Risk Factors for Severe Bronchiolitis: A Retrospective Review of Patients Admitted to the University Hospital in Central Region of Slovenia

Background: Bronchiolitis is a potentially life-threatening respiratory infection that affects children. Viral infections of the lower respiratory tract represent a global problem.

Objective: The objective of our study was to determine the microbiological and clinical factors associated with the severity of bronchiolitis.

Methods: A retrospective chart review of children

Results: The study included 761 children. The most frequently detected viruses were respiratory syncytial virus (RSV), human rhinovirus (hRV) and human bocavirus (hBoV). Patient groups (PED, WARD, PICU) differed in Wang respiratory score for the severity of bronchiolitis (p<0.001). No statistically significant differences in causative viruses were found comparing the three groups. There was a significantly lower proportion of children with the presence of more than 1 virus in nasopharyngeal swab, in patients who needed treatment in PICU compared to PED and WARD groups (p = 0.017). The three groups statistically significantly differed in age and birth weight, proportion of patients with comorbidities, treatment with bronchodilator and use of antibiotics. However, multiple regression analysis revealed that only younger patient age and the use of antibiotics were associated with a more severe disease course.

Conclusion: RSV, hRV and hBoV were the most frequently detected viruses in our patients with bronchiolitis. The majority of bronchiolitis patients admitted to the PICU had only one virus detected. Younger age and the use of antibiotics were associated with a more severe course of the disease.