ETIOLOGICAL SPECTRUM OF COMMUNITY-ACQUIRED RESPIRATORY INFECTIONS IN HOSPITALIZED PEDIATRIC PATIENTS BY MULTIPLEX MOLECULAR APPROACH: A TERTIARY CARE CENTER BASED STUDY FROM NORTH INDIA

Abstract

Background: Respiratory infections are a leading cause of illness and death among children, globally. India, especially states like Uttar Pradesh (UP), bears a disproportionate burden due to factors such as high population density, environmental pollution, seasonal variation, and limited healthcare access. Despite national data availability, there is a lack of region-specific molecular epidemiological insights, particularly for older children (>5 years) and regions like Western UP. This study focuses on identifying and characterizing the viral and bacterial agents responsible for hospitalized children with respiratory distress in Western UP. Methods: A hospital-based surveillance study was conducted in the neonatal and pediatric intensive care units (NICU/PICU) of a tertiary care center in Uttar Pradesh. A total of 210 clinical samples (Nasopharyngeal swab) were obtained from study population with clinical features consistent with acute respiratory infection (ARI). We employed multiplex real-time polymerase chain reaction (RT-PCR) for molecular detection of viral and bacterial agents, and conventional culture-based techniques for bacterial isolation and identification. Results: A total of 210 nasopharyngeal swabs from pediatric cases (0–14 years) were evaluated for respiratory pathogens. Viral etiology was detected in 56(26.6%) of the cases. Among these, respiratory syncytial virus (RSV) was the predominant pathogen (42.85%), followed by Rhinovirus (21.42%), Adenovirus (17.85%), and Influenza B virus (7.14%). Mixed viral infections were identified in a subset of cases, specifically RSV/Rhinovirus (7.14%) and RSV/Adenovirus (3.57%). Bacteriological analysis demonstrated the presence of bacterial pathogens in 32 (15.23%) of the samples. The most prevalent being Streptococcus pneumonia 14/32 (43.75%), followed by Klebsiella pneumonia 08/32 (25%), Morexella Sps. 06/32 (18.75%), Escherichia coli 02/32 (6.25%) and Acinetobacter baumanii 02/32 (6.25%). Conclusion: The findings highlight the necessity for integrated diagnostic approaches, particularly synchronous testing methodologies, along with targeted preventive strategies to enhance the effective management of pediatric respiratory infections. Syndromic molecular testing is an effective approach to identify causative pathogen so that targeted treatment may be given timely.