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G524(P) The molecular epidemiology and clinical disease severity of Human Rhino virus infections in hospitalised children
  1. J Srinivasan1,
  2. C McINally1,
  3. S Soo1,2,
  4. M Diggle2,
  5. H Vyas2
  1. 1Paediatrics, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
  3. 3Paediatric Respiratory Medicine and Intensive Care, Nottingham University Hospitals NHS Trust, Nottingham, UK

Abstract

Introduction Human rhinoviruses (RV) are one of the main aetiological agents responsible for respiratory tract infections. RVs are divided into three species termed Rhinovirus A, B and C with over 150 types identified within these species. There has been growing evidence of RV infections causing severe respiratory illness in vulnerable populations such as infants with underlying respiratory or immunocompromised conditions.

Aims and objectives We aimed to evaluate molecular epidemiology and associated clinical severity of Rhino virus infections retrospectively in hospitalised children aged < than 2 years.

Materials and methods Nasopharyngeal and respiratory secretions from hospitalised children who tested positive for Rhino virus were included. The only exclusion factor was children with cystic fibrosis. We analysed rhino virus subtypes and its clinical association on samples obtained during the study period from January 2014 until August 2014. In total 100 clinical samples met the criteria which was then subtyped. Viral subtyping was performed by nucleic acid extraction, amplification and sequencing of the 5’ non-coding region (NCR) of the viral genome. Information on demographics, antecedent respiratory conditions and risk factors (immune suppression), clinical presentation and progress (oxygen and ventilation requirements) were collected. Additional data collected includes presence or absence of viral respiratory co infections, bacterial infections and antibiotic treatment.

Results The distribution of RV species, subtyped by sequencing regions of the 5’NCR observed in this study were; 57 RV-A, two RV-B and 29 RV-C. The data generated in this study provided some suggestive evidence of RV-C infection being associated with more severe acute respiratory symptoms and that RV-A infection although more prevalent commonly results in fever and is associated with extended patient length of stay in hospital. The 5’NCR sequencing assay utilised in this study was able to subtype 91% of clinical samples within a diagnostic laboratory setting using only clinical sample nucleic acid extracts.

Conclusion The knowledge of sub type in infants and young children would be quite useful to predict the disease severity and clinical course especially in vulnerable population. Also it does illustrate the importance of prevention of nosocomial Rhinovirus infections in the interest of avoiding excessive bed-days.

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