Original Article
Association of Human Metapneumovirus with Radiologically Diagnosed Community-Acquired Alveolar Pneumonia in Young Children

https://doi.org/10.1016/j.jpeds.2009.07.014Get rights and content

Objectives

To determine the involvement of human metapneumovirus (HMPV) in childhood community-acquired alveolar pneumonia (CAAP) and compare the demographic, clinical, and laboratory features of HMPV-associated CAAP and CAAP associated with other respiratory viruses.

Study design

Nasopharyngeal wash specimens obtained prospectively over a 4-year period from children age < 5 years evaluated in the emergency department with radiologically diagnosed CAAP and from healthy controls were tested for HMPV by reverse-transcriptase polymerase chain reaction and for respiratory syncytial virus (RSV), adenovirus, influenza and parainfluenza viruses by direct immunofluorescence and culture.

Results

HMPV was detected in 108 of 1296 patients (8.3%) versus RSV in 23.1%, adenovirus in 3.4%, influenza A virus in 2.9%, and parainfluenza viruse in 2.9%. During the period of peak activity (November to May), HMPV was detected in 95 of 1017 patients (9.3%) and in 3 of 136 controls (2.2%) (P = .005). The patients with HMPV were older than those with RSV (P < .001) with a more common history of acute otitis media requiring tympanocentesis (P = .032), wheezing (P = .001) and gastrointestinal symptoms (P < .001) and a lower hospitalization rate (P = .005).

Conclusions

The high detection rate suggests an important role for HMPV in childhood CAAP. Our findings identify demographic and clinical features of HMPV-positive CAAP and its age-related impact on hospital admissions.

CAAP
Community-acquired alveolar pneumonia
CRP
C-reactive protein
DFA
Direct immunofluorescence assay
ED
Emergency Department
HMPV
Human metapneumovirus
HMPVco
HMPV copathogen
LRTI
Lower respiratory tract infection
PCR
Polymerase chain reaction
RSV
Respiratory syncytial virus
RT-PCR
Reverse-transcriptase polymerase chain reaction
WBC
White blood cell

Cited by (0)

Supported by research grants from the Israeli Ministry of Science, MedImmune, Wyeth, and GlaxoSmithKline. The study sponsors had no involvement in study design, the collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the manuscript for publication. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript. The authors declare no conflicts of interest.

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