Frequent Respiratory Viral Infections in Children with Febrile Neutropenia - A Prospective Follow-Up Study
Identifieur interne : 000861 ( Main/Exploration ); précédent : 000860; suivant : 000862Frequent Respiratory Viral Infections in Children with Febrile Neutropenia - A Prospective Follow-Up Study
Auteurs : Martina Söderman [Suède] ; Samuel Rhedin [Suède] ; Thomas Tolfvenstam [Suède] ; Maria Rotzén-Östlund [Suède] ; Jan Albert [Suède] ; Kristina Broliden [Suède] ; Anna Lindblom [Suède]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
Febrile neutropenia is common in children undergoing chemotherapy for the treatment of malignancies. In the majority of cases, the cause of the fever is unknown. Although respiratory viruses are commonly associated with this condition, the etiologic significance of this finding remains unclear and is therefore the subject of this study.
Nasopharyngeal aspirates were collected during 87 episodes of febrile neutropenia in children age 0–18 years, being treated at a children’s oncology unit between January 2013 and June 2014. Real-time polymerase chain reaction was used to determine the presence of 16 respiratory viruses. Follow-up samples were collected from children who tested positive for one or more respiratory viruses. Rhinoviruses were genotyped by VP4/VP2 sequencing. Fisher’s exact test and Mann-Whitney U test were used for group comparisons.
At least one respiratory virus was detected in samples from 39 of 87 episodes of febrile neutropenia (45%), with rhinoviruses the most frequently detected. Follow-up samples were collected after a median of 28 days (range, 9–74 days) in 32 of the 39 virus-positive episodes. The respiratory viral infection had resolved in 25 episodes (78%). The same virus was detected at follow-up in one coronavirus and six rhinovirus episodes. Genotyping revealed a different rhinovirus species in two of the six rhinovirus infections.
The frequency of respiratory viral infections in this group of patients suggests an etiologic role in febrile neutropenia. However, these findings must be confirmed in larger patient cohorts.
Url:
DOI: 10.1371/journal.pone.0157398
PubMed: 27309354
PubMed Central: 4911076
Affiliations:
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type="main">Frequent Respiratory Viral Infections in Children with Febrile Neutropenia - A Prospective Follow-Up Study</title><author><name sortKey="Soderman, Martina" sort="Soderman, Martina" uniqKey="Soderman M" first="Martina" last="Söderman">Martina Söderman</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Rhedin, Samuel" sort="Rhedin, Samuel" uniqKey="Rhedin S" first="Samuel" last="Rhedin">Samuel Rhedin</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Tolfvenstam, Thomas" sort="Tolfvenstam, Thomas" uniqKey="Tolfvenstam T" first="Thomas" last="Tolfvenstam">Thomas Tolfvenstam</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Unit for Highly Pathogenic Viruses, Public Health Agency of Sweden; Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Unit for Highly Pathogenic Viruses, Public Health Agency of Sweden; Stockholm</wicri:regionArea><wicri:noRegion>Public Health Agency of Sweden; Stockholm</wicri:noRegion></affiliation></author><author><name sortKey="Rotzen Stlund, Maria" sort="Rotzen Stlund, Maria" uniqKey="Rotzen Stlund M" first="Maria" last="Rotzén-Östlund">Maria Rotzén-Östlund</name><affiliation wicri:level="3"><nlm:aff id="aff003"><addr-line>Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Microbiology, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>Department of Microbiology Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Microbiology Tumor and Cell Biology, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Albert, Jan" sort="Albert, Jan" uniqKey="Albert J" first="Jan" last="Albert">Jan Albert</name><affiliation wicri:level="3"><nlm:aff id="aff003"><addr-line>Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Microbiology, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>Department of Microbiology Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Microbiology Tumor and Cell Biology, Karolinska Institutet, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Broliden, Kristina" sort="Broliden, Kristina" uniqKey="Broliden K" first="Kristina" last="Broliden">Kristina Broliden</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Lindblom, Anna" sort="Lindblom, Anna" uniqKey="Lindblom A" first="Anna" last="Lindblom">Anna Lindblom</name><affiliation wicri:level="3"><nlm:aff id="aff001"><addr-line>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medicine Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Astrid Lindgrens Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden</addr-line></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Astrid Lindgrens Children’s Hospital, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objective</title><p>Febrile neutropenia is common in children undergoing chemotherapy for the treatment of malignancies. In the majority of cases, the cause of the fever is unknown. Although respiratory viruses are commonly associated with this condition, the etiologic significance of this finding remains unclear and is therefore the subject of this study.</p></sec><sec id="sec002"><title>Study design</title><p>Nasopharyngeal aspirates were collected during 87 episodes of febrile neutropenia in children age 0–18 years, being treated at a children’s oncology unit between January 2013 and June 2014. Real-time polymerase chain reaction was used to determine the presence of 16 respiratory viruses. Follow-up samples were collected from children who tested positive for one or more respiratory viruses. Rhinoviruses were genotyped by VP4/VP2 sequencing. Fisher’s exact test and Mann-Whitney U test were used for group comparisons.</p></sec><sec id="sec003"><title>Results</title><p>At least one respiratory virus was detected in samples from 39 of 87 episodes of febrile neutropenia (45%), with rhinoviruses the most frequently detected. Follow-up samples were collected after a median of 28 days (range, 9–74 days) in 32 of the 39 virus-positive episodes. The respiratory viral infection had resolved in 25 episodes (78%). The same virus was detected at follow-up in one coronavirus and six rhinovirus episodes. Genotyping revealed a different rhinovirus species in two of the six rhinovirus infections.</p></sec><sec id="sec004"><title>Conclusion</title><p>The frequency of respiratory viral infections in this group of patients suggests an etiologic role in febrile neutropenia. 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Ruuskanen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schenk, T" uniqKey="Schenk T">T Schenk</name></author><author><name sortKey="Maier, B" uniqKey="Maier B">B Maier</name></author><author><name sortKey="Hufnagel, M" uniqKey="Hufnagel M">M Hufnagel</name></author><author><name sortKey="Strahm, B" uniqKey="Strahm B">B Strahm</name></author><author><name sortKey="Kontny, U" uniqKey="Kontny U">U Kontny</name></author><author><name sortKey="Neumann Haefelin, D" uniqKey="Neumann Haefelin D">D Neumann-Haefelin</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Suède</li></country><region><li>Svealand</li></region><settlement><li>Stockholm</li></settlement></list><tree><country name="Suède"><region name="Svealand"><name sortKey="Soderman, Martina" sort="Soderman, Martina" uniqKey="Soderman M" first="Martina" last="Söderman">Martina Söderman</name></region><name sortKey="Albert, Jan" sort="Albert, Jan" uniqKey="Albert J" first="Jan" last="Albert">Jan Albert</name><name sortKey="Albert, Jan" sort="Albert, Jan" uniqKey="Albert J" first="Jan" last="Albert">Jan Albert</name><name sortKey="Broliden, Kristina" sort="Broliden, Kristina" uniqKey="Broliden K" first="Kristina" last="Broliden">Kristina Broliden</name><name sortKey="Lindblom, Anna" sort="Lindblom, Anna" uniqKey="Lindblom A" first="Anna" last="Lindblom">Anna Lindblom</name><name sortKey="Lindblom, Anna" sort="Lindblom, Anna" uniqKey="Lindblom A" first="Anna" last="Lindblom">Anna Lindblom</name><name sortKey="Rhedin, Samuel" sort="Rhedin, Samuel" uniqKey="Rhedin S" first="Samuel" last="Rhedin">Samuel Rhedin</name><name sortKey="Rotzen Stlund, Maria" sort="Rotzen Stlund, Maria" uniqKey="Rotzen Stlund M" first="Maria" last="Rotzén-Östlund">Maria Rotzén-Östlund</name><name sortKey="Rotzen Stlund, Maria" sort="Rotzen Stlund, Maria" uniqKey="Rotzen Stlund M" first="Maria" last="Rotzén-Östlund">Maria Rotzén-Östlund</name><name sortKey="Tolfvenstam, Thomas" sort="Tolfvenstam, Thomas" uniqKey="Tolfvenstam T" first="Thomas" last="Tolfvenstam">Thomas Tolfvenstam</name><name sortKey="Tolfvenstam, Thomas" sort="Tolfvenstam, Thomas" uniqKey="Tolfvenstam T" first="Thomas" last="Tolfvenstam">Thomas Tolfvenstam</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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