Viral Etiology of Acute Bronchiolitis in Hospitalized Infants and the Effect on Clinical Course

Ali Kanık 1, Kayı Eliaçık 1, Begüm Koyun 1, Osman Tolga İnce 1, Yeşer Karaca Derici 2, Nisel Özkalay Yılmaz 2, Dilek Yılmaz Çiftdoğan 3
1İzmir Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, İzmir, Türkiye
2İzmir Tepecik Eğitim ve Araştırma Hastanesi, Klinik Mikrobiyoloji Bölümü, İzmir, Türkiye
3İzmir Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Enfeksiyon Hastalıkları Kliniği, İzmir, Türkiye

J Pediatr Inf 2016; 10: 93-98
DOI: 10.5152/ced.2016.2425
Key Words: Acute bronchiolitis, hospitalization period, multiplex PCR, viral etiology

Objective: It was aimed to determine the viral agents in hospitalized infants with acute bronchiolitis and to evaluate the association between clinical course and these agents.


Material and Methods: This study was carried out with the retrospective review of 177 patients aged 1 month-2 years old who were hospitalized in İzmir Tepecik Teaching Hospital between October 2014 and May 2015 due to acute bronchiolitis. Nasopharyngeal swab samples were examined for respiratory sinsitial virus (RSV) A+B, rhinovirus, influenzae virus A+B, parainfluenzae virus 1, 2, 3 and 4, human metapneumo virus, adenovirus, coronavirus OCD43, 229E and NL63, bocavirus and enterovirus with ‘‘Multiplex Polymerase chain reaction’’ (M-PCR) method. The relationship was evaluated between the determinated agents and the demographic, clinic, laboratory features and the hospitalization period.


Results: Among the 177 patients who were included in the study, in 159 (89.8%) at least one agent was detected by using M-PCR method. The mean age of these 159 patients was 6.27 ± 5.10 months and 109 (68.6%) were male. 282 agents were detected. While in 88 (55.3%) cases a single virus were detected, in 71 (44.7%) multipl virus were determined.  In the evalutaion of both single and multipl agents group, RSV was the most common virus (n=101, 57.1%). It was followed by 48 (27.1%) rinovirus and 23 (13.0%) influenzae virus. While the inital clinical scores were the highest in adenovirus infection, there was no difference between the other viral infections with single or multiple agents in terms of initial clinical scores and hospitalization period.


Conclusion: Despite the new diagnostic methods of variable viruses, RSV is still continuing with high ratios in the hospitalized infants with acute bronchiolitis. In this study no significant association was detected between the clinical features and the viral agents.(J Pediatr Inf 2016; 10: 93-8)