{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:43:43Z","timestamp":1791434623245,"version":"4.3.3"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Rhinovirus (RV) is often detected in children hospitalized with pneumonia, but the role of RV in causing pneumonia is still unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>White blood cell count, C-reactive protein, procalcitonin, and myxovirus resistance protein A (MxA) levels were determined from blood samples in children (<jats:italic>n<\/jats:italic>\u2009=\u200924) hospitalized with radiologically verified pneumonia. Respiratory viruses were identified from nasal swabs by using reverse transcription polymerase chain reaction assays. Among RV-positive children, the cycle threshold value, RV subtyping by sequence analysis, and the clearance of RV by weekly nasal swabs were determined. RV-positive children with pneumonia were compared to other virus-positive children with pneumonia, and to children (<jats:italic>n<\/jats:italic>\u2009=\u200913) with RV-positive upper respiratory tract infection from a separate earlier study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RV was detected in 6 children and other viruses in 10 children with pneumonia (viral co-detections excluded). All RV-positive children with pneumonia had high white blood cell counts, plasma C-reactive protein or procalcitonin levels, or alveolar changes in chest radiograph strongly indicating bacterial infection. The median cycle threshold value for RV was low (23.2) indicating a high RV load, and a rapid clearance of RV was observed in all. Blood level of viral biomarker MxA was lower among RV-positive children with pneumonia (median 100\u2005\u03bcg\/L) than among other virus-positive children with pneumonia (median 495\u2005\u03bcg\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.034) or children with RV-positive upper respiratory tract infection (median 620\u2005\u03bcg\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our observations suggest a true viral-bacterial coinfection in RV-positive pneumonia. Low MxA levels in RV-associated pneumonia need further studies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1137777","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T05:00:33Z","timestamp":1678856433000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Biomarkers of viral and bacterial infection in rhinovirus pneumonia"],"prefix":"10.3389","volume":"11","author":[{"given":"Maria","family":"Hartiala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Lahti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Toivonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Waris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Ruuskanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ville","family":"Peltola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1111\/resp.12472","article-title":"Incidence of viral infection detected by PCR and real-time PCR in childhood community-acquired pneumonia: a meta-analysis","volume":"20","author":"Wang","year":"2015","journal-title":"Respirology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1831","DOI":"10.1002\/jmv.21590","article-title":"Rhinovirus infections in children: a retrospective and prospective hospital-based study","volume":"81","author":"Peltola","year":"2009","journal-title":"J Med Virol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1016\/S0140-6736(10)61459-6","article-title":"Viral pneumonia","volume":"377","author":"Ruuskanen","year":"2011","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1111\/j.1651-2227.2010.01924.x","article-title":"Community-acquired pneumonia in children: what's old? 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