Pertussis predictors in hospitalized infants with acute lower respiratory tract infection

Background. Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains d...

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Autores principales: Laura, Moreno, Montanaro, Patricia, Bujedo, Elizabeth, Cámara, Jorge, Abilar, C., Terzoni, M., Romano, M., Inés, Marqués, Quiroga, Daniel, Orecchini, Alejandra, Jacome, Javier, Ferrero, Fernando
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2013
Materias:
coqueluche
RSV
infección respiratoria aguda
linfocitos
pertussis
acute respiratory infection
lymphocytes
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/20233
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-20233
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic coqueluche
RSV
infección respiratoria aguda
linfocitos
pertussis
RSV
acute respiratory infection
lymphocytes
spellingShingle coqueluche
RSV
infección respiratoria aguda
linfocitos
pertussis
RSV
acute respiratory infection
lymphocytes
Laura, Moreno
Montanaro, Patricia
Bujedo, Elizabeth
Cámara, Jorge
Abilar, C.
Terzoni, M.
Romano, M.
Inés, Marqués
Quiroga, Daniel
Orecchini, Alejandra
Jacome, Javier
Ferrero, Fernando
Pertussis predictors in hospitalized infants with acute lower respiratory tract infection
topic_facet coqueluche
RSV
infección respiratoria aguda
linfocitos
pertussis
RSV
acute respiratory infection
lymphocytes
author Laura, Moreno
Montanaro, Patricia
Bujedo, Elizabeth
Cámara, Jorge
Abilar, C.
Terzoni, M.
Romano, M.
Inés, Marqués
Quiroga, Daniel
Orecchini, Alejandra
Jacome, Javier
Ferrero, Fernando
author_facet Laura, Moreno
Montanaro, Patricia
Bujedo, Elizabeth
Cámara, Jorge
Abilar, C.
Terzoni, M.
Romano, M.
Inés, Marqués
Quiroga, Daniel
Orecchini, Alejandra
Jacome, Javier
Ferrero, Fernando
author_sort Laura, Moreno
title Pertussis predictors in hospitalized infants with acute lower respiratory tract infection
title_short Pertussis predictors in hospitalized infants with acute lower respiratory tract infection
title_full Pertussis predictors in hospitalized infants with acute lower respiratory tract infection
title_fullStr Pertussis predictors in hospitalized infants with acute lower respiratory tract infection
title_full_unstemmed Pertussis predictors in hospitalized infants with acute lower respiratory tract infection
title_sort pertussis predictors in hospitalized infants with acute lower respiratory tract infection
description Background. Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination.Objective. Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction.Materials and methods. Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was  comparaperformed by calculating OR with 95% CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential.Results. We included 174 infants, 72 (41%) BP and 102 (59%) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87% vs. 6%, OR: 14.8 p <0.01), apnea (38% vs. 3%, OR: 13.4 p <0.01) and vomiting (26% vs. 5% , OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95% CI :0,64-0, 81).Conclusions. In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2013
url https://revistas.unc.edu.ar/index.php/med/article/view/20233
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last_indexed 2024-09-03T20:59:26Z
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spelling I10-R327-article-202332024-08-27T18:22:11Z Pertussis predictors in hospitalized infants with acute lower respiratory tract infection Predictores de coqueluche al ingreso en lactantes hospitalizados con infección respiratoria aguda baja Laura, Moreno Montanaro, Patricia Bujedo, Elizabeth Cámara, Jorge Abilar, C. Terzoni, M. Romano, M. Inés, Marqués Quiroga, Daniel Orecchini, Alejandra Jacome, Javier Ferrero, Fernando coqueluche RSV infección respiratoria aguda linfocitos pertussis RSV acute respiratory infection lymphocytes Background. Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination.Objective. Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction.Materials and methods. Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was  comparaperformed by calculating OR with 95% CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential.Results. We included 174 infants, 72 (41%) BP and 102 (59%) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87% vs. 6%, OR: 14.8 p <0.01), apnea (38% vs. 3%, OR: 13.4 p <0.01) and vomiting (26% vs. 5% , OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95% CI :0,64-0, 81).Conclusions. In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections. Antecedentes. La tos ferina o coqueluche, producida por Bordetella pertussis (BP) representa un problema re-emergente en nuestro medio. Aunque suele considerarse que la enfermedad es relativamente fácil de identificar, las infecciones por Virus Respiratorio Sincicial (VRS) pueden presentarse con síntomas similares en los lactantes siendo difícil su discriminación.Objetivo. Comparar síntomas clínicos y estudios complementarios al ingreso en lactantes hospitalizados con infección respiratoria aguda (IRA) por BP y por VSR a fin de establecer marcadores que posibiliten su predicción clínica temprana.Material y método. Estudio observacional, analítico, transversal de casos cruzados, comparando menores de 6 meses internados por IRA y sospecha de coqueluche (2007-2012) en los que se identificó BP (PCR y cultivo) y/o VRS (inmunofluorescencia en secreciones nasales); se excluyeron los pacientes con coinfecciones.Se realizó un análisis bivariado mediante el cálculo de OR con IC95%. Se consideró significativo un valor de p<0,05. Las variables en estudio fueron: edad, sexo, tos en accesos, cianosis, vómitos, apneas, sibilancias y hemograma completo con fórmula leucocitaria.Resultados. Se incluyeron 174 lactantes; 72 (41%) BP y 102 (59%) VRS. Edad 2±1 mes (Rango:1-6). En ambos grupos se documentó tos y sibilancias (OR:1,2 (0,9-1,5) p:0,1 y OR:0,9 (0,8-1,06) p:0,2, respectivamente). Cianosis (87% vs. 6%;OR:14,8 p<0,01), apnea (38% vs. 3%;OR:13,4 p<0,01) y vómitos (26% vs. 5%;OR:3,4 p<0,01) fueron más frecuentes en lactantes con BP. El recuento absoluto de linfocitos fue significativamente mayor en niños con BP (9387±6317 vs. 5127±2766;p<0,01). Por curva ROC se identificó a 9000 cel/ml como el mejor punto para diferenciar BP de VSR (abc= 0,73; IC95%:0,64-0,81).Conclusiones. En lactantes menores de 6 meses con IRA la presencia al ingreso de apnea, cianosis y linfocitosis predicen significativamente coqueluche permitiendo diferenciarlos de aquellos con infecciones por VRS. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2013-06-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/20233 10.31053/1853.0605.v70.n2.20233 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 70 No. 2 (2013); 63-69 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 70 Núm. 2 (2013); 63-69 Revista da Faculdade de Ciências Médicas de Córdoba; v. 70 n. 2 (2013); 63-69 1853-0605 0014-6722 10.31053/1853.0605.v70.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/20233/19892 Derechos de autor 2013 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0

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