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Arch Pediatr Adolesc Med. 2012 Aug;166(8):700-6.

Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis.

Author information

  • 1Department of Medicine, Children’s Hospital Boston, Boston 02115, USA. jonathan.mansbach@childrens.harvard.edu

Abstract

OBJECTIVE:

To determine whether hospital length of stay(LOS) for acute bronchiolitis is influenced by the infecting pathogen.

DESIGN:

A prospective observational cohort study was performed during 3 consecutive years.

SETTING:

Sixteen US hospitals participated in the study.

PARTICIPANTS:

Children younger than 2 years hospitalized with bronchiolitis were included.

MAIN EXPOSURE:

The results of nasopharyngeal aspirate polymerase chain reaction pathogen testing served as the main exposure.

MAIN OUTCOME MEASURE:

Hospital LOS was determined.

RESULTS:

Of 2207 participants, 72.0% had respiratory syncytial virus (RSV) and 25.6% had human rhinovirus(HRV); the incidence of each of the other viruses and bacteria was 7.8% or less. Multiple pathogen infections were present in 29.8% of the children. There were 1866 children(84.5%) with RSV and/or HRV. Among these 1866 children, the median age was 4 months and 59.5% were male. The median LOS was 2 days (interquartile range,1-4 days). Compared with children who had only RSV,an LOS of 3 or more days was less likely among children with HRV alone (adjusted odds ratio [AOR], 0.36; 95%CI, 0.20-0.63; P.001) and those with HRV plus non-RSV pathogens (AOR, 0.39; 95% CI, 0.23-0.66; P.001)but more likely among children with RSV plus HRV(AOR,1.33; 95% CI, 1.02-1.73; P=.04), controlling for 15 demographic and clinical factors.

CONCLUSIONS:

In this multicenter study of children hospitalized with bronchiolitis, RSV was the most common virus detected, but HRV was detected in one-quarter of the children. Since 1 in 3 children had multiple virus infections and HRV was associated with LOS, these data challenge the effectiveness of current RSV-based cohorting practices, the sporadic testing for HRV in bronchiolitis research, and current thinking that the infectious etiology of severe bronchiolitis does not affect short-term outcomes.

PMID:
22473882
[PubMed - indexed for MEDLINE]
PMCID:
PMC3394902
Free PMC Article
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