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Pediatr Infect Dis J. 2014 Aug;33(8):829-34. doi: 10.1097/INF.0000000000000313.

Hospital length-of-stay is associated with rhinovirus etiology of bronchiolitis.

Author information

1
From the *Department of Pediatrics, Turku University Hospital, Turku, Finland; †Department of Medicine, Boston Children's Hospital, Boston, MA; ‡Departments of Molecular Virology and Microbiology, and Pediatrics, Baylor College of Medicine, Houston, TX; §Department of Pediatrics, Kuopio University Hospital, Kuopio; ¶Department of Pediatrics, Tampere University Hospital, Tampere, Finland; and ‖Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; **Allergy Unit, Tampere University Hospital, Tampere, Finland.

Abstract

OBJECTIVE:

To determine whether hospital length-of-stay (LOS) for bronchiolitis is influenced by the causative virus: respiratory syncytial virus (RSV) or rhinovirus.

METHODS:

This prospective study was carried out in 3 university hospitals in Finland during 2 consecutive winter seasons. We enrolled consecutive children <2 years of age hospitalized with an attending physician's diagnosis of bronchiolitis. All enrolled children were included in the primary analysis. A parallel analysis was also conducted using a stricter definition for bronchiolitis (age <12 months and no history of wheeze). Polymerase chain reaction was used to test the nasopharyngeal aspirate samples for multiple respiratory pathogens.

RESULTS:

The median age of the 408 children was 8 months, 73% had no history of wheeze and their median hospital LOS was 2 days. 144 (35%) children had RSV only and 92 (23%) children rhinovirus only infections. Children with rhinovirus only had shorter duration of prehospital symptoms, higher disease severity score at entry and more often a history of wheezing (all P ≤ 0.001). Controlling for 7 demographic and clinical characteristics, those with rhinovirus only had shorter hospital LOS when compared with children with RSV only (adjusted odds ratio: 0.45; 95% confidence interval: 0.22-0.92; P = 0.03). The rhinovirus only finding was similar in the subset of 206 children with stricter diagnosis (adjusted odds ratio: 0.30; 0.06-1.49; P = 0.14).

CONCLUSIONS:

Hospital LOS is associated with rhinovirus etiology of bronchiolitis. Our data call attention to the importance of both RSV and rhinovirus testing in clinical research.

PMID:
25222302
DOI:
10.1097/INF.0000000000000313
[Indexed for MEDLINE]

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