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Children
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Viral Respiratory Infections and Bacterial Superinfections in Children
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Viral Respiratory Infections and Bacterial Superinfections in Children

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Infectious Diseases".

Deadline for manuscript submissions: 1 June 2025 | Viewed by 3715

Special Issue Editors

Dr. Victor Daniel Miron

E-Mail
Guest Editor
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: infectious diseases; pediatric infectious diseases; viral diagnostics; viral epidemiology; viral infection; influenza; respiratory syncytial viruses; SARS-CoV-2; respiratory tract infections; pneumococcal infections; bacterial superinfection; medicine based; vaccination; childhood/pediatric obesity
Prof. Dr. Irina Magdalena Dumitru

E-Mail Website
Guest Editor
1. Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
2. Clinical Infectious Disease Hospital of Constanta, 900178 Constanta, Romania
Interests: infectious diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Viral respiratory infections are exceedingly prevalent among children and represent a significant health concern within the pediatric population. These infections are one of the primary causes for pediatric assessments or for visits to hospital emergency departments. A common concern that often arises in the treatment of these viral infections is the fear of bacterial superinfection. This fear frequently leads to the premature or unnecessary addition of antibiotics to the treatment regimen, a practice that has been shown to contribute markedly to the escalating rates of antimicrobial resistance. Considering this, the purpose of this Special Issue is to cast a spotlight on the clinical and epidemiological characteristics of bacterial superinfections that may occur in the backdrop of various respiratory viral infections such as influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, among others. It is also aimed at gathering and showcasing practical evidence drawn from real clinical cases to better understand these phenomena. Additionally, this issue seeks to provide insight into the bacterial complications that can accompany viral respiratory infections, including conditions like sinusitis, otitis, pneumonia, meningitis, or sepsis. By presenting well-documented evidence and making easy-to-use data available, this Special Issue aspires to be a valuable resource for clinicians. It aims to aid in the effective management of viral respiratory infections complicated by bacterial superinfections, thereby improving patient outcomes and contributing to the fight against antimicrobial resistance.

Dr. Victor Daniel Miron
Prof. Dr. Irina Magdalena Dumitru
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • viral infections
  • bacterial superinfections
  • respiratory viruses
  • influenza
  • RSV
  • SARS-CoV-2
  • pneumococcal disease
  • otitis, pneumonia, meningitis, sepsis
  • antimicrobial resistance

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Published Papers (3 papers)

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Research

16 pages, 780 KiB  
Article
Analysis of Pathogens in Respiratory Tract Infections and Their Effect on Disease Severity: Retrospective Data from a Tertiary Care German Children’s Hospital
by Petros Strempas, Heidi Weberruss, Thomas Bollinger and Thomas Rupprecht
Children 2025, 12(4), 438; https://doi.org/10.3390/children12040438 - 29 Mar 2025
Viewed by 305
Abstract
Background: Respiratory tract infections (RTIs) represent a frequent cause of inpatient admission in children’s hospitals, especially in the fall and winter seasons, resulting in major healthcare problems due to a lack of beds. The age and seasonal distribution of each pathogen seem to [...] Read more.
Background: Respiratory tract infections (RTIs) represent a frequent cause of inpatient admission in children’s hospitals, especially in the fall and winter seasons, resulting in major healthcare problems due to a lack of beds. The age and seasonal distribution of each pathogen seem to be multifactorial features that influence the course of infection. Other severity predictors appear to be the length of hospital stay, the presence or absence of oxygen demand, and the value of inflammatory markers. Methods: All inpatients from our children’s hospital between 2021 and 2023 who had a nasopharyngeal swab and presented with RTI symptoms were recruited for this retrospective cohort study. The parameters of interest were age, swab result, month of detection, CRP values, duration of hospitalization, presence of oxygen demand, and comorbidities. The data were analyzed using chi-square tests, paired t-tests and regression analysis to determine the associations of differences between the groups. Results: Detection of more than one respiratory pathogen in the same swab, apart from combinations with SARA-CoV-2, influenza, or RS-virus, was not associated with longer hospital stay, higher mean maximal CRP values, or oxygen demand compared to mono-infection with the same pathogens. In contrast, the detection of a pathogen versus no detection could be related to higher rates of oxygen demand and higher CRP values. Conclusions: Since co-infection with more than one virus, excluding those with epidemic potential, was not associated with a more severe course of RTIs, strict patient isolation seems to be dispensable for several viruses, as well as isolation of infected or colonized patients. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children)
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12 pages, 1746 KiB  
Article
Exploring the Clinical Characteristics and Outcomes of Rhinovirus Infection in Hospitalized Children Compared with Other Respiratory Viruses
by Sigrid Covaci, Claudiu Filimon and Mihai Craiu
Children 2024, 11(11), 1303; https://doi.org/10.3390/children11111303 - 28 Oct 2024
Viewed by 1527
Abstract
Background: Acute viral respiratory tract infections constitute a significant challenge in pediatric healthcare globally, with rhinovirus representing one of the primary etiological agents. In this context, we conducted a study with the objective of identifying the clinical characteristics and outcomes of rhinovirus infection [...] Read more.
Background: Acute viral respiratory tract infections constitute a significant challenge in pediatric healthcare globally, with rhinovirus representing one of the primary etiological agents. In this context, we conducted a study with the objective of identifying the clinical characteristics and outcomes of rhinovirus infection in comparison with other respiratory viruses in children hospitalized in one of the largest pediatric hospitals in the capital of Romania. Methods: We conducted a retrospective study among children hospitalized for influenza-like illness symptoms and who were tested by multiplex RT-PCR with a nasopharyngeal swab between May 2020 and December 2021. Results: A total of 496 children were eligible for inclusion in the study, and the positivity rate for at least one virus was 58.5%. The rhinovirus was identified in 138 patients (median age 12.5 months), representing 27.8% of all children tested and 49.3% of all positive samples. Although the clinical features of children with rhinovirus were dominated by cough (63.7%) and dyspnea (51.6%), no symptoms were identified that were strongly associated with rhinovirus infection in comparison to other respiratory viruses. The probability of receiving an antibiotic prescription was 1.92 times lower (p = 0.011) in children who tested positive for rhinovirus compared to children with negative RT-PCR results. The incidence of acute bronchiolitis or acute bronchitis, acute respiratory failure, and acute otitis media was higher among rhinovirus-positive children than among those who tested negative via RT-PCR. However, the incidence of these conditions was similar among children who tested positive for other respiratory viruses. Conclusions: Rhinovirus was the most prevalent virus identified in children hospitalized with influenza-like illness symptoms. The utilization of multiplex RT-PCR molecular tests is instrumental in elucidating etiology with precision and implementation of these advanced diagnostic methods, which can bring significant benefits in practice. A positive result for rhinovirus helps to reduce the unnecessary administration of antibiotics and optimizes patient management, thus decreasing the risk of severe complications such as acute respiratory failure and acute otitis media. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children)
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10 pages, 820 KiB  
Article
Incidence and Characteristics of Pediatric Patients with Acute Otitis Hospitalized in a Romanian Infectious Diseases Hospital
by Vlad Ștefan Pleșca, Anca Streinu-Cercel, Oana Săndulescu, Anca Cristina Drăgănescu, Răzvan Hainăroșie and Anca Doina Pleșca
Children 2024, 11(7), 832; https://doi.org/10.3390/children11070832 - 8 Jul 2024
Cited by 2 | Viewed by 1185
Abstract
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and [...] Read more.
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and 2023, with the aim of quantifying the incidence and impact of acute otitis (AO) according to pediatric age subgroups. Results: A total of 1118 cases diagnosed with AO were eligible and included in the analysis. Acute congestive otitis media was the most common subtype, identified in 53.3% of cases, followed by acute purulent otitis media (APOM) in 26.7% of children. The majority of AO cases (69.9%) were diagnosed in the pre-pandemic period (2018–2019), and infants (10.6%), toddlers (49.4%), and preschoolers (29.2%) were the most affected age groups. A viral infection associated with the AO episode was documented in 49.6% of cases. Influenza viruses were most commonly reported (20.5%), followed by SARS-CoV-2 (5.8%), and adenovirus (4.9%). A total of 38 cases of AO were identified in children with measles. In 15.9% of APOM cases, Streptococcus pneumoniae was isolated by culture from otic secretions. The duration of hospitalization was longer in children with APOM and acute otitis externa compared to the other subtypes of AO (p < 0.001). Conclusions: Our study highlights the importance of ENT (ear, nose, and throat) monitoring in children hospitalized for acute infectious diseases, as the majority of AO cases occur in the context of a viral infection. These findings emphasize the necessity for tailored assessment and intervention in suspected cases of AO, especially in young children under 5 years of age. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children)
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