In Very Young Infants Severity of Acute Bronchiolitis Depends On Carried Viruses
Identifieur interne : 000116 ( Pmc/Checkpoint ); précédent : 000115; suivant : 000117In Very Young Infants Severity of Acute Bronchiolitis Depends On Carried Viruses
Auteurs : Christophe Marguet [France] ; Marc Lubrano [France] ; Marie Gueudin [France] ; Pascal Le Roux [France] ; Antoine Deschildre [France] ; Chantal Forget [France] ; Laure Couderc [France] ; Daniel Siret [France] ; Marie-Dominique Donnou [France] ; Michael Bubenheim [France] ; Astrid Vabret [France] ; François Freymuth [France]Source :
- PLoS ONE [ 1932-6203 ] ; 2009.
Abstract
RT amplification reaction has revealed that various single viruses or viral co-infections caused acute bronchiolitis in infants, and RV appeared to have a growing involvement in early respiratory diseases. Because remaining controversial, the objective was to determine prospectively the respective role of RSV, RV, hMPV and co-infections on the severity of acute bronchiolitis in very young infants.
209 infants (median age: 2.4 months) were enrolled in a prospective study of infants <1 year old, hospitalized for a first episode of bronchiolitis during the winter epidemic season and with no high risk for severe disease. The severity was assessed by recording SaO2% at admission, a daily clinical score (scale 0–18), the duration of oxygen supplementation and the length of hospitalization. Viruses were identified in 94.7% by RT amplification reaction: RSV only (45.8%), RV only (7.2%), hMPV only (3.8%), dual RSV/RV (14.3%), and other virus only (2%) or coinfections (9%). RV compared respectively with RSV and dual RSV/RV infection caused a significant less severe disease with a lower clinical score (5[3.2–6] vs. 6[4–8], p = 0.01 and 5.5[5–7], p = 0.04), a shorter time in oxygen supplementation (0[0–1] days vs. 2[0–3] days, p = 0.02 and 2[0–3] days, p = 0.03) and a shorter hospital stay (3[3–4.7] days vs.6 [5–8] days, p = 0.001 and 5[4–6] days, p = 0.04). Conversely, RSV infants had also longer duration of hospitalization in comparison with RSV/RV (p = 0.01) and hMPV (p = 0.04). The multivariate analyses showed that the type of virus carried was independently associated with the duration of hospitalization.
This study underlined the role of RV in early respiratory diseases, as frequently carried by young infants with a first acute bronchiolitis. RSV caused the more severe disease and conversely RV the lesser severity. No additional effect of dual RSV/RV infection was observed on the severity.
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DOI: 10.1371/journal.pone.0004596
PubMed: 19240806
PubMed Central: 2644758
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Hospital Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Siret, Daniel" sort="Siret, Daniel" uniqKey="Siret D" first="Daniel" last="Siret">Daniel Siret</name><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital Moulin du Pré, Saint-Nazaire, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital Moulin du Pré, Saint-Nazaire</wicri:regionArea><placeName><settlement type="city">Saint-Nazaire</settlement></placeName></affiliation></author><author><name sortKey="Donnou, Marie Dominique" sort="Donnou, Marie Dominique" uniqKey="Donnou M" first="Marie-Dominique" last="Donnou">Marie-Dominique Donnou</name><affiliation wicri:level="1"><nlm:aff id="aff7"><addr-line>Pediatric Lung Function Tests and Respiratory Diseases Unit, Brest University Hospital, Morvan, Brest, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Pediatric Lung Function Tests and Respiratory Diseases Unit, Brest University Hospital, Morvan, Brest</wicri:regionArea><placeName><settlement type="city">Brest</settlement></placeName></affiliation></author><author><name sortKey="Bubenheim, Michael" sort="Bubenheim, Michael" uniqKey="Bubenheim M" first="Michael" last="Bubenheim">Michael Bubenheim</name><affiliation wicri:level="1"><nlm:aff id="aff8"><addr-line>Biostatistics Department, Rouen University Hospital-Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Biostatistics Department, Rouen University Hospital-Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Vabret, Astrid" sort="Vabret, Astrid" uniqKey="Vabret A" first="Astrid" last="Vabret">Astrid Vabret</name><affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen</wicri:regionArea><placeName><settlement type="city">Caen</settlement></placeName></affiliation></author><author><name sortKey="Freymuth, Francois" sort="Freymuth, Francois" uniqKey="Freymuth F" first="François" last="Freymuth">François Freymuth</name><affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen</wicri:regionArea><placeName><settlement type="city">Caen</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19240806</idno><idno type="pmc">2644758</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644758</idno><idno type="RBID">PMC:2644758</idno><idno type="doi">10.1371/journal.pone.0004596</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000155</idno><idno type="wicri:Area/Pmc/Curation">000153</idno><idno type="wicri:Area/Pmc/Checkpoint">000116</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">In Very Young Infants Severity of Acute Bronchiolitis Depends On Carried Viruses</title><author><name sortKey="Marguet, Christophe" sort="Marguet, Christophe" uniqKey="Marguet C" first="Christophe" last="Marguet">Christophe Marguet</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Lubrano, Marc" sort="Lubrano, Marc" uniqKey="Lubrano M" first="Marc" last="Lubrano">Marc Lubrano</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Gueudin, Marie" sort="Gueudin, Marie" uniqKey="Gueudin M" first="Marie" last="Gueudin">Marie Gueudin</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Virology, Rouen University Hospital Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Virology, Rouen University Hospital Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Le Roux, Pascal" sort="Le Roux, Pascal" uniqKey="Le Roux P" first="Pascal" last="Le Roux">Pascal Le Roux</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital-Flaubert, Le Havre, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital-Flaubert, Le Havre</wicri:regionArea><placeName><settlement type="city">Le Havre</settlement></placeName></affiliation></author><author><name sortKey="Deschildre, Antoine" sort="Deschildre, Antoine" uniqKey="Deschildre A" first="Antoine" last="Deschildre">Antoine Deschildre</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Lille University Hospital Jeanne de Flandres, Lille, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Lille University Hospital Jeanne de Flandres, Lille</wicri:regionArea><placeName><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Forget, Chantal" sort="Forget, Chantal" uniqKey="Forget C" first="Chantal" last="Forget">Chantal Forget</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Respiratory Diseases and Allergy Unit, Pediatric Department, Regional Hospital, Elbeuf, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases and Allergy Unit, Pediatric Department, Regional Hospital, Elbeuf</wicri:regionArea><wicri:noRegion>Elbeuf</wicri:noRegion><wicri:noRegion>Elbeuf</wicri:noRegion></affiliation></author><author><name sortKey="Couderc, Laure" sort="Couderc, Laure" uniqKey="Couderc L" first="Laure" last="Couderc">Laure Couderc</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Siret, Daniel" sort="Siret, Daniel" uniqKey="Siret D" first="Daniel" last="Siret">Daniel Siret</name><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital Moulin du Pré, Saint-Nazaire, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital Moulin du Pré, Saint-Nazaire</wicri:regionArea><placeName><settlement type="city">Saint-Nazaire</settlement></placeName></affiliation></author><author><name sortKey="Donnou, Marie Dominique" sort="Donnou, Marie Dominique" uniqKey="Donnou M" first="Marie-Dominique" last="Donnou">Marie-Dominique Donnou</name><affiliation wicri:level="1"><nlm:aff id="aff7"><addr-line>Pediatric Lung Function Tests and Respiratory Diseases Unit, Brest University Hospital, Morvan, Brest, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Pediatric Lung Function Tests and Respiratory Diseases Unit, Brest University Hospital, Morvan, Brest</wicri:regionArea><placeName><settlement type="city">Brest</settlement></placeName></affiliation></author><author><name sortKey="Bubenheim, Michael" sort="Bubenheim, Michael" uniqKey="Bubenheim M" first="Michael" last="Bubenheim">Michael Bubenheim</name><affiliation wicri:level="1"><nlm:aff id="aff8"><addr-line>Biostatistics Department, Rouen University Hospital-Charles Nicolle, Rouen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Biostatistics Department, Rouen University Hospital-Charles Nicolle, Rouen</wicri:regionArea><placeName><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Vabret, Astrid" sort="Vabret, Astrid" uniqKey="Vabret A" first="Astrid" last="Vabret">Astrid Vabret</name><affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen</wicri:regionArea><placeName><settlement type="city">Caen</settlement></placeName></affiliation></author><author><name sortKey="Freymuth, Francois" sort="Freymuth, Francois" uniqKey="Freymuth F" first="François" last="Freymuth">François Freymuth</name><affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen</wicri:regionArea><placeName><settlement type="city">Caen</settlement></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>RT amplification reaction has revealed that various single viruses or viral co-infections caused acute bronchiolitis in infants, and RV appeared to have a growing involvement in early respiratory diseases. Because remaining controversial, the objective was to determine prospectively the respective role of RSV, RV, hMPV and co-infections on the severity of acute bronchiolitis in very young infants.</p></sec><sec><title>Methods and Principal Findings</title><p>209 infants (median age: 2.4 months) were enrolled in a prospective study of infants <1 year old, hospitalized for a first episode of bronchiolitis during the winter epidemic season and with no high risk for severe disease. The severity was assessed by recording SaO<sub>2</sub>% at admission, a daily clinical score (scale 0–18), the duration of oxygen supplementation and the length of hospitalization. Viruses were identified in 94.7% by RT amplification reaction: RSV only (45.8%), RV only (7.2%), hMPV only (3.8%), dual RSV/RV (14.3%), and other virus only (2%) or coinfections (9%). RV compared respectively with RSV and dual RSV/RV infection caused a significant less severe disease with a lower clinical score (5[3.2–6] vs. 6[4–8], p = 0.01 and 5.5[5–7], p = 0.04), a shorter time in oxygen supplementation (0[0–1] days vs. 2[0–3] days, p = 0.02 and 2[0–3] days, p = 0.03) and a shorter hospital stay (3[3–4.7] days vs.6 [5–8] days, p = 0.001 and 5[4–6] days, p = 0.04). Conversely, RSV infants had also longer duration of hospitalization in comparison with RSV/RV (p = 0.01) and hMPV (p = 0.04). The multivariate analyses showed that the type of virus carried was independently associated with the duration of hospitalization.</p></sec><sec><title>Conclusion</title><p>This study underlined the role of RV in early respiratory diseases, as frequently carried by young infants with a first acute bronchiolitis. RSV caused the more severe disease and conversely RV the lesser severity. No additional effect of dual RSV/RV infection was observed on the severity.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title>PLoS ONE</journal-title><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19240806</article-id><article-id pub-id-type="pmc">2644758</article-id><article-id pub-id-type="publisher-id">08-PONE-RA-07274R1</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0004596</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline"><subject>Infectious Diseases/Viral Infections</subject><subject>Pediatrics and Child Health/Respiratory Pediatrics</subject><subject>Respiratory Medicine/Respiratory Infections</subject></subj-group></article-categories><title-group><article-title>In Very Young Infants Severity of Acute Bronchiolitis Depends On Carried Viruses</article-title><alt-title alt-title-type="running-head">RV and RSV Bronchiolitis</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Marguet</surname><given-names>Christophe</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lubrano</surname><given-names>Marc</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gueudin</surname><given-names>Marie</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Le Roux</surname><given-names>Pascal</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Deschildre</surname><given-names>Antoine</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Forget</surname><given-names>Chantal</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Couderc</surname><given-names>Laure</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Siret</surname><given-names>Daniel</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Donnou</surname><given-names>Marie-Dominique</given-names></name><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bubenheim</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="aff8"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Vabret</surname><given-names>Astrid</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref></contrib><contrib contrib-type="author"><name><surname>Freymuth</surname><given-names>François</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Rouen University Hospital Charles Nicolle, Rouen, France</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Department of Virology, Rouen University Hospital Charles Nicolle, Rouen, France</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital-Flaubert, Le Havre, France</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Lille University Hospital Jeanne de Flandres, Lille, France</addr-line></aff><aff id="aff5"><label>5</label><addr-line>Respiratory Diseases and Allergy Unit, Pediatric Department, Regional Hospital, Elbeuf, France</addr-line></aff><aff id="aff6"><label>6</label><addr-line>Respiratory Diseases, Allergy and CF Unit, Pediatric Department, Regional Hospital Moulin du Pré, Saint-Nazaire, France</addr-line></aff><aff id="aff7"><label>7</label><addr-line>Pediatric Lung Function Tests and Respiratory Diseases Unit, Brest University Hospital, Morvan, Brest, France</addr-line></aff><aff id="aff8"><label>8</label><addr-line>Biostatistics Department, Rouen University Hospital-Charles Nicolle, Rouen, France</addr-line></aff><aff id="aff9"><label>9</label><addr-line>Laboratory of Human and Molecular Virology, Caen University Hospital Clemenceau, Caen, France</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Morty</surname><given-names>Rory Edward</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1">University of Giessen Lung Center, Germany</aff><author-notes><corresp id="cor1">* E-mail: <email>christophe.marguet@chu-rouen.fr</email></corresp><fn fn-type="con"><p>Conceived and designed the experiments: CM FF. Performed the experiments: AV. Analyzed the data: CM MG MB AV FF. Contributed reagents/materials/analysis tools: AV. Wrote the paper: CM FF. Contributed to the inclusion and follow up of the infants: ML PLR AD CF LC DS MDD. Acquisition of data: ML PLR AD CF LC DS MDD. Collection of data: ML PLR AD CF LC DS MDD. Participated to the collection of nasal secretions and identification of viruses, acquisition and interpretation of these results: MG AV. Revised the manuscript: ML MG PLR AD CF LC DS MDD AV FF. Contributed to the collection and the quality of the database and to the statistics: MB. Has full access to all of data: MB. Contributed to conception, design and analyses of virology: FF. Participated in the redaction of methods paragraphs and to the interpretation of the results of virology: FF.</p></fn></author-notes><pub-date pub-type="collection"><year>2009</year></pub-date><pub-date pub-type="epub"><day>25</day><month>2</month><year>2009</year></pub-date><volume>4</volume><issue>2</issue><elocation-id>e4596</elocation-id><history><date date-type="received"><day>10</day><month>11</month><year>2008</year></date><date date-type="accepted"><day>19</day><month>1</month><year>2009</year></date></history><copyright-statement>Marguet et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement><copyright-year>2009</copyright-year><abstract><sec><title>Background</title><p>RT amplification reaction has revealed that various single viruses or viral co-infections caused acute bronchiolitis in infants, and RV appeared to have a growing involvement in early respiratory diseases. Because remaining controversial, the objective was to determine prospectively the respective role of RSV, RV, hMPV and co-infections on the severity of acute bronchiolitis in very young infants.</p></sec><sec><title>Methods and Principal Findings</title><p>209 infants (median age: 2.4 months) were enrolled in a prospective study of infants <1 year old, hospitalized for a first episode of bronchiolitis during the winter epidemic season and with no high risk for severe disease. The severity was assessed by recording SaO<sub>2</sub>% at admission, a daily clinical score (scale 0–18), the duration of oxygen supplementation and the length of hospitalization. Viruses were identified in 94.7% by RT amplification reaction: RSV only (45.8%), RV only (7.2%), hMPV only (3.8%), dual RSV/RV (14.3%), and other virus only (2%) or coinfections (9%). RV compared respectively with RSV and dual RSV/RV infection caused a significant less severe disease with a lower clinical score (5[3.2–6] vs. 6[4–8], p = 0.01 and 5.5[5–7], p = 0.04), a shorter time in oxygen supplementation (0[0–1] days vs. 2[0–3] days, p = 0.02 and 2[0–3] days, p = 0.03) and a shorter hospital stay (3[3–4.7] days vs.6 [5–8] days, p = 0.001 and 5[4–6] days, p = 0.04). Conversely, RSV infants had also longer duration of hospitalization in comparison with RSV/RV (p = 0.01) and hMPV (p = 0.04). The multivariate analyses showed that the type of virus carried was independently associated with the duration of hospitalization.</p></sec><sec><title>Conclusion</title><p>This study underlined the role of RV in early respiratory diseases, as frequently carried by young infants with a first acute bronchiolitis. RSV caused the more severe disease and conversely RV the lesser severity. No additional effect of dual RSV/RV infection was observed on the severity.</p></sec></abstract><counts><page-count count="6"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>France</li></country><settlement><li>Brest</li><li>Caen</li><li>Le Havre</li><li>Lille</li><li>Rouen</li><li>Saint-Nazaire</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Marguet, Christophe" sort="Marguet, Christophe" uniqKey="Marguet C" first="Christophe" last="Marguet">Christophe Marguet</name></noRegion><name sortKey="Bubenheim, Michael" sort="Bubenheim, Michael" uniqKey="Bubenheim M" first="Michael" last="Bubenheim">Michael Bubenheim</name><name sortKey="Couderc, Laure" sort="Couderc, Laure" uniqKey="Couderc L" first="Laure" last="Couderc">Laure Couderc</name><name sortKey="Deschildre, Antoine" sort="Deschildre, Antoine" uniqKey="Deschildre A" first="Antoine" last="Deschildre">Antoine Deschildre</name><name sortKey="Donnou, Marie Dominique" sort="Donnou, Marie Dominique" uniqKey="Donnou M" first="Marie-Dominique" last="Donnou">Marie-Dominique Donnou</name><name sortKey="Forget, Chantal" sort="Forget, Chantal" uniqKey="Forget C" first="Chantal" last="Forget">Chantal Forget</name><name sortKey="Freymuth, Francois" sort="Freymuth, Francois" uniqKey="Freymuth F" first="François" last="Freymuth">François Freymuth</name><name sortKey="Gueudin, Marie" sort="Gueudin, Marie" uniqKey="Gueudin M" first="Marie" last="Gueudin">Marie Gueudin</name><name sortKey="Le Roux, Pascal" sort="Le Roux, Pascal" uniqKey="Le Roux P" first="Pascal" last="Le Roux">Pascal Le Roux</name><name sortKey="Lubrano, Marc" sort="Lubrano, Marc" uniqKey="Lubrano M" first="Marc" last="Lubrano">Marc Lubrano</name><name sortKey="Siret, Daniel" sort="Siret, Daniel" uniqKey="Siret D" first="Daniel" last="Siret">Daniel Siret</name><name sortKey="Vabret, Astrid" sort="Vabret, Astrid" uniqKey="Vabret A" first="Astrid" last="Vabret">Astrid Vabret</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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