The potential influence of human parainfluenza viruses detected during hospitalization among critically ill patients in Kuwait, 2013-2015

Sahar Essa 1, Haya Al-Tawalah 2, Sarah AlShamali 3, Widad Al-Nakib 4

Affiliations

03 February 2017

-

doi: 10.1186/s12985-017-0681-0

Abstract

Background: The four types of human parainfluenza viruses (PIV) are important causes of community-acquired pneumonia, particularly in children; however, limited information exists about the incidence of PIV in critically ill patients. The aim of this study is to describe the spectrum, incidence and clinical features of PIV-associated infections diagnosed during the hospital stay of patients admitted to pediatric intensive care unit (PICU) and intensive care unit (ICU) of 5 medical centers across Kuwait.

Methods: This was a population-based, retrospective study from 2013 to 2015. Specimens were analyzed by molecular methods. This analysis was performed using the database of Virology Unit, Mubarak Al-Kabeer Hospital. Data from 1510 admitted patients with suspected respiratory viral infections was extracted.

Results: The database contained a total of 39 (2.6%) patients infected with PIV (53.8% male and 46.2% females) and 20 (51.3%) were under 1 year of age. The most frequently isolated type was type 3 (28, 71.8%) followed by type 1 (9, 23.1%). At admission the most common clinical diagnosis was pneumonia in 12 patients (30.8%, p < 0.05) followed by bronchiolitis in 10 patients (25.6%).

Conclusion: PIV plays an important yet unrecognized role in the outcomes of PIUC and ICU patients. Our results contribute to the limited epidemiologic data of PIV in PIUC and ICU in this region.

Keywords: Intensive Care Unit (ICU); Parainfluenza viruses; Pediatric intensive care unit (PICU).

Figures

Fig. 1 Monthly distribution of PIV infections in ICU and PICU

Fig. 1 Monthly distribution of PIV infections in ICU and PICU

Fig. 2 Monthly distribution of PIV-1, PIV-3, and PIV-4 infections

Fig. 2 Monthly distribution of PIV-1, PIV-3, and PIV-4 infections

Similar articles

The burden of infections by parainfluenza virus in hospitalized children in Spain.

Calvo C, García-García ML, Ambrona P, Rico M, Pozo F, Del Mar Molinero M, Pérez-Breña P, Casas I.Pediatr Infect Dis J. 2011 Sep;30(9):792-4. doi: 10.1097/INF.0b013e318212ea50.PMID: 21343837

Surveillance for respiratory syncytial virus and parainfluenza virus among patients hospitalized with pneumonia in Sarawak, Malaysia.

Fieldhouse JK, Toh TH, Lim WH, Ting J, Ha SJ, Hii KC, Kong CI, Wong TM, Wong SC, Warkentien TE, Gray GC.PLoS One. 2018 Aug 15;13(8):e0202147. doi: 10.1371/journal.pone.0202147. eCollection 2018.PMID: 30110367 Free PMC article.

Population-based Surveillance for Medically Attended Human Parainfluenza Viruses From the Influenza Incidence Surveillance Project, 2010-2014.

Steffens A, Finelli L, Whitaker B, Fowlkes A.Pediatr Infect Dis J. 2016 Jul;35(7):717-22. doi: 10.1097/INF.0000000000001140.PMID: 26974891 Free PMC article.

Respiratory syncytial virus and parainfluenza virus infections in the immunocompromised host.

Wendt CH, Hertz MI.Semin Respir Infect. 1995 Dec;10(4):224-31.PMID: 8668850 Review.

Pulmonary infections with respiratory syncytial virus and the parainfluenza viruses.

Henderson FW.Semin Respir Infect. 1987 Jun;2(2):112-21.PMID: 2827280 Review.

Cited by

Genetic analysis of human parainfluenza virus type 4 associated with severe acute respiratory infection in children in Luohe City, Henan Province, China, during 2017-2018.

Zhou S, Mao N, Zhang Y, Cui A, Zhu Z, Hu R, Xu J, Xu W.Arch Virol. 2021 Sep;166(9):2585-2590. doi: 10.1007/s00705-021-05154-3. Epub 2021 Jul 6.PMID: 34231027 Free PMC article.

Update in Viral Infections in the Intensive Care Unit.

Fragkou PC, Moschopoulos CD, Karofylakis E, Kelesidis T, Tsiodras S.Front Med (Lausanne). 2021 Feb 23;8:575580. doi: 10.3389/fmed.2021.575580. eCollection 2021.PMID: 33708775 Free PMC article. Review.

The Clinical Characteristics and Outcomes of Adult Patients With Pneumonia Related to Three Paramyxoviruses.

Chen L, Han X, Li Y, Zhang C, Xing X.Front Med (Lausanne). 2021 Jan 18;7:574128. doi: 10.3389/fmed.2020.574128. eCollection 2020.PMID: 33537323 Free PMC article.

KMEL References

https://pubmed.ncbi.nlm.nih.gov/\

References

  1.  
    1. Ghani AS, Morrow BM, Hardie DR, Argent AC. An investigation into the prevalence and outcome of patients admitted to a pediatric intensive care unit with viral respiratory tract infections in Cape Town, South Africa. Pediatr Crit Care Med. 2012;13:e275–e281. doi: 10.1097/PCC.0b013e3182417848. - DOI - PubMed
  2.  
    1. Leung TF, Lam DS, Miu TY, Hon KL, Chau CS, Ku SW, Lee RS, Chow PY, Chiu WK, Ng DK, Hong Kong Society of Paediatric Respirology (HKSPR) RSV Concern Group Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children. Infection. 2014;42:343–350. doi: 10.1007/s15010-013-0557-1. - DOI - PMC - PubMed
  3.  
    1. Henrickson KJ. Parainfluenza viruses. Clin Microbiol Rev. 2003;16:242–264. doi: 10.1128/CMR.16.2.242-264.2003. - DOI - PMC - PubMed
  4.  
    1. Marx A, Gary HE, Jr, Marston BJ, Erdman DD, Bremen RF, Török TJ, Plouffe JF, File TM, Jr, Anderson LJ. Parainfluenza virus infection among adults hospitalized for lower respiratory tract infection. Clin Infect Dis. 1999;29:134–140. doi: 10.1086/520142. - DOI - PubMed
  5.  
    1. Lukšić I, Kearns PK, Scott F, Rudan I, Campbell H, Nair H. Viral etiology of hospitalized acute lower respiratory infections in children under 5 years of age–a systematic review and meta-analysis. Croat Med. 2013;J54:122–134. - PMC - PubMed
  6.  
    1. Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia. Lancet. 2011;377:1264–1275. doi: 10.1016/S0140-6736(10)61459-6. - DOI - PMC - PubMed
  7.  
    1. Bicer S, Giray T, Çöl D, Erdağ GC, Vitrinel A, Gürol Y, Çelik G, Kaspar C, Küçük O. Virological and clinical characterizations of respiratory infections in hospitalized children. Ital J Pediatr. 2013;39:e22. doi: 10.1186/1824-7288-39-22. - DOI - PMC - PubMed
  8.  
    1. Srinivasan A, Wang C, Yang J, Inaba H, Jerry LS, Wing H, Hayden RT. Parainfluenza Virus Infections in Children with Hematologic Malignancies. Pediatr Infect Dis. 2011;J30:855–859. doi: 10.1097/INF.0b013e31821d190f. - DOI - PMC - PubMed
  9.  
    1. Choi SH, Hong SB, Ko GB, Lee Y, Park HJ, Park SY, Moon SM, Cho OH, Park KH, ChongYP KSH, Huh JW, Sung H, Do KH, Lee SO, Kim MN, Jeong JY, Lim CM, Kim YS, Woo JH, Koh Y. Viral infection in patients with severe pneumonia requiring intensive care unit admission. Am J Respir Crit Care Med. 2012;186:325–332. doi: 10.1164/rccm.201112-2240OC. - DOI - PubMed
  10.  
    1. Wiemken T, Peyrani P, Bryant K, Kelley RR, Summers gill J, Arnold F, Carrico R, McKinney WP, Jonson C, Carrico K, Ramirez J. Incidence of respiratory viruses in patients with community-acquired pneumonia admitted to the intensive care unit: results from the Severe Influenza Pneumonia Surveillance (SIPS) project. Eur J Clin Microbiol Infect Dis. 2013;32:705–710. doi: 10.1007/s10096-012-1802-8. - DOI - PubMed
  11.  
    1. Gomez M, Mufson MA, Dubovsky F, Knightly C, Zeng W, Losonsky G. Phase-I study MEDI-534, of a live, attenuated intranasal vaccine against respiratory syncytial virus and parainfluenza-3 virus in seropositive children. Pediatr Infect Dis J. 2006;28:655–658. doi: 10.1097/INF.0b013e318199c3b1. - DOI - PubMed
  12.  
    1. Sato M, Wright PF. Current status of vaccines for parainfluenza virus infections. Pediatr Infect Dis. 2008;J27:S123–S125. doi: 10.1097/INF.0b013e318168b76f. - DOI - PubMed
  13.  
    1. Schmidt AC, Schaap-Nutt A, Bartlett EJ, Schomacker H, Boonyaratanakornkit J, Karron RA, Collins PL. Progress in the development of human parainfluenza virus vaccines. Expert Rev Respir Med. 2011;5:515–526. doi: 10.1586/ers.11.32. - DOI - PMC - PubMed
  14.  
    1. Khadadah M, Essa S, Higazi Z, Behbehani N, Al-Nakib W. Respiratory syncytial virus and human rhinoviruses are the major causes of severe lower respiratory tract infections in Kuwait. J Med Virol. 2010;8:1462–1467. doi: 10.1002/jmv.21823. - DOI - PMC - PubMed
  15.  
    1. Meqdam MM, Subaih SH, Thwiny IR. Rapid detection and clinical features of influenza and parainfluenza in infants and young children hospitalized with acute lower respiratory illnesses. J Trop Pediatr. 2005;51:160–165. doi: 10.1093/tropej/fmi002. - DOI - PubMed
  16.  
    1. Nasarallh G, Meqdam MM, Al-Shurman A. Prevalence of parainfluenza and influenza viruses among Jordanian children with upper respiratory tract infection. Saudi Med J. 2000;21:841–845.
  17.  
    1. Counihan ME, Shay DK, Holman RC, Lowther SA, Anderson LJ. Human parainfluenza virus-associated hospitalizations among children less than five years of age in the United States. Pediatr Infect Dis. 2001;J20:646–653. doi: 10.1097/00006454-200107000-00003. - DOI - PubMed
  18.  
    1. Weinberg GA, Hall CB, Iwane MK, Staat MA, Curns AT, Erdman DD, Szilagyi PG. Parainfluenza virus infection of young children: estimates of the population-based burden of hospitalization. J Pediatr. 2009;154:694–699. doi: 10.1016/j.jpeds.2008.11.034. - DOI - PubMed
  19.  
    1. Liu WK, Liu Q, Chen DH, Liang HX, Chen XK, Huang WB, Qin S, Yang ZF, Zhou R. Epidemiology and clinical presentation of the four human parainfluenza virus types. BMC Infect Dis. 2013;13:28. doi: 10.1186/1471-2334-13-28. - DOI - PMC - PubMed
  20.  
    1. Feng L, Li Z, Zhao S, Nair H, Lai S, Xu W, Li M, Wu J, Ren L, Liu W, Yuan Z, Chen Y, Wang X, Zhao Z, Zhang H, Li F, Ye X, Li S, Feikin D, Yu H, Yang W. Viral etiologies of hospitalized acute lower respiratory infection patients in China, 2009–2013. PLoS One. 2014;9:e99419. doi: 10.1371/journal.pone.0099419. - DOI - PMC - PubMed
  21.  
    1. Morgan OW, Chittaganpitch M, Clague B, Chantra S, Sanasuttipun W, Prapasiri P, Naorat S, Laosirithavorn Y, Peret TCT, Erdman DD, Baggett HC, Olsen SJ, Fry AM. Hospitalization due to human parainfluenza virus-associated lower respiratory tract illness in rural Thailand. Influenza Other Respir Viruses. 2013;7:280–285. doi: 10.1111/j.1750-2659.2012.00393.x. - DOI - PMC - PubMed
  22.  
    1. Shatizadeh S, Yavarian J, Rezaie F, Mahmoodi M, Naseri M, Azad TM. Epidemiological and clinical evaluation of children with respiratory virus infections. Med J Islam Repub Iran. 2014;28:1–6. - PMC - PubMed
  23.  
    1. Nasreen S, Luby SP, Brooks WA, Homaira N, Al Mamun A, Bhuiyan MU, Rahman M, Ahmed D, Abedin J, Rahman M, Alamgir ASM, Fry AM, Streatfield PK, Rahman A, Bresee J, Widdowson MA, Azziz-Baumgartner E. Population-based incidence of severe acute respiratory virus infections among children aged <5 years in rural Bangladesh, 2010. PLoS One. 2014;9:e89978. doi: 10.1371/journal.pone.0089978. - DOI - PMC - PubMed
  24.  
    1. Feikin DR, Njenga MK, Bigogo G, Aura B, Aol G, Audi A, Jagero G, Muluare PO, Gikunju S, Nderitu L, Balish A, Winchell J, Schneider E, Erdman D, Oberste MS, Katz MA, Breiman RF. Etiology and incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007–2010. PLoS One. 2012;7:e43656. doi: 10.1371/journal.pone.0043656. - DOI - PMC - PubMed
  25.  
    1. Noyola DE, Arteaga-Dominguez G. Contribution of respiratory syncytial virus, influenza and parainfluenza viruses to acute respiratory infections in San Luis Potosi, Mexico. Pediatr Infect Dis J. 2005;24:1049–1052. doi: 10.1097/01.inf.0000190026.58557.93. - DOI - PubMed
  26.  
    1. de Arruda E, Hayden FG, McAuliffe JF, De Sousa MA, Mota SB, McAuliffe MI, Geist FC, Carvalho EP, Fernandes MC, Guerrant RL, Gwaltney JM., Jr Acute respiratory viral infections in ambulatory children of urban northeast Brazil. J Infect Dis. 1991;164:252–258. doi: 10.1093/infdis/164.2.252. - DOI - PubMed
  27.  
    1. Teo WY, Rajadurai VS, Sriram B. Morbidity of parainfluenza 3 outbreak in preterm infants in a neonatal unit. Ann Acad Med Singapore. 2010;39:837–846. - PubMed
  28.  
    1. Yang HT, Jiang Q, Zhou X, Bai MQ, Si HL, Wang XJ, Lu Y, Zhao H, He HB, He CQ. Identification of a natural human serotype 3 parainfluenza virus. Virol J. 2011;8:58. doi: 10.1186/1743-422X-8-58. - DOI - PMC - PubMed
  29.  
    1. Peltola V, Heikkinen T, Ruuskanen O. Clinical courses of croup caused by influenza and parainfluenza viruses. Pediatr Infect Dis. 2002;J21:76–78. doi: 10.1097/00006454-200201000-00020. - DOI - PubMed
  30.  
    1. Calvo C, Garcia-Garcia ML, Ambrona P, Rico M, Pozo F, Del Mar Molinero M, Pérez-Breña P, Casas I. The burden of infections by parainfluenza virus in hospitalized children in Spain. Pediatr Infect Dis J. 2011;30:792–794. doi: 10.1097/INF.0b013e318212ea50. - DOI - PubMed
  31.  
    1. Fé MMM, Monteiro AJ, Moura FE. Parainfluenza virus infections in a tropical city: clinical and epidemiological aspects. Braz J Infect Dis. 2008;12:192–197. doi: 10.1590/S1413-86702008000300006. - DOI - PubMed
  32.  
    1. Oh JW. Respiratory viral infections and early asthma in childhood. Allergol Int. 2006;55:369–372. doi: 10.2332/allergolint.55.369. - DOI - PubMed
  33.  
    1. Cai XY, Lu XD, Lin GY, Cai ZW, Lin C, Chen PZ, Zheng YL, Zhou XH, Feng XY, Xiao ZX. Monitoring of viral pathogens in pediatric intensive care unit and analysis of clinical significance. Chin J Pediatr. 2013;51:453–459. - PubMed
  34.  
    1. Cilla G, Onate E, Perez-Yarza EG, Montes M, Vicente D, Perez-Trallero E. Viruses in community-acquired pneumonia in children aged less than 3 years old: High rate of viral coinfection. J Med Virol. 2008;80:1843–1849. doi: 10.1002/jmv.21271. - DOI - PMC - PubMed
  35.  
    1. Essa S, Owayed A, Altawalah H, Khadadah M, Behbehani N, Al-Nakib W. Mixed Viral Infections Circulating in Hospitalized Patients with Respiratory Tract Infections in Kuwait. Adv Virol. 2015;2015:e714062. doi: 10.1155/2015/714062. - DOI - PMC - PubMed
  36.  
    1. Fabbiani M, Terrosi C, Martorelli B, Valentini M, Bernini L, Cellesi C, Cusi MG. Epidemiological and clinical study of viral respiratory tract infections in children from Italy. J Med Virol. 2009;81:750–756. doi: 10.1002/jmv.21457. - DOI - PMC - PubMed
  37.  
    1. Pierangeli A, Gentile M, Di Marco P, Pagnotti P, Scagnolari C, Trombetti S, Lo Russo L, Tromba V, Moretti C, Midulla F, Antonelli G. Detection and typing by molecular techniques of respiratory viruses in children hospitalized for acute respiratory infection in Rome, Italy. J Med Virol. 2007;79:463–468. doi: 10.1002/jmv.20832. - DOI - PMC - PubMed
  38.  
    1. Johnson D. Croup. BMJ Clin Evid. 2009;2009. ISSN: 17528526.
  39.  
    1. Pavia AT. Viral infections of the lower respiratory tract: old viruses, new viruses, and the role of diagnosis. Clin Infect Dis. 2011;52(suppl 4):S284–S289. doi: 10.1093/cid/cir043. - DOI - PMC - PubMed
  40.  
    1. Greenberg SB, Allen M, Wilson J, Atmar RL. Respiratory viral infections in adults with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;162:167–173. doi: 10.1164/ajrccm.162.1.9911019. - DOI - PubMed
  41.  
    1. Gump DW, Phillips CA, Forsyth BR, McIntosh K, Lamborn KR, Stouch WHO Role of infection in chronic bronchitis. Am Rev Respir Dis. 1976;113:465–474. - PubMed
  42.  
    1. Kurai D, Saraya T, Ishii H, Takizawa H. Virus-induced exacerbations in asthma and COPD. Front Microbiol. 2013;4(Issue). OCT. doi: 10.3389/fmicb.2013.00293. - PMC - PubMed
  43.  
    1. Smith CB, Golden CA, Kanner RE, Renzetti AD., Jr Association of viral and Mycoplasma pneumoniae infections with acute respiratory illness in patients with chronic obstructive pulmonary diseases. Am Rev Respir Dis. 1980;12:225–232. - PubMed
  44.  
    1. Heilman CA. From the National Institute of Allergy and Infectious Diseases the World Health Organization. Respiratory syncytial and parainfluenza viruses. J Infect Dis. 1990;161:402–406. doi: 10.1093/infdis/161.3.402. - DOI - PubMed
  45.  
    1. Henderson FW. Pulmonary infections with respiratory syncytial virus and the parainfluenza viruses. Semin Respir Infect. 1987;2:112–121. - PubMed
  46.  
    1. Collins PL, Chanock RM, McIntosh K. Parainfluenza viruses. In: Fields BN, Knipe DM, Howley PM, editors. Fields virology. 3. Philadelphia: Lippincott-Raven; 1996. pp. 1205–1210.
  47.  
    1. Killgore GE, Dowdle WR. Antigenic characterization of parainfluenza 4A and 4B by the hemagglutination-inhibition test and distribution of HI antibody in human sera. Am J Epidemiol. 1970;91:308–316. - PubMed
  48.  
    1. Aguilar JC, Pérez-Breña MP, García ML, Cruz N, Erdman DD, Echevarría JE. Detection and identification of human parainfluenza viruses 1, 2, 3, and 4 in clinical samples of pediatric patients by multiplex reverse transcription-PCR. J Clin Microbiol. 2000;38:1191–1195. - PMC - PubMed
  49.  
    1. García GML, Aguilar RJ, Echeverría MJE, Calvo RC, Pinto FI, Ordobás GM, Roman Riechmann E, Pérez Breña P. Parainfluenza virus type 4 infections. An Esp Pediatr. 2002;57:116–120. doi: 10.1016/S1695-4033(02)78684-0. - DOI - PubMed
  50.  
    1. Miall F, Rye A, Fraser M, Hunter A, Snowden JA. Human parainfluenza type 4 infections: a case report highlighting pathogenicity and difficulties in rapid diagnosis in the post-transplant setting. Bone Marrow Transplant. 2002;29:541–542. doi: 10.1038/sj.bmt.1703402. - DOI - PubMed
  51.  
    1. Hazlett DT, Bell TM, Tukei PM, Ademba GR, Ochieng WO, Magana JM, Gathara GW, Wafula EM, Pamba A, Ndinya-Achola JO. Viral etiology and epidemiology of acute respiratory infections in children in Nairobi, Kenya. AmJTrop Med Hyg. 1988;39(6):632–640. - PubMed
  52.  
    1. Tsai HP, Kuo PH, Liu CC, Wang JR. Respiratory viral infections among pediatric inpatients and outpatients in Taiwan from 1997 to 1999. J Clin Microbiol. 2001;39:111–118. doi: 10.1128/JCM.39.1.111-118.2001. - DOI - PMC - PubMed
  53.  
    1. Weinberg GA. Parainfluenza viruses: an underappreciated cause of pediatric respiratory morbidity. Pediatr Infect Dis. 2006;J25:447–448. doi: 10.1097/01.inf.0000218037.83110.c4. - DOI - PubMed
  54.  
    1. Reed G, Jewett PH, Thompson J, Tollefson S, Wright PF. Epidemiology and clinical impact of parainfluenza virus infections in otherwise healthy infants and young children <5 years old. J Infect Dis. 1997;175:807–813. doi: 10.1086/513975. - DOI - PubMed
  55.  
    1. Pecchinia R, Berezina EN, Souzab MC, Vaz-de-Limab L, Satob N, Salgadob M, Ueda M, Passos SD, Rangel R, Catebelota A. Parainfluenza virus as a cause of acute respiratory infection in hospitalized children. Braz J Infect Dis. 2015;19:358–362. doi: 10.1016/j.bjid.2015.03.002. - DOI - PMC - PubMed
  56.  
    1. Bakir TMF, Halawani MB, Ramia S. Viral aetiology and epidemiology of acute respiratory infections in hospitalized Saudi children. J Trop Pediatr. 1998;44:100–103. doi: 10.1093/tropej/44.2.100. - DOI - PMC - PubMed
  57.  
    1. Hall CB. Respiratory syncytial virus and parainfluenza virus. N Engl J Med. 2001;344:1917–1928. doi: 10.1056/NEJM200106213442507. - DOI - PubMed

Page Navigation