Upper airway viruses and bacteria and clinical outcomes in children with cough

O'Grady, Kerry-Ann F., Grimwood, Keith, Sloots, Theo P., Whiley, David, Acworth, Jason P., Phillips, Natalie, Marchant, Julie, Goyal, Vikas, & Chang, Anne B. (2016) Upper airway viruses and bacteria and clinical outcomes in children with cough. Pediatric Pulmonology. (In Press)

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Abstract

Background

  • Cough is symptomatic of a broad range of acute and chronic pediatric respiratory illnesses. No studies in children have tested for an extended panel of upper airway respiratory viruses and bacteria to identify whether they predict cough outcomes, irrespective of clinical diagnosis at the time of acute respiratory illness (ARI). We therefore determined whether upper airway microbes independently predicted hospitalization and persistent cough 28-days later in children presenting with an ARI, including cough as a symptom.

Methods

  • A cohort study of children aged <15-years were followed for 28-days after presenting to a pediatric emergency department with an ARI where cough was also a symptom. Socio-demographic factors, presenting clinical features and a bilateral anterior nasal swab were collected at enrolment. Polymerase chain reaction assays tested for 7 respiratory bacteria and 17 viruses. Predictors of hospitalization and persistent cough at day-28 were evaluated in logistic regression models.

Results

  • 817 children were included in the analysis; median age 27.7-months. 116 (14.2%, 95%CI 11.8, 16.6) children were hospitalized and 163 (20.0%, 95%CI 17.2, 22.7) had persistent cough at day-28. Hospitalized children were were more likely to have RSV A or B detected on nasal swab than those not admitted (aRR 1.8, 95%CI 1.0, 3.3). M. catarrhalis (aRR 1.8, 95%CI 1.2, 2.7) was the only microbial difference between children with and without cough persistence (aRR for those with cough at day 28: 1.8, 95%CI 1.2, 2.7).

Discussion

  • An etiologic role for M. catarrhalis in the pathogenesis of persistent cough post-ARI is worth exploring, especially given the burden of chronic cough in children and its relationship with chronic lung disease.

Impact and interest:

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ID Code: 96579
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Cough, Children, Microbiology, Upper Airways, Clinical outcomes
DOI: 10.1002/ppul.23527
ISSN: 1099-0496
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL MICROBIOLOGY (110800)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Funding:
Copyright Owner: Copyright 2016 Wiley Periodicals, Inc.
Deposited On: 06 Jul 2016 22:52
Last Modified: 04 Oct 2016 05:13

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