Infectious Pathogens that Could Trigger Cough in Children Outside Winter Epidemic Season

Background: Children‟s cough is the most prevalent reason for consultation with doctor. For this age group most of the trigger factors are attributed to infectious pathogens. During epidemic seasons the causative agents are quickly identified and unified treatment guidelines are easily created and covered. Outside epidemic season however the etiological profile could be in a very broad spectrum and thus could hamper the fast appropriate management. Methods: A real life observational study for 6 months (outside winter) on 74 children divided in 4 groups: 24 children with bronchial asthma (BA), 20 with chronic wet cough (CWC), 24 with bronchiolitis and bronchitis (AB) and 10 healthy children (HC) as a control. We collected serum, nasopharyngeal and deep throat swabs from specific pathogen detection (culture examination, PCR, ELISA). Results: In the HC we didn„t identify any pathogens in the throat samples. In 20% of the nasal swabs we cultured Staphylococcus aureus. In 33% of the patients from the AB group we found only viruses (RSV, hRV and hMPV), in 25% we found combined infection with virus and bacteria (mainly Moraxella catarrhal is and Streptococcus pneumoniae). The BA group in 25% we found only viruses (Adenovirus, hRV and RSV). In 56% of the cases Streptococcus pneumoniae was confirmed in the throat swabs vs. only 33% for isolated Moraxella catarrhal is. Only in 10% of the CWC group we found viral infection (hMPV, Adenovirus and RV), 50% had Streptococcus pneumoniae and the rest 40% - polymicrobial etiology incl. S.aureus, H.influenzae, S. pyogenes, E.aerogenes. Conclusion: For immunocompetent children outside winter seasons the most common infectious cough triggers are M.catarrhalis, S.pneumoniae, hRV, RSV and Adenoviruses. Acknowledgement: This work was supported by grants from the Medical University of Sofia (Council of Medical Science, project no. 7770/2017, grant no. 106/2018and project no. 7771/2017, grant no. 107/2018).

Keywords: chronic wet cough, bronchial asthma, immunocompetent children