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

Authors

  • María Becerra Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú. Médico pediatra
  • Victor Fiestas Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú. médico infectólogo http://orcid.org/0000-0002-5554-3542
  • José Tantaleán Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú. Universidad Nacional Federico Villarreal. Lima, Perú. Médico pediatra
  • Gabriela Mallma Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú. fisioterapista cardiorrespiratório
  • Margarita Alvarado Unidad de Cuidados Intensivos Pediátricos, Instituto Nacional de Salud del Niño. Lima, Perú. enfermera
  • Victoria Gutiérrez Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú. bióloga
  • Maribel Huaringa Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú. tecnólogo médico
  • Nancy Rojas Centro Nacional de Salud Pública, Instituto Nacional de Salud. Lima, Perú. bióloga

DOI:

https://doi.org/10.17843/rpmesp.2019.362.4081

Keywords:

Human Respiratory Syncytial Virus, Real-Time Polymerase chain reaction, Pediatric Intensive Care Units, Peru

Abstract

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.

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Published

2019-06-28

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Section

Original Article

How to Cite

1.
Becerra M, Fiestas V, Tantaleán J, Mallma G, Alvarado M, Gutiérrez V, et al. Viral etiology of severe acute respiratory infections in a pediatric intensive care unit. Rev Peru Med Exp Salud Publica [Internet]. 2019 Jun. 28 [cited 2024 Apr. 14];36(2):231-8. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/4081

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