Clinical characteristics of respiratory microorganisms in children hospitalized due to lower respiratory tract infections between 2019 and 2022 in a private hospital in Lima, Peru

Abstract

Introduction. Lower respiratory tract infection (LRTI) is the leading cause of childhood death. Etiological agents showed seasonal, geographic, and pandemic-related variation.
Objective. To determine the clinical characteristics of respiratory pathogens in children hospitalized due to LRTI before, during, and after the pandemic in a private hospital in Lima, Peru.
Materials and methods. A retrospective cohort study of patients under 13 years of age hospitalized with LRTI. Two multiplex polymerase chain reaction (PCR) tests, CLART® Fast PneumoVir and PneumoCLART Bacteria®, were used to identify pathogens. We identified factors associated with prolonged hospitalization based on general characteristics and the presence of positive pathogens.
Results. A total of 612 patient records were analyzed. The average age was 2.89 years. Respiratory syncytial virus (RSV) was identified in 33.7% of cases, influenza A in 26.3%, and Haemophilus sp in 19.3%. Before the COVID-19 pandemic, 48.9% of patients had a viral etiologic agent, and 88.1% had one after the pandemic. During the pre-pandemic period, 17.3% of patients had more than one microorganism, with frequent coinfections of RSV with Haemophilus sp (10.78%), RSV with metapneumovirus (8.82%), and RSV with influenza A (8.82%). Additionally, the identification of RSV was associated with prolonged hospital stays of more than 6 days (p = 0.005).
Conclusions. This study found that viral etiologic agents were predominant before and after the pandemic. Furthermore, coinfections between bacteria and viruses were frequent. RSV was the most common and was associated with coinfections and prolonged hospital stays.