Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017

IntroductionThe burden of morbidity and mortality of severe respiratory illness (SRI) remains disproportionately high among young children, and in low-and middle-income countries. We used a multi-pathogen respiratory PCR assay to detect pathogens in children aged &lt;5 years hospitalized with SR...

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Main Authors: Malefu Moleleki, Cayla Reddy, Kedibone Ndlangisa, Mignon du Plessis, Orienka Hellferscee, Omphe Mekgoe, Sibongile Walaza, Stefano Tempia, Cheryl Cohen, Anne von Gottberg, Nicole Wolter
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Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1498197/full
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author Malefu Moleleki
Malefu Moleleki
Cayla Reddy
Cayla Reddy
Kedibone Ndlangisa
Kedibone Ndlangisa
Mignon du Plessis
Mignon du Plessis
Orienka Hellferscee
Orienka Hellferscee
Omphe Mekgoe
Sibongile Walaza
Sibongile Walaza
Stefano Tempia
Stefano Tempia
Stefano Tempia
Cheryl Cohen
Cheryl Cohen
Anne von Gottberg
Anne von Gottberg
Nicole Wolter
Nicole Wolter
author_facet Malefu Moleleki
Malefu Moleleki
Cayla Reddy
Cayla Reddy
Kedibone Ndlangisa
Kedibone Ndlangisa
Mignon du Plessis
Mignon du Plessis
Orienka Hellferscee
Orienka Hellferscee
Omphe Mekgoe
Sibongile Walaza
Sibongile Walaza
Stefano Tempia
Stefano Tempia
Stefano Tempia
Cheryl Cohen
Cheryl Cohen
Anne von Gottberg
Anne von Gottberg
Nicole Wolter
Nicole Wolter
author_sort Malefu Moleleki
collection DOAJ
description IntroductionThe burden of morbidity and mortality of severe respiratory illness (SRI) remains disproportionately high among young children, and in low-and middle-income countries. We used a multi-pathogen respiratory PCR assay to detect pathogens in children aged &lt;5 years hospitalized with SRI.MethodsProspective syndromic surveillance for SRI was performed at two sentinel hospitals in South Africa between January and December 2017. Nasopharyngeal aspirates and sputa were collected and tested using a real-time polymerase chain reaction based TaqMan Array Card (TAC) for the detection of 21 respiratory pathogens. Pathogen detection was compared by age group using the chi-squared test and seasonal frequency analysed.ResultsFrom January through December 2017, 361 children were enrolled and of these, 198 cases with sufficient specimen volume were included in this study. Overall, 189/198 (95%) of the children tested positive for at least one pathogen. Common viruses identified included rhinovirus (65/198; 33%), respiratory syncytial virus (RSV) (54/198; 27%), adenovirus (34/198; 17%), and enterovirus (28/198; 14%). Common bacteria detected included Haemophilus influenzae (121/198; 61%), Streptococcus pneumoniae (114/198; 58%), Klebsiella pneumoniae (61/198; 31%), Staphylococcus aureus (52/198; 26%), and Acinetobacter baumannii (27/198; 14%).DiscussionBacterial detections were high in our study driven by the high detection of S. pneumoniae and H. influenzae. Co-detections of pathogens were common and require clinical evaluation to determine their relevance in clinical management. Further, given the high prevalence of RSV amongst children hospitalized with SRI, there is an urgent need for continued efforts towards access to maternal RSV vaccines and therapeutic interventions such as monoclonal antibodies particularly in low- and middle-income countries which experience the highest burden of RSV-associated disease.
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spelling doaj-art-7a1e093afb9e4d3eb62c557d2e35b7f22025-08-20T03:24:47ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-06-011310.3389/fped.2025.14981971498197Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017Malefu Moleleki0Malefu Moleleki1Cayla Reddy2Cayla Reddy3Kedibone Ndlangisa4Kedibone Ndlangisa5Mignon du Plessis6Mignon du Plessis7Orienka Hellferscee8Orienka Hellferscee9Omphe Mekgoe10Sibongile Walaza11Sibongile Walaza12Stefano Tempia13Stefano Tempia14Stefano Tempia15Cheryl Cohen16Cheryl Cohen17Anne von Gottberg18Anne von Gottberg19Nicole Wolter20Nicole Wolter21Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Medical Virology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaSchool of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaSchool of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaMassGenics, Duluth, GA, United StatesCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaSchool of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaIntroductionThe burden of morbidity and mortality of severe respiratory illness (SRI) remains disproportionately high among young children, and in low-and middle-income countries. We used a multi-pathogen respiratory PCR assay to detect pathogens in children aged &lt;5 years hospitalized with SRI.MethodsProspective syndromic surveillance for SRI was performed at two sentinel hospitals in South Africa between January and December 2017. Nasopharyngeal aspirates and sputa were collected and tested using a real-time polymerase chain reaction based TaqMan Array Card (TAC) for the detection of 21 respiratory pathogens. Pathogen detection was compared by age group using the chi-squared test and seasonal frequency analysed.ResultsFrom January through December 2017, 361 children were enrolled and of these, 198 cases with sufficient specimen volume were included in this study. Overall, 189/198 (95%) of the children tested positive for at least one pathogen. Common viruses identified included rhinovirus (65/198; 33%), respiratory syncytial virus (RSV) (54/198; 27%), adenovirus (34/198; 17%), and enterovirus (28/198; 14%). Common bacteria detected included Haemophilus influenzae (121/198; 61%), Streptococcus pneumoniae (114/198; 58%), Klebsiella pneumoniae (61/198; 31%), Staphylococcus aureus (52/198; 26%), and Acinetobacter baumannii (27/198; 14%).DiscussionBacterial detections were high in our study driven by the high detection of S. pneumoniae and H. influenzae. Co-detections of pathogens were common and require clinical evaluation to determine their relevance in clinical management. Further, given the high prevalence of RSV amongst children hospitalized with SRI, there is an urgent need for continued efforts towards access to maternal RSV vaccines and therapeutic interventions such as monoclonal antibodies particularly in low- and middle-income countries which experience the highest burden of RSV-associated disease.https://www.frontiersin.org/articles/10.3389/fped.2025.1498197/fullsevere respiratory illnesscommunity-acquired pneumoniaTaqMan Array Cardchildhood pneumoniaSouth Africarespiratory pathogens
spellingShingle Malefu Moleleki
Malefu Moleleki
Cayla Reddy
Cayla Reddy
Kedibone Ndlangisa
Kedibone Ndlangisa
Mignon du Plessis
Mignon du Plessis
Orienka Hellferscee
Orienka Hellferscee
Omphe Mekgoe
Sibongile Walaza
Sibongile Walaza
Stefano Tempia
Stefano Tempia
Stefano Tempia
Cheryl Cohen
Cheryl Cohen
Anne von Gottberg
Anne von Gottberg
Nicole Wolter
Nicole Wolter
Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017
Frontiers in Pediatrics
severe respiratory illness
community-acquired pneumonia
TaqMan Array Card
childhood pneumonia
South Africa
respiratory pathogens
title Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017
title_full Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017
title_fullStr Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017
title_full_unstemmed Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017
title_short Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017
title_sort respiratory pathogens detected in children aged 5 years hospitalized with severe respiratory illness south africa 2017
topic severe respiratory illness
community-acquired pneumonia
TaqMan Array Card
childhood pneumonia
South Africa
respiratory pathogens
url https://www.frontiersin.org/articles/10.3389/fped.2025.1498197/full
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