Respiratory tract infections in children (literature review)

Authors

DOI:

https://doi.org/10.15574/SP.2025.8(152).6469

Keywords:

bronchitis, bronchiolitis, upper respiratory tract, lower respiratory tract, pneumonia

Abstract

Respiratory tract infections are among the most frequent disorders in the clinical practice of every pediatrician and pediatric otolaryngologist, and are also associated with significant morbidity and mortality. They are considered the second most important cause of death of children under the age of five and are the leading cause of global child mortality, which is an urgent problem for pediatrics and pediatric otolaryngology.

Aim - based on an analysis of modern literary data, systematize information about respiratory tract infections in the context of the characteristics of their manifestation and the severity of their course.

Data from the scientific literature on modern etiopathogenesis, problems of diagnosis and treatment of respiratory tract infections, their impact on the quality of life and burden on the health care system were analyzed.

In the world of modern ideas, respiratory tract infections are the most frequent disorders in the clinical practice of every pediatrician and pediatric otolaryngologist, and acute lower respiratory tract infections, such as pneumonia and bronchiolitis, are the main cause of morbidity and mortality among young children. They lead to serious medical costs, significantly affect the quality of life and require effective prevention strategies to reduce the burden on the health care system.

Conclusions. The analysis of modern literary sources showed that data on the characteristics of respiratory tract infections in children are insufficient due to the limited role of clinical, laboratory and radiological characteristics, which leads to multiple visits to the doctor and affects the quality of life. Acute respiratory tract infections lead to serious medical costs, and this economic burden tends to increase. In this regard, to reduce morbidity and mortality, recommendations on clinical management and diagnostic issues, research to identify epidemiological and clinical features, effective prevention strategies to reduce the burden on the health care system are needed.

The authors declare no conflict of interest.

References

Ameli F, Brocchetti F, Mignosi S, Tosca MA, Gallo F, Ciprandi G. (2020, Nov 10). Recurrent respiratory infections in children: a study in clinical practice. Acta Biomed. 91(4): e2020179. doi: 10.23750/abm.v91i4.8585. PMID: 33525273; PMCID: PMC7927520.

Basa M, Sovti A. (2022). Treatment of the most common respiratory infections in children. Arh. farm. 72: 275-299. https://doi.org/10.5937/arhfarm72-37857

Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C et al. (2011). The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. [Internet]. 53(7): e25-76. https://doi.org/10.1093/cid/cir531; PMid:21880587 PMCid:PMC7107838

Branche AR, Falsey AR. (2016). Parainfluenza virus infection. SeminRespirCrit Care Med. 37(4): 538-554. https://doi.org/10.1055/s-0036-1584798; PMid:27486735 PMCid:PMC7171724

Chang TH, Liu YC, Lin SR, Chiu PH, Chou CC et al. (2023, Aug). Clinical characteristics of hospitalized children with community-acquired pneumonia and respiratory infections: Using machine learning approaches to support pathogen prediction at admission. J Microbiol Immunol Infect. 56(4): 772-781. Epub 2023 May 1. PMID: 37246060. https://doi.org/10.1016/j.jmii.2023.04.011; PMid:37246060

Chen J, Hu P, Zhou T, Zheng T, Zhou L et al. (2018, Jul 5). Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009-2014. BMC Pediatr. 18(1): 216. https://doi.org/10.1186/s12887-018-1203-y; PMid:29976175 PMCid:PMC6034247

Cristiana M. (2020, Mar-Apr). Nascimento-Carvalho Community-acquired pneumonia among children: the latest evidence for an updated management. J Pediatr (Rio J). 96; Suppl 1: 29-38. https://doi.org/10.1016/j.jped.2019.08.003; PMid:31518547 PMCid:PMC7094337

De Maio F, Buonsenso D, Bianco DM, Giaimo M, Fosso B, Monzo FR et al. (2022, Mar 7). Comparative Fecal Microbiota Analysis of Infants With Acute Bronchiolitis Caused or Not Caused by Respiratory Syncytial Virus. Front Cell Infect Microbiol. 12: 815715. https://doi.org/10.3389/fcimb.2022.815715; PMid:35330643 PMCid:PMC8940166

Donà D, Luise D, Da Dalt L, Giaquinto C. (2017). Treatment of Community-Acquired Pneumonia: Are All Countries Treating Children in the Same Way? A Literature Review. Int J Pediatr. 2017: 4239268. Epub 2017 Nov 6. https://doi.org/10.1155/2017/4239268; PMid:29234355 PMCid:PMC5694995

El-Azami-El-Idrissi M, Lakhdar-Idrissi M, Chaouki S, Atmani S, Bouharrou A, Hida M. (2016, May 12). Pediatric recurrent respiratory tract infections: when and how to explore the immune system? (About 53 cases). Pan Afr Med J. 24: 53. https://doi.org/10.11604/pamj.2016.24.53.3481; PMid:27642394 PMCid:PMC5012823

Gao M, Yao X, Mao W, Shen C, Zhang Z, Huang Q et al. (2020, Aug 1). Etiological analysis of virus, mycoplasma pneumoniae and chlamydia pneumoniae in hospitalized children with acute respiratory infections in Huzhou. Virol J. 17(1): 119. https://doi.org/10.1186/s12985-020-01380-4; PMid:32738914 PMCid:PMC7395355

Ge X, Han Z, Chen H, Cheng J, Gao M, Sun H. (2015, Oct). Characterization of acute respiratory infections among 340 infants in Wuxi, Jiangsu Province. Ann Transl Med. 3(18): 264. doi: 10.3978/j.issn.2305-5839.2015.10.23. PMID: 26605310; PMCID: PMC4630556.

Gu YE, Park JY, Lee MK, Lim IS. (2020, Jan). Characteristics of human parainfluenza virus type 4 infection in hospitalized children in Korea. Pediatr Int. 62(1): 52-58. Epub 2020 Jan 19. https://doi.org/10.1111/ped.14049; PMid:31705838 PMCid:PMC7167709

Hooli S, King C, McCollum ED, Colbourn T, Lufesi N, Mwansambo C et al. (2023, Apr). In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset. Int J Infect Dis. 129: 240-250. https://doi.org/10.1016/j.ijid.2023.02.005; PMid:36805325 PMCid:PMC10017350

Howie SRC, Murdoch DR. (2019, Jan). Global childhood pneumonia: the good news, the bad news, and the way ahead. The Lancet Global Health. 7; 1: e4-e5. https://doi.org/10.1016/S2214-109X(18)30446-7; PMid:30497987

Jain S, Williams DJ, Arnold SR, Ampofo K, Bramley AM, Reed C et al. (2015, Feb 26). Community-Acquired Pneumonia Requiring Hospitalization among U.S. сhildren. N Engl J Med. 372(9): 835-845. https://doi.org/10.1056/NEJMoa1405870; PMid:25714161 PMCid:PMC4697461

Le Roux DM, Zar HJ. (2017). Community-acquired pneumonia in children - a changingspectrum of disease. PediatrRadiol. 47(11): 1392-1398. https://doi.org/10.1007/s00247-017-3827-8; PMid:29043417 PMCid:PMC5608782

Li Y, Johnson EK, Shi T, Campbell H, Chaves SS, Commaille-Chapus C et al. (2021, Feb). National burden estimates of hospitalisations for acute lower respiratory infections due to respiratory syncytial virus in young children in 2019 among 58 countries: a modelling study. Lancet Respir Med. 9(2): 175-185. Epub 2020 Sep 21. https://doi.org/10.1016/S2213-2600(20)30322-2; PMid:32971018

Li Y, WangX, BlauDM, CaballeroMT, FeikinDR, GillCJetal. (2022, May 28). Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 399(10340): 2047-2064. Epub 2022 May 19. https://doi.org/10.1016/S0140-6736(22)00478-0; PMid:35598608 PMCid:PMC7613574

Mancinelli L, Onori M, Concato C, Sorge R, Chiavelli S, Coltella L et al. (2016, Jan 8). Clinical features of children hospitalized with influenza A and B infections during the 2012-2013 influenza season in Italy. BMC Infect Dis. 16: 6. https://doi.org/10.1186/s12879-015-1333-x; PMid:26743673 PMCid:PMC4705698

Marengo RL, Ciceran A, Del Río Navarro BE. (2017). Upper respiratory tract infections in children and adults: burden and management. J Respir. 5; Suppl 14: 22-28. https://doi.org/10.33590/emjrespir/10313231

McAllister DA, Liu L, Shi T, Chu Y, Reed C, Burrows J et al. (2019, Jan). Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis. Lancet Glob Health. 7(1): e47-e57. Epub 2018 Nov 26. https://doi.org/10.1016/S2214-109X(18)30408-X; PMid:30497986 PMCid:PMC6293057

Neves JF. (2024). Expert Perspectives on Safeguarding Infants and Children from Respiratory Syncytial Virus. EMJ Respir. 12; Suppl 1: 2-5. doi: 10.33590/emjrespir/10306329.

Oumei H, Xuefeng W, Jianping L, Kunling S, Rong M, Zhenze C et al. (2018, Mar). Etiology of community-acquired pneumonia in 1500 hospitalized children. J Med Virol. 90(3): 421-428. Epub 2017 Nov 9. https://doi.org/10.1002/jmv.24963; PMid:28975629 PMCid:PMC7166354

Roh EJ, Lee MH, Lee JY, Kim HB, Ahn YM, Kim JK et al. (2022, Apr 4). Analysis of national surveillance of respiratory pathogens for community-acquired pneumonia in children and adolescents. BMC Infect Dis. 22(1): 330. https://doi.org/10.1186/s12879-022-07263-z; PMid:35379181 PMCid:PMC8977558

Schaad UB, Esposito S, Razi CH. (2015). Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide. Archives of Pediatric Infectious Diseases [Internet]. 4(1): e31039. https://doi.org/10.5812/pedinfect.31039

Scheltema NM, Gentile A, Lucion F, Nokes DJ, Munywoki PK, Madhi SA et al. (2017). Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series. Lancet Glob Health [Internet]. 5(10): e984-e991. doi: 10.1016 / S2214-109X (17) 30344-3.

Su M, Wang Q, Li D, Wang LL, Wang CY, Wang JL et al. (2021, Feb 5). Prevalence and clinical characteristics of hospitalized children with community-acquired Mycoplasma pneumoniae pneumonia during 2017/2018, Chengde, China. Medicine (Baltimore). 100(5): e23786. https://doi.org/10.1097/MD.0000000000023786; PMid:33592835 PMCid:PMC7870167

Tabatabai J, Ihling CM, Manuel B, Rehbein RM, Schnee SV, Hoos J et al.(2023, Mar 1). Viral Etiology and Clinical Characteristics of Acute Respiratory Tract Infections in Hospitalized Children in Southern Germany (2014-2018). Open Forum Infect Dis. 10(3): ofad110. https://doi.org/10.1093/ofid/ofad110; PMid:36968956 PMCid:PMC10034757

Wang X, Li Y, Deloria-Knoll M, Madhi SA, Cohen C, Ali A. (2021, Jan). Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018: a systematic review and modelling study. Lancet Glob Health. 9(1): e33-e43. Epub 2020 Nov 26. https://doi.org/10.1016/S2214-109X(20)30393-4; PMid:33248481 PMCid:PMC7783516

Wanlapakorn N, Thongpan I, Sarawanangkoor N, Vichaiwattana P, Auphimai C, Srimuan D et al.(2023, Nov 13). Epidemiology and clinical characteristics of severe acute respiratory infections among hospitalized children under 5 years of age in a tertiary care center in Bangkok, Thailand, 2019-2020. Heliyon. 9(11): e22300. https://doi.org/10.1016/j.heliyon.2023.e22300; PMid:38045212 PMCid:PMC10692904

Wilkes C, Bava M, Graham HR, Duke T; ARI Review group. (2023, Feb 24). What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review. J Glob Health. 13: 05003. https://doi.org/10.7189/jogh.13.05003; PMid:36825608 PMCid:PMC9951126

Zou S, Mohtar SH, Othman R, Hassan RM, Liang K et al. (2024, Jan 2). Platelet distribution width as an useful indicator of influenza severity in children. BMC Infect Dis. 24(1): 9. https://doi.org/10.1186/s12879-023-08890-w; PMid:38166827 PMCid:PMC10759456

Published

2025-12-28