Infección respiratoria aguda viral en niños menores de 5 años. Estudio epidemiológico en dos centros de Buenos Aires, Argentina

Abstract

Arch Argent Pediatr 2011;109(4):296-304 / 296 RESUMEN Introducción. Las infecciones respiratorias agudas (IRA) son la mayor causa de hospitalización en edades extremas de la vida. Objetivos. Identificar los agentes etiológicos de IRA viral en niños < 5 años hospitalizados y ambulatorios; describir estacionalidad y caracterís-ticas clínico-epidemiológicas de la enfermedad. Población y métodos. Estudio descriptivo, transversal y multicéntrico en dos centros privados de Buenos Aires, en niños con IRA alta y baja. Se registraron antecedentes, cuadros clínicos y estudios virológicos. Resultados. Se estudiaron 347 pacientes: 235 hospitalizados; 112 ambulatorios. Los hospitalizados fueron menores que los ambulatorios (8 vs. 19 meses, p <0,001), presentaron más frecuentemente bronquiolitis (74% hospitalizados vs. 24% ambulatorios) y neumonía (14% hospitalizados vs. 5% ambulatorios). Solo la edad se asoció significativamente a hospitalización (p= 0,01). Se identificó etiología viral en 81% de los hospitalizados y 57% de los ambulatorios. El virus más frecuente fue rinovirus seguido por virus respiratorio sincicial. Se observó circulación viral durante todo el año, especialmente en otoño e invierno. En pacientes hospitalizados, la mediana de hospitalización fue 3,5 días. Requirieron cuidados intensivos 25 (11%) pacientes, y 7 (3%) recibieron asistencia ventilatoria mecánica. No hubo letalidad. Conclusiones. Las técnicas de diagnóstico virológico permitieron identificar agentes etiológicos en la mayoría de los pacientes hospitalizados y en más de la mitad de los ambulatorios con IRA. La incorporación de RT-PCR para rinovirus, permitió la identificación de este agente etioló-gico. La circulación viral se observó a lo largo de todo el año. La bronquiolitis fue causa de internación en 174/201 (86,5%) niños con IRA y la neumonía en 33/39 (84,6%) niños. Palabras clave: virus respiratorios, infección respiratoria aguda, bronquiolitis, RT-PCR, rinovirus. SUMMARY Introduction. Acute respiratory infections (ARI)are a major cause of hospitalization particularly at the extreme ages of life. Objectives. To determine the viral diagnosis in children < 5 years old with ARI, seasonality, clinical and epidemiological characteristics. Population and methods. A cross-sectional, descriptive and multicenter study was performed. Respiratory samples from patients with ARI hospitalized or outpatients with < 5 days of respiratory symptoms from June 2008 to May 2009 were studied for respiratory viruses. Clinical and demographic data were recorded. Results. A total of 347 patients were enrolled: 234 hospitalized and 112 outpatients. Hospitalized patients were younger compared with outpatients (8 vs. 19 months, p <0.001) and presented more frequently bronchiolitis (74% hospitalized vs. 24% outpatients) and pneumonia (14% hospitalized vs. 5% outpatients). Age was statistically associated with hospitalization (p= 0.01). Viral diagnosis was achieved in 81% hospitalized and 57% of outpatients. Rhinovirus was the most frequent followed by respiratory sync...

The role of rhinovirus in children hospitalized for acute respiratory disease, Santa Fe, Argentina

“…The months with the largest circulation of RSV (June 2010 and July 2010; data not shown) match those months where HRV was detected less frequently. Our findings are in line with observations in previous studies [Calvo Rey et al, ; Miller et al, ; Fry et al, ; Vidaurreta et al, ; Albuquerque et al, ; Bicer et al, ]. Differences are likely to exist in HRV seasonality depending on the year being surveyed.…”

“…Several research studies have measured HRV frequency in ARI hospitalized children, ranging from 16 to 57.8%. The 38.1% value from this study is within this range of values, considering PCR‐tested samples as a denominator [Calvo Rey et al, ; Miller et al, ; Fry et al, ; Iwane et al, ; Vidaurreta et al, ; Albuquerque et al, ; Huijskens et al, ; Marcone et al, ; Piñero Fernández et el., 2012; Bicer et al, ].…”

Prevalence and seasonality of viral respiratory infections in a temperate climate region: A 24‐year study (1997–2020)

“…The main differences with other reports are due to the different viruses evaluated, as not all include RV, EV, or herpes viruses 4,5,11 . As expected, our positivity rates are lower than in studies using molecular techniques, which are more sensitive and can identify a wider range of viruses than conventional methods 6,13,14,20–22 …”

“…The detection frequency of FLUAV and FLUBV also differed from the literature, as although infections caused by these viruses follow a yearly epidemical pattern, their intensity fluctuates 4,6,7,9,12 . Furthermore, some viruses were found in lower frequencies (especially hMPV, RV, EV, and some PIV) than in other studies using molecular methods 13,20–22 …”

“…The few long‐term studies on respiratory virus epidemiology published to date 4–9 show seasonal patterns of circulation in defined geographical areas. However, most reports cover shorter periods 10–14 . The epidemiological studies carried out in Spain are restricted to a few seasons, 15 certain viruses, 16 or particular groups of patients, 17 and to our knowledge, none have focused on the prevalence of several respiratory viruses within a broad population over a long period of time.…”