Community-acquired Respiratory Infections in Young Children With Congenital Heart Diseases in the Palivizumab Era
| Autor: | CONSTANCIO MEDRANO-LOPEZ, Rosa Collell Hernandez, Ruth Solana-Gracia, Maria Mar Ballesteros-García, Francesca Perin, Luis Garcia Guereta, Beatriz Insa, Fernando Centeno |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Microbiology (medical) Palivizumab medicine.medical_specialty Pediatrics Heart Diseases Antibodies Monoclonal Humanized Antiviral Agents Intensive care Epidemiology medicine Humans Respiratory Tract Infections Respiratory tract infections business.industry Incidence Incidence (epidemiology) Infant Newborn Antibodies Monoclonal Infant medicine.disease respiratory tract diseases Community-Acquired Infections Hospitalization Malnutrition Infectious Diseases medicine.anatomical_structure El Niño Spain Virus Diseases Pediatrics Perinatology and Child Health Female business medicine.drug Respiratory tract |
| Zdroj: | Pediatric Infectious Disease Journal. 29:1077-1082 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0b013e3181efdac5 |
| Popis: | To investigate the epidemiology of acute respiratory tract infections (ARIs) in children younger than 24 months old with hemodynamically significant congenital heart diseases. Primary aim: incidence of hospital admission due to ARI. Secondary aims: risk factors, etiologic agents, clinical outcomes, and usefulness of preventive measures.Prospective, multicenter, epidemiologic study conducted in 57 Spanish hospitals covering four 7-month seasons (2004-2008).A total of 2613 patients were eligible for the study. Three hundred fifty-four patients (13.5%) (95% confidence interval: 12.3-14.9) required a total of 453 hospital admissions. Clinical diagnoses: bronchiolitis (54.1%), upper respiratory tract infection (21%), pneumonia (19.9%), and others (17.4%). Median length of hospital stay: 7.0 days. No etiologic agent was identified in two-thirds of the patients. In the remaining patients either a single agent (26.8%) or polymicrobial infection (5%) was identified. Respiratory syncytial virus (RSV) was the agent that was most commonly found (3.8% specific hospitalization rate). Children receiving adequate RSV prophylaxis (90.5%) had a 58.2% (95% confidence interval: 37.6-78.3) reduction in RSV hospitalization. Risk factors for admission included malnourishment, infant age, male gender, chromosome alterations, wheezing, inadequate RSV prophylaxis fulfillment, and siblings11 years of age. Pediatric intensive care unit care was required in 21.8% of the admissions and 9 patients (0.34%) died.Hospital admission rate and severity of ARI remain as important issues in hemodynamically significant congenital heart disease patients. The strict fulfillment of prophylactic recommendations against RSV is the only protective factor that can be modulated to decrease the ARI hospital admission rate. |
| Databáze: | OpenAIRE |
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