Etiology and severity of community acquired pneumonia in children from Uruguay: a 4-year study

Abstract

The 4-year study (1987-1990) covered the major clinical-epidemiological characteristics of pneumonia in children as diagnosed at the emergency service of the Children's Hospital, as well as etiologies, and factors involved in the most severe cases. Etiology was determined in 47.7% of the 541 pneumonia cases, involving 283 pathogens of which 38.6% were viruses and 12.6% bacteria. Viral and mixed etiologies were more frequent in children under 12 months of age. Bacteria predominated in ages between 6 and 23 months. Among the viruses, respiratory syncytial virus predominated (66%). The bacterial pneumonias accounted for 12.2% of the recognized etiologies. The most important bacterial agents were S. pneumoniae (64%) and H. influenzae (19%). H. influenzae and mixed infections had a relevant participation during the 1988 season, pointing to annual variations in the relative participation of pathogens and its possible implication in severity of diseases. Correlation of severity and increased percentage of etiological diagnosis was assessed: patients with respiratory rates over 70 rpm, or pleural effusion and/or extensive pulmonary parenchyma compromise yielded higher positive laboratory results. Various individual and family risk factors were recognized when comparing pneumonia children with healthy controls.

Parainfluenza Viruses

“…Recently, at least onethird of pneumonia hospitalizations have been in children with chronic diseases (115; Henrickson et al, submitted). Viruses have been shown to cause up to 90% of these LRI, especially in the first year (66,70,156,205,262,270), and this percentage decreases to approximately 50% by school age (70,173,205). After 9 to 10 years of age, viruses cause a decreasing but still significant amount of pneumonia in immunocompetent individuals.…”

Diagnóstico etiológico das pneumonias: uma visão crítica

“…Europa* Finlândia Estados Unidos (Uruguai) Hortal et al 51 Schaad et al 112 Juven et al 87 Wubbel 76 .…”

Abordagem hierarquizada para a identificação de fatores associados à hospitalização por pneumonia, em menores de cinco anos de idade: estudo caso-controle

“…A etiologia e a severidade da pneumonia, em crianças uruguaianas menores de cinco anos de idade, foram estudadas por Hortal et al (1994) 83), baixo peso (escore-z de peso para idade <-2) (OR=4,47) e infecção pelo HIV (OR=4,15) (JACKSON et al, 2013).…”

“…A idade materna de 20 ou mais anos pode reduzir entre 33% (OR=0,67) a 53% (OR=0,47) a chance de internação (NASCIMENTO et al, 2004;VICTORA et al, 1994), enquanto a idade de menos de 20 anos pode aumentar em 68% (OR=1,68) a 98% (OR=1,98) essa chance, bem como a idade acima de 44 anos (OR=5,38) (CESAR et al, 1997;HORTAL et al, 1994).…”

“…A falta de adesão ao pré-natal representa um expressivo incremento na chance de desenvolver pneumonia grave (OR=4,63) (HORTAL et al, 1994).…”