Investigation of the coexistence of influenza type virus A/B and group A beta haemolytic streptococcus in children diagnosed with acute upper respiratory infection presenting to the pediatric outpatient clinic of TOBB ETU Medical Faculty Hospital

Abstract

Objective: Coinfections of the respiratory tract due to bacteria and viruses are a common health problem worldwide. Acute upper respiratory tract infections (URTI) are among the most common infections in the pediatric age group. This study aimed to determine the incidence and co-occurrence rates of Influenza virus A/B and AGBHS infections according to age groups and years in children who applied to TOBB ETU Hospital Pediatric’s Clinic with the complaint of acute URTI. Methods: The data of patients between the ages of 0-18, who were admitted to TOBB ETU Medical Faculty Hospital Pediatric’s Outpatient Clinic between 1January 2015 and 31 July 2019 with the diagnosis of acute URTI tested for simultaneous throat culture, which rapid Strep A antigen test and Influenza virus type A / B test, obtained from the hospital information system and analysed. Results: The results of a total of 2515 (1203 F / 1312 M) patients between the ages of 0-18 years, who were simultaneously diagnosed with acute URTI and who had simultaneous throat culture, rapid Strep A antigen test and Influenza virus type A/B tests were examined. AGBHS, Influenza virus type A/ B were found 24%, 18%, 9% positive, respectively. While AGBHS positivity was found at the highest in the 7-11 age group (30%) and it was found at the lowest rate (%15) in the 0-2 year group. Influenza A virus positivity was found at similar rates as 18%, 18%, 17%, in the 3-6, 7-11 and 12-18 year group, respectively and in the 0-2 year group, the lowest rate was reported as 12%. Influenza B virus positivity was highest in the 7-11 age group with a rate of 13%. According to gender, AGBHS, Influenza virus type A/ B positivity were similar. %19 of Influenza A and 26% of Influenza B virus positive patients coexistence of AGBHS were detected. When evaluated according to seasons, Influenza type A/B and AGBHS coexistence were high both in winter and spring months. Conclusion: It is known that Influenza viruses increase susceptibility to bacterial infections and secondary bacterial infections cause a signifcant increase in morbidity and mortality. Unnecessary antibiotics are prescribed to 45-66% of the patients who apply for URI. It is therefore important to diagnose bacterial coinfections during Influenza virus outbreaks. The decision to add the antibacterial drug to the treatment along with antiviral agent should be considered when presence of bacterial infections with Influenza viruses are proven. © 2020. INFLUENZA VE AGBHS BIİRLIİKTELIİĞIİNIİN ARAŞTIRILMASI. All rights reserved.