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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000313
Original Studies

Hospital Length-of-stay Is Associated With Rhinovirus Etiology of Bronchiolitis

Jartti, Tuomas MD*; Aakula, Matilda BM*; Mansbach, Jonathan M. MD, MPH; Piedra, Pedro A. MD; Bergroth, Eija MD§; Koponen, Petri MD; Kivistö, Juho E. MD¶**; Sullivan, Ashley F. MS, MPH; Espinola, Janice A. MPH; Remes, Sami MD§; Korppi, Matti MD; Camargo, Carlos A. Jr. MD, DrPH

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Objective: To determine whether hospital length-of-stay (LOS) for bronchiolitis is influenced by the causative virus: respiratory syncytial virus (RSV) or rhinovirus.

Methods: This prospective study was carried out in 3 university hospitals in Finland during 2 consecutive winter seasons. We enrolled consecutive children <2 years of age hospitalized with an attending physician’s diagnosis of bronchiolitis. All enrolled children were included in the primary analysis. A parallel analysis was also conducted using a stricter definition for bronchiolitis (age <12 months and no history of wheeze). Polymerase chain reaction was used to test the nasopharyngeal aspirate samples for multiple respiratory pathogens.

Results: The median age of the 408 children was 8 months, 73% had no history of wheeze and their median hospital LOS was 2 days. 144 (35%) children had RSV only and 92 (23%) children rhinovirus only infections. Children with rhinovirus only had shorter duration of prehospital symptoms, higher disease severity score at entry and more often a history of wheezing (all P ≤ 0.001). Controlling for 7 demographic and clinical characteristics, those with rhinovirus only had shorter hospital LOS when compared with children with RSV only (adjusted odds ratio: 0.45; 95% confidence interval: 0.22–0.92; P = 0.03). The rhinovirus only finding was similar in the subset of 206 children with stricter diagnosis (adjusted odds ratio: 0.30; 0.06–1.49; P = 0.14).

Conclusions: Hospital LOS is associated with rhinovirus etiology of bronchiolitis. Our data call attention to the importance of both RSV and rhinovirus testing in clinical research.

© 2014 by Lippincott Williams & Wilkins, Inc.


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