Etiology and Risk Factors for Admission to the Pediatric Intensive Care Unit in Children With Encephalitis in a Developing Country.

Autor:	Guerrero MP; From the Department of Pediatrics, Universidad del Valle, Cali, Colombia., Romero AF; Department of Pediatrics, Hospital Universitario de Neiva, Huila, Colombia.; Department of Pediatrics, Universidad Surcolombiana, Neiva, Colombia., Luengas M; Department of Pediatrics, Infectious Diseases Unit, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia.; Department of Pediatrics, Hospital Militar Central, Bogotá, Colombia., Dávalos DM; Centro de Estudios en Infectología Pediátrica, Cali, Colombia.; Department of Public Health, Universidad Icesi, Cali, Colombia., Mesa-Monsalve JG; Department of Pediatrics, Clínica Las Américas Auna, Medellín, Colombia., Vivas-Trochez R; Department of Pediatrics, Clínica SOMA, Universidad Cooperativa de Colombia, Medellín, Colombia., Camacho-Moreno G; Department of Pediatrics, Infectious Diseases Unit, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia., Trujillo-Valencia M; Department of Pediatrics, Hospital Pablo Tobón Uribe, Medellín, Colombia.; Universidad CES, Medellín, Colombia.; Universidad Pontificia Bolivariana, Medellín, Colombia., Giraldo JPC; Centro de Estudios en Infectología Pediátrica, Cali, Colombia.; Department of Pediatrics, Universidad del Quindío, Armenia, Colombia., Mejía LF; Department of Pediatrics, Fundación Clínica Infantil Club Noel, Cali, Colombia., Rojas-Hernández JP; From the Department of Pediatrics, Universidad del Valle, Cali, Colombia.; Department of Pediatrics, Fundación Clínica Infantil Club Noel, Cali, Colombia.; Universidad Libre, Cali, Colombia., Vinasco N; Universidad Libre, Cali, Colombia., Racines AR; Universidad Libre, Cali, Colombia., Meléndez A; Universidad Libre, Cali, Colombia., Beltrán CP; Department of Pediatrics, Universidad de Antioquia, Clínica el Rosario, Clínica del Prado, Medellín, Colombia., López P; From the Department of Pediatrics, Universidad del Valle, Cali, Colombia.; Centro de Estudios en Infectología Pediátrica, Cali, Colombia., Chaucanez Y; Department of Pediatrics, Hospital Infantil Los Ángeles, Pasto, Colombia., Patiño J; Department of Pediatrics, Fundación Valle del Lili, Cali, Colombia., Rodríguez WC; Department of Pediatrics, Hospital Infantil Napoleón Franco Pareja, Universidad de Cartagena, Cartagena, Colombia., Salgado D; Department of Pediatrics, Hospital Universitario de Neiva, Huila, Colombia., Martínez M; Department of Pediatrics, Hospital Universitario de Neiva, Huila, Colombia., Restrepo A; Department of Pediatrics, Infectious Diseases Unit, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia., Márquez K; Department of Pediatrics, Infectious Diseases Unit, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia., Galvis D; Department of Pediatrics, Infectious Diseases Unit, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia., Benavidez I; From the Department of Pediatrics, Universidad del Valle, Cali, Colombia., Rojas CA; From the Department of Pediatrics, Universidad del Valle, Cali, Colombia., Cantor E; Centro de Estudios en Infectología Pediátrica, Cali, Colombia.; Universidad de Valparaíso, Valparaíso, Chile., López Medina E; From the Department of Pediatrics, Universidad del Valle, Cali, Colombia.; Centro de Estudios en Infectología Pediátrica, Cali, Colombia.; Clínica Imbanaco, Grupo Quirón Salud, Cali, Colombia.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2022 Oct 01; Vol. 41 (10), pp. 806-812. Date of Electronic Publication: 2022 Jul 14.
DOI:	10.1097/INF.0000000000003637
Abstrakt:	Objective: To describe a cohort of pediatric patients with encephalitis and their risk factors for admission to the pediatric intensive care unit (PICU). Study Design: Children (<18 years old), with encephalitis evaluated by conventional microbiology and syndromic, multiplex test in cerebrospinal fluid (CSF) between July 2017 and July 2020, were recruited from 14 hospitals that comprise the Colombian Network of Encephalitis in Pediatrics. Multivariate analyses were used to evaluate risk factors associated with the need for PICU admission. Results: Two hundred two children were included, of which 134 (66.3%) were male. The median age was 23 months (IQR 5.7-73.2). The main etiologies were bacteria (n = 55, 27%), unspecified viral encephalitis (n = 44, 22%) and enteroviruses (n = 27, 13%), with variations according to age group. Seventy-eight patients (38.6%) required management in the PICU. In multivariate analysis, factors associated with admission to the PICU were the presence of generalized seizures (OR 2.73; 95% CI: 1.82-4.11), status epilepticus (OR 3.28; 95% CI: 2.32-4.62) and low leukocyte counts in the CSF (OR 2.86; 95% CI: 1.47-5.57). Compared with enterovirus, bacterial etiology (OR 7.50; 95% CI: 1.0-56.72), herpes simplex encephalitis (OR 11.81; 95% CI: 1.44-96.64), autoimmune encephalitis (OR 22.55; 95% CI: 3.68-138.16) and other viral infections (OR 5.83; 95% CI: 1.09-31.20) increased the risk of PICU admission. Conclusions: Data from this national collaborative network of pediatric patients with encephalitis allow early identification of children at risk of needing advanced care and can guide the risk stratification of admission to the PICU. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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