Childhood pneumonia and bronchiolitis is a leading cause of illness and death in young children worldwide with Respiratory Syncytial Virus (RSV) as the main viral cause. RSV has been associated with annual respiratory disease outbreaks and bacterial co-infection has also been reported. This study is the first RSV study in young children hospitalized with community-acquired pneumonia (CAP) in Belém city, Pará (Northern Brazil). It had the objective of determining the prevalence of RSV infection and evaluating the patients’ clinical and epidemiological features. Methods. We conducted a prospective study across eight hospitals from November 2006 to October 2007. In this study, 1,050 nasopharyngeal aspirate samples were obtained from hospitalized children up to the age of three years with CAP, and tested for RSV antigen by direct immunofluorescence assay and by Reverse Transcription Polymerase Chain Reaction (RT-PCR) for RSV subtype identification. Levels of C-reactive protein (CRP) and results of bacterial infection were also obtained. Results. RSV infection was diagnosed in 243 (23.1%) children. The mean age of the RSV-positive group was lower than the RSV-negative group (12.1 months vs 15.5 months, both ranged 1-36 months, p<0.001) whereas gender distribution was similar. The RSV-positive group showed lower CRP mean levels when compared to the RSV-negative group (15.3 vs 24.0 mg/dL, p<0.05). Radiological findings showed that 54.2% of RSV-positive group and 50.3% of RSV-negative group had interstitial infiltrate. Bacterial infection was identified predominantly in the RSV-positive group (10% vs 4.5%, p<0.05). Rhinorrhea and nasal obstruction were predominantly observed in the RSV-positive group. A co-circulation of subtypes A and B was noted, with a predominance of subtype B (209/227). Multivariate analysis revealed that age under 1 year (p<0.015), CRP levels under 48 mg/dL (p<0.001) and bacterial co-infection (p<0.032) were independently associated with the presence of RSV as opposed to RSV-negative group, and in analyze of symptoms, nasal obstruction were independently associated with RSV-positive group (p<0.001). Conclusion. The present study highlights the relevance of RSV infection in hospitalized cases of CAP in our region; our findings warrant the conduct of further investigations which can help design strategies for controlling the disease.
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