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

O'Grady, Kerry-Ann F., Grimwood, Keith, Sloots, Theo P. , Whiley, David M. , Acworth, Jason P. , Phillips, Natalie, Marchant, Julie, Goyal, Vikas and Chang, Anne B. (2017) Upper airway viruses and bacteria and clinical outcomes in children with cough. Pediatric Pulmonology, 52 3: 373-381. doi:10.1002/ppul.23527


Author O'Grady, Kerry-Ann F.
Grimwood, Keith
Sloots, Theo P.
Whiley, David M.
Acworth, Jason P.
Phillips, Natalie
Marchant, Julie
Goyal, Vikas
Chang, Anne B.
Title Upper airway viruses and bacteria and clinical outcomes in children with cough
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 1099-0496
8755-6863
Publication date 2017-03-01
Year available 2016
Sub-type Article (original research)
DOI 10.1002/ppul.23527
Open Access Status Not yet assessed
Volume 52
Issue 3
Start page 373
End page 381
Total pages 9
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Collection year 2018
Language eng
Formatted 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 seven respiratory bacteria and 17 viruses. Predictors of hospitalization and persistent cough at day-28 were evaluated in logistic regression models.

Results: Eight hundred and seventeen 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 more likely to have RSV A or B detected on nasal swab than those not admitted (adjusted relative risk (aRR) 1.8, 95%CI 1.0, 3.3). M. catarrhalis was the only microbial difference between children with and without cough persistence (aRR for those with cough at day 28: 2.1, 95%CI 1.3, 3.1).

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.
Keyword Children
Cough
Cough duration
Hospitalization
Microbiology
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Child Health Research Centre Publications
 
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