ref. No. IPB-2014-4]). Written consent was obtained before enrollment from each patient or their guardians.

Consent for publication

Not applicable.

Competing interests

The authors have no conflicts of interest to disclose.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Frequency of respiratory viruses among patients with ARIs in North China, 2012–2015, by age group and hospital settings. The colored ribbons show 95% binomial confidence intervals of detection rates. Abbreviation: IFVs, Influenza viruses; HRVs, Human rhinoviruses; PIVs, Human parainfluenza viruses; RSV, Respiratory syncytial virus; HAdVs, Human adenoviruses; HBoV, Human bocaviruses; hMPV, Human metapneumovirus; HCoVs, Human coronaviruses
Fig. 2
Fig. 2
Adjusted Odds Ratios for risk factors or viruses associated with hospitalization of patients with ARIs, according to age groups. Horizontal lines indicate 99% confidence intervals. The reference group is assigned aOR = 1. Abbreviation: IFVs, Influenza viruses; HRVs, Human rhinoviruses; PIVs, Human parainfluenza viruses; RSV, Respiratory syncytial virus; HAdVs, Human adenoviruses; HBoV, Human bocaviruses; hMPV, Human metapneumovirus; HCoVs, Human coronaviruses
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