[Viral etiology of severe acute respiratory infections in a pediatric intensive care unit].

Autor: Becerra M; Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú., Fiestas V; Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú., Tantaleán J; Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú.; Universidad Nacional Federico Villarreal. Lima, Perú., Mallma G; Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú., Alvarado M; Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú., Gutiérrez V; Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú., Huaringa M; Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú., Rojas N; Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú.
Jazyk: Spanish; Castilian
Zdroj: Revista peruana de medicina experimental y salud publica [Rev Peru Med Exp Salud Publica] 2019 Apr-Jun; Vol. 36 (2), pp. 231-238. Date of Electronic Publication: 2019 Aug 22.
DOI: 10.17843/rpmesp.2019.362.4081
Abstrakt: Objectives.: To identify the main viral etiological agents in patients with severe acute respiratory infection (SARI) hospitalized in a Pediatric Intensive Care Unit (PICU) and to analyze their clinical characteristics.
Materials and Methods.: Prospective longitudinal study in children under five years of age hospitalized due to SARI at the PICU of t Instituto Nacional de Salud del Niño (National Children´s Hospital) in Lima, Peru. Real-time direct immunofluorescence and RT-PCR tests were performed for the diagnosis of respiratory viruses on tracheal aspirate or nasopharyngeal swab samples.
Results.: We included 117 patients. Median age was four months, 66% had comorbidity and 91% required mechanical ventilation. Respiratory virus monoinfection was identified in 47% and viral co-infection in 2.6%, with the respiratory syncytial virus subtype A (RSV-A) being the most frequent. The median length of hospitalization was 21 days and 20 (17%) patients died. An association was found between a history of chronic lung disease and RSV-A infection (p=0.045), and between Down syndrome and influenza A virus infection (p=0.01). After controlling for potential confounders, congenital heart disease (RR 3.1; 95% CI: 1.3-5.8, p=0.002) and nosocomial infection (RR 2.6; 95% CI: 1.0-5.3, p=0.01) were found to increase the risk of death in patients with SARI.
Conclusions.: RSV-A was the most common viral etiology in children under five hospitalized by SARI at the PICU. No association was found between viral infection and patient survival.
Databáze: MEDLINE
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