July 29, 2015
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Nasopharyngeal bacteria, respiratory viruses linked to acute respiratory infection symptoms

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Previously unexplained acute symptoms of respiratory tract infection in pediatric outpatients may be associated with respiratory viruses and nasopharyngeal bacteria, specifically Moraxella catarrhalis, according to a recent study.

“Symptoms of respiratory tract infection, namely rhinitis, nasal congestion and cough, which are generally considered to be primarily caused by respiratory viruses, were significantly associated with M. catarrhalis bacterium,” Johanna M. Uitti, MD, of Turku University Hospital, Finland, and colleagues wrote. “Fever was associated with several respiratory viruses, instead of nasopharyngeal bacteria.”

The researchers studied bacteria culture samples and PCR results from 426 pediatric outpatients aged 6 to 35 months with respiratory tract infections. Of those, 201 tested positive for acute otitis media. Study participants were analyzed for specific acute symptoms associated with respiratory tract infection such as fever, rhinitis, cough, nasal congestion, conjunctivitis, earache and diarrhea.

The most common acute symptoms of respiratory tract infection were associated with the presence of the nasopharyngeal bacteria M. catarrhalis. These symptoms included rhinitis (OR = 5.07; 95% CI, 1.93-13.36), nasal congestion (OR = 2.03; 95% CI, 1.25-3.31) and cough (OR = 1.91; 95% CI, 1.15-3.17).

Fever was associated with influenza viruses (OR = 6.61; 95% CI, 1.66-26.27), human metapneumovirus (OR = 3.84; 95% CI, 1.25-11.77), coronaviruses (OR = 3.45; 95% CI, 1.53-7.75) and parainfluenza viruses (OR = 2.18; 95% CI, 1.07-4.47). Cough also was associated with respiratory syncytial virus (OR = 7.2; 95% CI, 1.59-32.71) and parainfluenza viruses (OR = 2.79; 95% CI, 1.02-7.69).

“Fever is associated with several respiratory viruses, thus suggesting that fever is primarily a sign of viral infection in young children mostly suffering from respiratory tract infection,” Uitti and colleagues wrote. “In contrast, rhinitis, nasal congestion and cough seem to be associated with M. catarrhalis, in the presence of viruses, thus suggesting that M. catarrhalis may act synergistically with respiratory viruses in order to induce the symptoms of respiratory tract infection.” – by David Costill

Disclosure: The researchers report no relevant financial disclosures.