Viral pathogens associated with acute respiratory illness in hospitalized adults and elderly from Zagreb, Croatia, 2016 to 2018.
AIMS
To investigate the viral etiology of acute respiratory infection (ARI) in hospitalized adults and elderly patients in Croatia, compare the prevalence of detected viruses, and to determine clinical characteristics and seasonal occurrence of investigated infections.


METHODS
From January 2016 to June 2018, a total of 182 adult patients presented with symptoms of ARI and admitted to the hospital were tested for 15 respiratory viruses by multiplex reverse-transcription polymerase chain reaction. Clinical data were collected by retrospective analysis of the patient's chart.


RESULTS
A virus was identified in 106 (58.5%) of the patients. The most commonly detected virus was influenza virus (41.5%), followed by respiratory syncytial virus (13.8%), human metapneumovirus (13.0%), parainfluenza viruses (12.2%), rhinoviruses (11.4%), adenovirus and coronaviruses with equal frequencies (3.3%), and enterovirus (1.6%). The serum level of C-reactive protein and white blood cell count were significantly lower in patients with respiratory viruses identified when compared with those in whom no virus was detected (P < 0.001 and P = 0.007, respectively). There were no differences in clinical symptoms according to the type of the detected virus, except for more frequent illness exposure recall for influenza infection ( P = 0.010). Influenza, parainfluenza, and pneumoviruses were detected mostly in winter months, while rhinoviruses in autumn and spring.


CONCLUSIONS
In addition to influenza, pneumoviruses, rhinoviruses, and parainfluenza viruses play an important role in etiology of ARIs in adults. Fast and accurate laboratory diagnosis for respiratory viruses in routine practice is needed for clinicians optimally manage patients with ARI and potentially avoid the unnecessary use of antimicrobial drugs.
['Civljak|Rok|R|', 'Tot|Tatjana|T|', 'Falsey|Ann R|AR|0000-0002-7141-9701', 'Huljev|Eva|E|', 'Vranes|Jasmina|J|', 'Ljubin-Sternak|Suncanica|S|0000-0002-6405-6922']
D000208:Acute Disease D000328:Adult D000368:Aged D000369:Aged, 80 and over D017523:Croatia D005260:Female D006760:Hospitalization D006801:Humans D008297:Male D008875:Middle Aged D015995:Prevalence D012141:Respiratory Tract Infections D012189:Retrospective Studies D012621:Seasons D014780:Viruses D055815:Young Adult
multiplex reverse-transcription polymerase chain reaction influenza respiratory syncytial virus human metapneumovirus