Document Detail


Community-acquired respiratory infections in young children with congenital heart diseases in the palivizumab era: the Spanish 4-season civic epidemiologic study.
MedLine Citation:
PMID:  20686437     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: 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.
PATIENTS AND METHODS: Prospective, multicenter, epidemiologic study conducted in 57 Spanish hospitals covering four 7-month seasons (2004-2008).
RESULTS: 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 siblings <11 years of age. Pediatric intensive care unit care was required in 21.8% of the admissions and 9 patients (0.34%) died.
CONCLUSIONS: 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.
Authors:
Constancio Medrano López; Luis García-Guereta;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  29     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1077-82     Citation Subset:  IM    
Affiliation:
Pediatric Cardiology Section, Hospital General Universitario Gregorio Marañón, Madrid, Spain. consmelu@yahoo.es
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Investigator
Investigator/Affiliation:
Constancio Medrano López / ; Fernando Ballesteros / ; Jaume Casaldaliga / ; Victorio Cuenca / ; Fuensanta Escudero / ; Lola García de la Calzada / ; Luis García-Guereta / ; Josefina Grueso / ; Beatriz Insa / ; Maite Luis / ; Fernando Rueda Núñez / ; Alberto Mendoza / ; M del Mar Rodríguez / ; Pedro Suárez / ; Concepción Quero / ; Julián Lirio / ; Elena Gómez / ; Fredy Prada Martínez / ; Francisco M Anaya / ; Patricia Aparicio / ; Julio Ardura Fernández / ; Sonia Arias / ; Ricardo del Alcazar / ; M del Mar Ballesteros / ; Juan Carretero / ; Susana Castro / ; Gabriel Cebria / ; Fernando Centeno Malfaz / ; Elena Coll / ; Rosa Collell / ; Natalia Cutillas / ; Eduardo Carbona / ; Juan J Díez Tomás / ; Gabriel Erdozaín / ; Juan F Exposito / ; Fernando García Alga / ; M Ángeles de la Fuente Sánchez / ; Eugenio Garrido Borreguero / ; Miguel A Granados Ruiz / ; Carmen Herrera del Rey / ; M Soledad Jiménez Casso / ; Bernardo López-Abel / ; Sabela Martínez / ; Carmen Olivera Avezuela / ; Ángeles Ortega / ; Alfonso Ortigado / ; Beatriz Picazo Angelin / ; Àngels Puigdevall / ; Agustín Romay / ; Carmen Ruiz-Berdejo Iznardi / ; Yolanda Ruiz del Prado / ; Rosa María Garrido Uriarte / ; Dolores Soriano / ; Silvia Teodoro / ; Ana Usano Carrasco / ; Fernando Vera Cristóbal / ; Mariano Vicente Cuevas / ; Marisa Antúnez / ; Félix Coserría Sánchez / ; M Clara Escobar / ; José M Galdeano / ; Esteban Pastor Menchaca / ; Ana Lázaro / ; María Duplá / ; Amparo Moya Bonora / ; Ana Cano / ; María Maravall Llagaria / ; Macarena Taguas Castaño / ; María Isabel Martínez / ; Jesús Fuentes / ; H Arquitecto Marcide / ; Javier Herrero / ; Ma Teresa Viadero / ; H Marqués de Valdecilla / ; Ma Ángeles Izquierdo / ; Javier Ayala Curiel / ; Dolores Soriano / ; Cristina Marimón / ; Begoña Manso / ; Hipólito Falcón González / ; Alicia Cajellón / ; Ángeles Ortega / ; Francesca Perin / ; Laura Moreno Galarraga / ; Carlos Briales Casero / ; Carolina Blanco / ; Adela Rodríguez Fernández / ; Ruth Solana García / ; Juan José Díaz Tomás / ; Gabriel Cebriá / ; Olga Domínguez García / ; Gema Íñigo Martín / ; Moisés Sorlí García / ; María Teresa Cortés Coto / ; Javier Pérez Lescure Picarzo / ; Sandra Villagrá / ; Ma del Mar Ballesteros García / ; Miguel Navalón Pérez / ; José Manuel Guía Torrent / ; Juana Ma Espín López / ; Carmen Ruiz-Berdejo Iznardi / ; Arantzazu González Marín / ; Raquel Merino Ingelmo / ; Ana Oliván Gallardo / ; Laura Oroz García / ; Mercedes Domínguez Cajal / ; Jesús García Pérez / ; Ma Ángeles Tejero / ; Ignacio Tejero Mateo / ; Ismael Martín / ; Eladio Ruiz / ; Gloria Vergara / ; Amparo Rubio / ; Maribel Serrano / ; Ana Reguillo / ; Jorge Colomer / ; Enrique Gil / ; Francisco Núñez / ; Beatriz Tomás / ; Teresa Cerdán / ; Gloria Muñoz / ; Amparo Sanchís / ; Raquel Simó / ; Antonio Sánchez / ; Elena Pérez Santaolalla / ; Belén Fernández Tudela / ; Bibiana Riaño / ; Francisco José Castro / ; Ma Victoria Pérez / ; Ma Teresa Bueno / ; Encarnación Montes Pecete / ; Rosa Baena Cortés / ; Mónica Fernández Espartero / ; Laura Cervantes Estévez / ; Susana Cobos Hinojal / ; Herminia Castro Pose / ; Dolores Pallares Moral / ; Paloma Milán del Bosch / ; Guadalupe Reguera Diez / ; Carmen Leiva / ; Ma José Sánchez Galindo / ; Pilar Pérez / ; Rosalía Líbano Murga / ; María José Puertas Martín / ; Cecilia Hernández Blanco / ; Gema Lucía Gracia Casado /

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