Viral–bacterial codetection and clinical and laboratory characteristics in children hospitalized with lower respiratory tract infections in a private hospital in Lima, Peru: a cross-sectional study

BACKGROUND: Viral-bacterial codetection is common and may increase clinical severity, but evidence in the Peruvian pediatric population is limited. The objective of the present study was to evaluate the clinical, laboratory, and seasonal characteristics associated with viral-bacterial codetection in children hospitalized for lower respiratory tract infections (LRTIs). METHODS: Cross-sectional secondary database study from a private hospital in Lima, Peru. We included patients < 13 years hospitalized for LRTIs with RT-qPCR results for respiratory viruses and/or bacteria. Viral-bacterial codetection was compared against other detection patterns using Poisson regression for binary outcomes and linear regression for continuous outcomes, with false discovery rate (FDR) correction for multiple comparisons. RESULTS: A total of 548 patients were included (median age 2.0 years; 50.5% female). Viral-bacterial codetection was identified in 21.5% of patients (n = 118), with RSV + Haemophilus influenzae being the most frequent combination. Compared with other detection patterns, viral-bacterial codetection was significantly associated with a higher prevalence of crackles (aPR: 1.30; 95% CI: 1.08-1.57), lower oxygen saturation at admission (β: -0.57; 95% CI: -1.04 to - 0.10), higher platelet counts (β: 30,452; 95% CI: 5,113-55,792), higher hemoglobin levels (β: 0.29 g/dL; 95% CI: 0.03-0.56), and longer hospital stay (β: 0.66 days; 95% CI: 0.02-1.29). However, after FDR correction for multiple comparisons, none of these associations reached statistical significance (q-values: 0.056-0.113). No difference was detected according to seasonality. CONCLUSIONS: Viral-bacterial codetection was common and was associated with crackles, lower oxygen saturation, longer hospital stay, and higher platelet counts; however, after FDR correction, none of these associations remained statistically significant, underscoring the exploratory nature of these findings and the need for larger, confirmatory studies.