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1.
Rev. chil. infectol ; 37(4): 371-382, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138561

ABSTRACT

Resumen Introducción: Los niños que reciben trasplante de precursores hematopoyéticos (TPH) pueden presentar infecciones respiratorias virales (IRV) durante episodios febriles. Los datos sobre su evolución clínica son escasos, así como la comparación de ellos con infecciones bacterianas (IB). Objetivo: Caracterizar la evolución clínica de pacientes con IRV, en comparación con IB en niños con TPH, cursando un episodio febril. Método: Estudio prospectivo en pacientes ≤ 18 años con cáncer y TPH ingresados por fiebre en el Hospital Luis Calvo Mackenna (2016-2019). Se realizó evaluación clínica y de laboratorio: hemocultivos, RPC para patógenos respiratorios (Filmarray®), cuantificación viral y medición de citoquinas en muestra nasal (Luminex®, 38 citoquinas). Se compararon los grupos IRV, IB y los de etiología no precisada (ENP) en relación con: infección respiratoria aguda (IRA), citoquinas nasales, ingreso a UCI, necesidad de ventilación mecánica, mortalidad y suspensión de antimicrobianos. Resultados: De 56 episodios febriles, 35 fueron IRV, 12 IB y 9 de ENP. Mediana de edad fue 8,5 años, 62% masculino. Un 94% de los casos IRV presentó IRA sintomática, versus 33% en los grupos IB y ENP (p < 0,001), con IRA baja en 69% de las IRV (p < 0,001). Rinovirus (54%) y coronavirus (15%) fueron las etiologías más frecuentemente detectadas. No hubo diferencias en citoquinas nasales entre los grupos IRV e IB. Ingreso a UCI: 11% del grupo IRV, 17% de IB y 11% de ENP (p = 0,88). Requirieron ventilación mecánica sólo 2 pacientes (p = 0,37) sin fallecimiento. Tras la detección viral respiratoria por RPC, se suspendió antimicrobianos en 26% de los casos con IRV (p = 0,04). Conclusión: Las IRV son frecuentes en niños con TPH y episodios febriles. La detección viral podría optimizar y racionalizar el uso de antimicrobianos en esta población.


Abstract Background: Children undergoing hematopoietic stem cell transplant (HSCT) can develop respiratory viral infections (RVI) during fever episodes. There are few data about clinical outcomes in RVI and compared to bacterial infections (BI) in this population. Aim: To determine clinical outcome of RVI, compared to BI in children with HSCT. Methods: Prospective study, patients ≤ 18 years with cancer and HSCT admitted with fever at a National Bone Marrow Transplant Center (Hospital Calvo Mackenna), Chile, (April-2016 to May-2019). Clinical assessment, laboratory tests, blood cultures, nasopharyngeal sample for multiplex-PCR (Filmarray®), viral loads by PCR and cytokine panel (Luminex®, 38 cytokines) were performed. The following outcomes were evaluated: upper/lower respiratory tract disease (RTD), admission to ICU, mechanical ventilation, mortality and antimicrobial withdrawal. Results: Of 56 febrile episodes, 35 (63%) were RVI, 12 (21%) BI and 9 (16%) with unknown etiology (UE). Median of age was 8.5 years, 62% male gender. Rhinovirus (54%) and coronavirus (15%) were the more frequent detected viruses. No significant differences in cytokine levels were observed between RVI and BI. 94% of RVI patients had symptomatic RTD, versus 33% in BI and 33% in UE group (p < 0.001), with lower-RTD in 69% of RVI group (p < 0,001). Admission to ICU was 11% in RVI, 17% in BI and 11% in UE group (p = 0.88); only 2 patients required mechanical ventilation (p = 0.37) and no mortality was reported. After an RVI was detected by PCR, antimicrobials were withdrawal in 26% of patients with RVI (p: 0.04). Conclusion: RVI are frequent etiologic agents in febrile episodes of patients with HSCT. Viral detection might help to rationalize the use of antimicrobials in this population.


Subject(s)
Humans , Male , Female , Child , Respiratory Tract Infections/virology , Virus Diseases/diagnosis , Hematopoietic Stem Cell Transplantation/adverse effects , Fever/virology , Respiratory Tract Infections/diagnosis , Chile , Prospective Studies
2.
Arch. argent. pediatr ; 118(3): 193-201, jun. 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1104196

ABSTRACT

Introducción. La infección respiratoria aguda baja por adenovirus es una importante causa de morbimortalidad en niños. Objetivos: Describir el patrón clínico-epidemiológico y los factores asociados en niños hospitalizados.Métodos. Estudio transversal en niños ingresados por infección respiratoria aguda baja al Hospital de Niños Ricardo Gutiérrez, Buenos Aires, en 2000-2018. El diagnóstico viral se realizó mediante inmunofluorescencia indirecta en secreciones nasofaríngeas. Se compararon características clínico-epidemiológicas de infección por adenovirus con otros virus respiratorios (virus sincicial respiratorio, influenza y parainfluenza). Se utilizó regresión logística múltiple para identificar predictores independientes de infección.Resultados. De 16018 pacientes con infección respiratoria aguda baja, 13545 fueron testeados para virus respiratorios y 6047 (el 45 %) fueron positivos. Adenovirus fue el agente menos frecuente [el 4,4 % (265) de los casos]; presentó una tendencia en descenso durante todo el período estudiado (pico en 2003) y circuló durante todo el año (pico en julio). El 63,8 % eran varones; mediana de edad: 11 meses (rango intercuartílico: 6-20). La presentación clínica más frecuente fue neumonía (el 63 %). El 50 % tenía internaciones previas por causa respiratoria; el 15,6 % eran reingresos; el 58,3 % tenía comorbilidades. El 19,2 % requirió asistencia ventilatoria; el 44 %registró complicaciones. La letalidad fue del 7,7 %. La infección por adenovirus se asoció a edad ≥ 12 meses, sexo masculino, presentación clínica de neumonía, internaciones previas por causas respiratorias y reinternaciones.Conclusiones. Los adenovirus fueron detectados con menor frecuencia que los otros virus respiratorios, aunque presentaron un importante perfil de morbimortalidad


Introduction. Acute lower respiratory tract infection (ALRTI) caused by adenovirus is a major cause of morbidity and mortality in children.Objectives. To describe the clinical and epidemiological pattern and associated factors in hospitalized children.Methods. Cross-sectional study in children admitted due to ALRTI to Hospital de Niños "Ricardo Gutiérrez," in the Autonomous City of Buenos Aires, between 2000 and 2018. Viral diagnosis was done by indirect immunofluorescence in nasopharyngeal secretions. The clinical and epidemiological characteristics of adenovirus infection were compared to other respiratory viruses (respiratory syncytial virus, influenza, and parainfluenza). A multiple logistic regression was done to identify independent predictors of infection.Results. Out of 16 018 patients with ALRTI, 13 545 were tested for respiratory viruses; 6047 (45 %) had a positive result. Adenovirus was the least common agent (4.4 % [265] of cases); it tended towards a reduction over the study period (peak in 2003) and circulated throughout the year (peak in July). In total, 63.8 % of patients were males; median age: 11 months (interquartile range: 6-20). The most common clinical presentation was pneumonia (63 %). Prior admissions due to respiratory conditions were seen in 50 %; 15.6 %were readmissions; 58.3 % had comorbidities. Ventilatory support was required by 19.2 %and complications were recorded in 44 %. The fatality rate was 7.7 %. Adenovirus infection was associated with age ≥ 12 months, male sex, clinical presentation of pneumonia, prior admissions due to respiratory conditions, and readmissions.Conclusions. Adenoviruses were less common than other respiratory viruses, although their morbidity and mortality were important


Subject(s)
Humans , Male , Female , Infant , Respiratory Tract Infections/epidemiology , Adenoviridae Infections/epidemiology , Pneumonia , Respiratory Tract Infections/virology , Epidemiologic Studies , Child, Hospitalized , Cross-Sectional Studies , Adenoviridae Infections/diagnosis , Fluorescent Antibody Technique, Indirect
3.
Braz. j. infect. dis ; 24(1): 73-80, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089322

ABSTRACT

ABSTRACT Introduction Influenza is an important cause of morbimortality worldwide. Although people at the extremes of age have a greater risk of complications, influenza has been more frequently investigated in the elderly than in children, and inpatients than outpatients. Yearly vaccination with trivalent or quadrivalent vaccines is the main strategy to control influenza. Objectives Determine the clinical and molecular characteristics of influenza A and B infections in children and adolescents with influenza-like illness (ILI). Methods: A cohort of outpatient children and adolescents with ILI was followed for 20 months. Influenza was diagnosed with commercial multiplex PCR platforms. Results: 179 patients had 277 episodes of ILI, being 79 episodes of influenza A and 20 episodes of influenza B. Influenza A and B cases were mild and had similar presentation. Phylogenetic tree of influenza B viruses showed that 91.6% belonged to the B/Yamagata lineage, which is not included in trivalent vaccines. Conclusions: Influenza A and B are often detected in children and adolescents with ILI episodes, with similar and mild presentation in outpatients. The mismatch between the circulating influenza viruses and the trivalent vaccine offered in Brazil may have contributed to the high frequency of influenza A and B in this population.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Young Adult , Influenza A virus/genetics , Influenza B virus/genetics , Outpatients/statistics & numerical data , Influenza, Human/virology , Phylogeny , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Seasons , Time Factors , Brazil/epidemiology , Influenza Vaccines , Prospective Studies , Follow-Up Studies , Statistics, Nonparametric , Influenza, Human/prevention & control , Influenza, Human/epidemiology
4.
Ciênc. Saúde Colet ; 25(9): 3365-3376, Mar. 2020. tab, graf
Article in Portuguese | LILACS, ColecionaSUS, SES-SP | ID: biblio-1133166

ABSTRACT

Resumo O objetivo deste artigo é avaliar a eficácia das máscaras faciais padrão tecido não tecido (TNT) para a prevenção de doenças respiratórias (MERS CoV, SARS-CoV e SARS-CoV-2) na população. Foi realizada busca nas bases de dados Medline, Embase, Cinahl, The Cochrane Library, Trip. Também busca complementar no Google Acadêmico, Rayyan e medRxiv. Não foram aplicados filtros relacionados a data, idioma ou status de publicação. Títulos e resumos foram rastreados e, posteriormente, textos completos foram avaliados. Foram incluídos três estudos: um ensaio clínico randomizado tipo cluster e duas revisões sistemáticas. O ensaio clínico indica benefício potencial de máscaras médicas para controle da fonte de infecção, para a doença respiratória clínica. Em uma das revisões sistemáticas, não foi possível estabelecer relação conclusiva entre uso da máscara e proteção contra infecção respiratória. Por fim, outra revisão sistemática demonstrou que máscaras são eficazes na prevenção da propagação de vírus respiratórios. As evidências apontam para benefício potencial das máscaras faciais padrão TNT. Para o cenário atual de pandemia por COVID 19, recomenda-se educação sobre uso adequado de máscaras, associado a medidas individuais de proteção.


Abstract Objectives: to evaluate the effectiveness of non-woven face masks for the prevention of respiratory infections (MERS CoV, SARS-CoV, and SARS-CoV-2) in the population. Methods: search in Medline, Embase, Cinahl, The Cochrane Library, Trip databases. Google Scholar, Rayyan and medRxiv were also consulted for complementary results. No filters related to date, language or publication status were applied. Titles and abstracts were screened, and later, full texts were evaluated. Results: three studies were included: a randomized cluster clinical trial and two systematic reviews. The clinical trial indicates a potential benefit of medical masks to control the source of clinical respiratory disease infection. In one of the systematic reviews, it was not possible to establish a conclusive relationship between the use of the mask and protection against respiratory infection. Finally, another systematic review indicated that masks are effective in preventing the spread of respiratory viruses. Conclusion: Evidence points to the potential benefit of standard non-woven face masks. For the current pandemic scenario of COVID-19, education on the appropriate use of masks associated with individual protection measures is recommended.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Masks , Pneumonia, Viral/epidemiology , Respiratory Tract Infections/prevention & control , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Randomized Controlled Trials as Topic , Coronavirus Infections , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Severe Acute Respiratory Syndrome/prevention & control , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/virology , SARS Virus/isolation & purification , Middle East Respiratory Syndrome Coronavirus/isolation & purification , Betacoronavirus , Betacoronavirus/isolation & purification
5.
Mem. Inst. Oswaldo Cruz ; 115: e200009, 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1135259

ABSTRACT

BACKGROUND Influenza viral load (VL) can be a decisive factor in determining the antiviral efficacy in viral clearance. OBJECTIVE This study aimed to evaluate the rate of infection and the role of influenza VL on the clinical spectrum of illnesses among different patient groups attended at a tertiary hospital in Brazil. METHODS Samples were collected from patients presenting acute respiratory infection from 2009 to 2013. Overall, 2262 samples were analysed and distributed into three groups: (i) asymptomatic (AS); (ii) symptomatic outpatients (OP); and (iii) hospitalised patients (HP). VL (expressed in Log10 RNA copies/mL) was calculated through a quantitative real-time one-step reverse transcription-polymerase chain reaction (RT-PCR) assay aimed at the M gene, with human RNAseP target as internal control and normalising gene of threshold cycle values. FINDINGS A total of 162 (7.16%) H1N1pdm09 positive samples were analysed. Patients aged from 0.08 to 77 years old [median ± standard deviation (SD): 12.5 ± 20.54]. Children with 5 to 11 years old presented the highest detection (p < 0.0001). AS patients had the lowest VL, with a significant difference when compared with symptomatic patients (p = 0.0003). A higher VL was observed within two days of disease onset. Ten patients (HP group) received antiviral treatment and were followed up and presented a mean initial VL of 6.64 ± 1.82. A complete viral clearance for 50% of these patients was reached after 12 days of treatment. MAIN CONCLUSIONS It is important to evaluate AS patients as potential spreaders, as viral shedding was still present, even at lower VL. Our results suggest that patients with underlying diseases and severe clinical symptoms may be considered for prolonged viral treatment.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Respiratory Tract Infections/virology , Influenza, Human/virology , Influenza A Virus, H1N1 Subtype/genetics , RNA, Viral/genetics , Acute Disease , Viral Load , Influenza A Virus, H1N1 Subtype/classification , Influenza A Virus, H1N1 Subtype/pathogenicity , Real-Time Polymerase Chain Reaction , Middle Aged
7.
Rev. Soc. Bras. Med. Trop ; 53: e20170498, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057294

ABSTRACT

Abstract INTRODUCTION: We report the results of the active surveillance of influenza infections in hospitalized patients and the evaluation of the seasonality and correlation with temperature and rainfall data. METHODS: During the 2-year study period, 775 patients were tested for 15 respiratory viruses (RVs). RESULTS: Most of the 57% of (n=444) virus-positive samples were human rhinovirus and respiratory syncytial virus. However, 10.4% (n=46) were influenza virus (80% FluA; 20% FluB). Age and SARI were significantly associated with influenza. FluB circulation was higher is 2013. CONCLUSIONS: In the post-epidemic period, influenza remains an important cause of hospitalization in SARI patients.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Respiratory Tract Infections/virology , Influenza, Human/epidemiology , Referral and Consultation , Respiratory Tract Infections/epidemiology , Seasons , Severity of Illness Index , Brazil/epidemiology , Sentinel Surveillance , Hospitalization , Middle Aged
8.
Braz. j. infect. dis ; 23(6): 427-434, Nov.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1089313

ABSTRACT

ABSTRACT To investigate the genetic variation and molecular epidemiology characteristics of Human Respiratory Syncytial Virus (HRSV) in Guizhou Province, nasopharyngeal aspirates were collected from patients with acute respiratory infection (ARI) in Guizhou Provincial People's Hospital, from December 2017 to March 2018, and inoculated to Hep-2 cells to isolate HRSV. Cells that showed cytopathic effect (CPE) were then confirmed by indirect immunofluorescence assay and reverse transcription. The sequence of the PCR products was determined for HRSV isolates, and the genetic variation was analyzed. Out of 196 nasopharyngeal aspirate samples, HRSV were isolated in 39. The second hypervariable region at the 3' terminal of glycoprotein gene (HVR2) sequence analysis showed that subgroup A was dominant. Seventy-nine percent of the isolates belonged to subgroup A, ON1 genotype, and 21 % belonged to subgroup B, BA9 genotype, which indicates that the dominant HRSV circulating in Guizhou Province was subgroup A, genotype ON1, co-circulating with a less prevalent subgroup B, genotype BA9.


Subject(s)
Humans , Child, Preschool , Respiratory Tract Infections/virology , Respiratory Syncytial Virus, Human/isolation & purification , Respiratory Syncytial Virus, Human/genetics , Respiratory Syncytial Virus Infections/virology , Phylogeny , Respiratory Tract Infections/epidemiology , China/epidemiology , Polymerase Chain Reaction , Sequence Analysis, DNA , Respiratory Syncytial Virus Infections/epidemiology , Molecular Epidemiology , Genotype , Nasal Cavity/virology
9.
Braz. j. microbiol ; 50(3): 677-684, July 2019. ilus., tab
Article in English | LILACS, ColecionaSUS, CONASS, SES-RS | ID: biblio-1121770

ABSTRACT

Human mastadenovirus (HAdV) genus is related to several diseases, among them upper and lower respiratory tract illness. HAdV species B, C, D, and E are mainly associated with respiratory infections. The goal of this work was to identify the HAdV species associated with respiratory infections in hospitalized patients from southern Brazil. Samples were collected from 1996 to 2004 and 2011 to 2017. During this period, 28,524 samples were collected, and 9983 were positive for respiratory viruses, being 435 for HAdV. From these 435 samples, 57 were selected for characterization of HAdV species. For screening the presence of HAdV, a partial sequence of the DNA polymerase gene (DNApol gene) was amplified by nested PCR. Partial nucleotide sequencing was performed in positive samples, and HAdV (DNApol gene) was detected in 53 samples: species B (28;49.1%), C (16;8.0%), D (2; 3.5%), E (5; 8.7%), and untyped (2; 3.5%). Specie D was found only in 2017 and specie E in 2011 and 2012. The age of the patients ranged from < 1 to 81 years old, and 62.3%were male. No relationship between gender orage and identified HAdV species were observed. In addition, in the period of 2013­2017, 18 samples from patients who died were analyzed: 11 were related to species B, 4 to C, and 2 to D and 1 remained untyped. Circulation of HAdV species D and Evaried over the years, but species B and C were present throughout the evaluated period. In addition, respiratory infections by HAdVaffect elderly and children mainly. (AU)


Subject(s)
Humans , Male , Female , Child , Aged , Aged, 80 and over , Respiratory System , Respiratory Tract Infections/virology , Mastadenovirus/pathogenicity , Nucleic Acids , Morbidity
10.
Rev. méd. Chile ; 147(7): 842-851, jul. 2019. tab, graf
Article in English | LILACS | ID: biblio-1058613

ABSTRACT

Background: Except for influenza pandemics, different observational studies have failed to demonstrate differences in mortality between various etiologies in adult patients hospitalized for respiratory infections. Aim: To compare clinical and mortality differences between different viral pathogens associated with severe acute respiratory infections (SARI) in hospitalized adults. Material and Methods: One-year prospective study in a sentinel center. We included 132 patients with SARI hospitalized for any of the nine viruses under study by PCR. Clinical variables were compared, excluding cases of coinfection. Results: A viral coinfection was identified in 12% and influenza infection in 56% of cases. Eighty percent of patients were aged ≥ 65 years, with a high frequency of comorbidities, 27% were bedridden. Twenty four percent were admitted to critical care units, 20% required ventilatory assistance and 16% died. Cases occurred throughout the year, with an expected seasonal peak between autumn and spring and a predominance of infections not associated with influenza during summer months. In the multivariate analysis, only being bedridden was significantly associated with mortality at discharge (Odds ratio 23.46; 95% confidence intervals 3.33-165.12, p < 0.01), without association with age, comorbidity, viral pathogen involved, laboratory parameters, clinical presentation or CURB65 score. No major clinical dissimilarities were found between different viral pathogens. Conclusions: In our series of patients, mostly elderly, only bedridden status was significantly associated with mortality at discharge in patients hospitalized for SARI. Viral pathogens were not relevant.


Los factores del huésped son más importantes que el tipo viral para predecir el desenlace en pacientes hospitalizados por infecciones respiratoria aguda grave. Exceptuando las pandemias de influenza, diferentes estudios observacionales no han logrado demostrar diferencias en mortalidad entre diferentes patógenos en pacientes adultos hospitalizados por infecciones respiratorias. Objetivo: Comparar diferencias clínicas y en mortalidad entre diferentes patógenos virales asociados a infección respiratoria aguda grave (IRAG) en adultos hospitalizados. Método: Estudio prospectivo durante un año en un centro centinela. Se incluyeron casos de IRAG hospitalizados por alguno de los 9 virus bajo estudio por RCP. Se compararon variables clínicas y desenlace. Resultados: Ingresaron 132 pacientes con IRAG. Se identificó coinfección viral en 12,1% e infección por influenza en 56,1%. La mayor parte era de la tercera edad (80,3%) con una alta frecuencia de comorbilidad y 27,3% estaba postrado. Veintitres coma cinco por ciento ingresó a unidad de cuidados críticos, 19,7% requirió asistencia ventilatoria y 15,9% fallecieron. Los casos ocurrieron todo el año, con un aumento estacional esperado entre otoño y primavera y predominio de infecciones no asociadas a influenza en verano. En el análisis multivariado, sólo la postración se asoció significativamente a mortalidad al egreso (ORa 23,46 IC95 3,33-165,12, p = 0,002), sin asociación con la edad, comorbilidad, patógeno viral involucrado, parámetros de laboratorio, presentación clínica o puntuación CURB65. No se encontraron discordancias clínicas mayores entre diferentes agentes virales. Conclusiones: En nuestra serie de pacientes, mayoritariamente de la tercera edad, sólo la postración se asoció significativamente a mortalidad al egreso en pacientes hospitalizados por IRAG. El patógeno viral no resultó ser relevante.


Subject(s)
Humans , Male , Female , Adult , Aged , Respiratory Tract Infections/mortality , Respiratory Tract Infections/virology , Seasons , Severity of Illness Index , Acute Disease , Prospective Studies , Risk Factors , Hospitalization
11.
Neumol. pediátr. (En línea) ; 14(1): 12-18, abr. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-995613

ABSTRACT

Acute respiratory infections represent a world pediatric health burden. RSV, influenza and adenoviruses are among the most frequent causative agents. Adenoviruses usually produce upper respiratory infections, but they can be responsible for acute lower respiratory infection in children with severe clinical outcome. It is necessary a special clinical and epidemiological organization to avoid nosocomial adenovirus local outbreaks. Rapid diagnose, done by immunofluorescence assay and PCR, individual case isolation and supportive therapy are necessary for an appropriate management. The increasing immune compromised population represents a challenge for the adenovirus diagnosis with quantitative PCR and for nosocomial infection control and potential antiviral treatment.


Las infecciones respiratorias agudas son un problema prioritario mundial de morbimortalidad infantil y son causadas predominantemente por virus, entre los que destacan el virus respiratorio sincicial (VRS), virus influenza (FLU) y adenovirus (ADV). Los ADV normalmente causan infecciones respiratorias altas, pero pueden provocar infecciones bajas muy graves, que dejan secuelas y tienen alta letalidad. Requieren un manejo clínico y epidemiológico especial para evitar los graves brotes nosocomiales observados en Latinoamérica. Esto incluye un diagnóstico rápido hecho con técnicas de inmunodiagnóstico y reacción en cadena polimerasa (PCR), aislamiento individual del paciente y terapia de soporte. En pacientes inmunocomprometidos, la infección por ADV representa un gran desafío para el diagnóstico, con uso de PCR cuantitativo (qPCR) y eventual tratamiento antiviral. El objetivo de esta revisión es el de actualizar las propiedades, patogenia, epidemiología y diagnóstico del ADV, con énfasis en los cuadros respiratorios de mayor morbimortalidad que se producen en algunos niños.


Subject(s)
Humans , Infant , Child , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , Adenovirus Infections, Human/diagnosis , Adenovirus Infections, Human/etiology , Respiratory Tract Infections/therapy , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Adenovirus Infections, Human/therapy , Adenovirus Infections, Human/epidemiology , Adenoviruses, Human/pathogenicity
12.
Rev. chil. infectol ; 36(1): 26-31, feb. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1003653

ABSTRACT

Resumen Introducción: La temprana detección viral en infecciones respiratorias agudas (IRA) es esencial para establecer una terapia apropiada y prevenir el contagio intrahospitalario. Objetivo: Comparar la eficacia de la técnica de inmunofluorescencia indirecta (IFI) con la reacción de polimerasa en cadena (RPC) para identificar virus respiratorios en niños hospitalizados por IRA. Métodos: Se incluyeron 47 aspirados nasofaríngeos de niños ≤ 2 años con IRA. La IFI incluyó virus respiratorio sincicial (VRS), adenovirus, influenza A y B y parainfluenza. La RPC incluyó, además, la detección de metapneumovirus, enterovirus/rinovirus, bocavirus y coronavirus. Se estimó sensibilidad, especificidad, valor predictor positivo y negativo (VPP/VPN) y correlación kappa para VRS mediante IFI en comparación a la RPC. Resultados: La IFI detectó únicamente VRS (29; 61,7%). La RPC detectó diversos virus, entre ellos VRS en 26 casos (55,3%), seguido por bocavirus (29,8%), enterovirus/ rinovirus (21,3%), adenovirus (14,9%) y parainfluenza (4,3%) entre otros, con 35,5% de co-infección. La IFI presentó sensibilidad: 85,7%, especificidad: 73,6%, VPP: 82,7%, VPN: 77,7% y kappa: 0,5990 (IC 95%; 0,36360,8346) para VRS. Conclusión: La IFI presenta buena sensibilidad, pero moderada especificidad para VRS. Sin embargo, falla en la detección de otros virus respiratorios. La introducción de RPC permitiría mejorar el diagnóstico etiológico de las IRA de origen viral.


Background: Early viral detection in acute respiratory infections (ARI) is essential to establish appropriate therapy and prevent nosocomial transmission. Objective: To compare the efficacy of indirect immunofluorescence technique (IIF) with the polymerase chain reaction (PCR) to identify respiratory viruses in children hospitalized for ARI. Methods: 47 nasopharyngeal aspirates of children ≤ 2 years with ARI were included. IFI included respiratory syncytial virus (RSV), adenovirus, influenza A and B and parainfluenza. PCR also included the detection of metapneumovirus, enterovirus/rhinovirus, bocavirus and coronavirus. Sensitivity, specificity, positive and negative predictive value (VPP/NPV) and kappa correlation for RSV were estimated by IIF compared to PCR. Results: The IIF detected only RSV (29; 61.7%). PCR detected several viruses, including RSV in 26 cases (55.3%), followed by bocavirus (29.8%), rhinovirus/enterovirus (21.3%), adenovirus (14.9%) and parainfluenza (4,3%) among others, with 35.5% of coinfection. The IIF presented sensitivity: 85.7%, specificity: 73.6%, PPV: 82.7%, NPV: 77.7% and kappa: 0.5990 (95% CI, 0.3636-0.8346) for RSV. Conclusion: The IIF presents good sensitivity, but moderate specificity for RSV. However, IIF fails to detect other respiratory viruses. The introduction of PCR would improve the etiological diagnosis of ARI of viral origin.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Viruses/isolation & purification , Nasopharynx/virology , Polymerase Chain Reaction/methods , Fluorescent Antibody Technique, Indirect/methods , Respiratory Tract Infections/virology , RNA Viruses/isolation & purification , Chile , Cross-Sectional Studies , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , DNA Viruses/isolation & purification
13.
Rev. Soc. Bras. Med. Trop ; 52: e20180249, 2019. tab
Article in English | LILACS | ID: biblio-1041556

ABSTRACT

Abstract INTRODUCTION: Prevalence of influenza A virus (Flu-A), respiratory syncytial virus (RSV), and human metapneumovirus (hMPV) was assessed in children with acute respiratory infections (ARIs). METHODS: Nasopharyngeal aspirates and throat swabs were subjected to real-time polymerase chain reaction (PCR) to detect RSV and Flu-A and to conventional PCR to detect hMPV. RESULTS: Of the 156 children assessed, 93 (59.6%) carried at least one virus, with 35.9% positive for RSV, 14.1% for hMPV, and 9.6% for Flu-A. The prevalence of co-infections was 2.6%. CONCLUSIONS: The high detection rate may reflect increased sensitivity of real-time PCR compared to traditional PCR and viral culture.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Respiratory Tract Infections/virology , Respiratory Syncytial Virus Infections/epidemiology , Paramyxoviridae Infections/epidemiology , Influenza, Human/epidemiology , Orthomyxoviridae/genetics , Respiratory Tract Infections/epidemiology , Nasopharynx/virology , Cross-Sectional Studies , Respiratory Syncytial Virus, Human/genetics , Metapneumovirus/genetics , Real-Time Polymerase Chain Reaction , Iran/epidemiology
14.
West Indian med. j ; 67(4): 298-303, Oct.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-1045864

ABSTRACT

ABSTRACT Objective: To assess viral and atypical bacterial agents using polymerase chain reaction in patients presenting with signs of acute respiratory tract infection (RTI) to Erzincan Mengucek Gazi Education and Research Hospital, Turkey. Methods: Viral and atypical bacterial agents were explored in patients presenting with RTI between February 1 and June 1, 2017. Genomic isolation was performed using a SolMag®12 fully-automated nucleic acid isolation system and SolMag® Virus Nucleic Acid Isolation Kit. Amplifications were performed using a SmartCycler-II thermocycler (Cepheid) device in accordance with the instructions provided by the manufacturer. Results: Of the 120 patients, 44 (36.6%) were found to have at least one agent. Polymerase chain reaction detected influenza viruses in 28 patients, respiratory syncytial virus in seven, cytomegalovirus (CMV) in six, Herpes simplex virus 1 (HSV1) in two, Chlamydophila pneumonia in two, Human Herpesvirus 6 in one, and Herpes simplex virus 2 in one. Also, coexistent HSV1 and CMV positivity was found in two cases. One patient had positivity in both influenza A and CMV. Among atypical bacterial agents, only two patients were found to have Chlamydophila pneumonia. There was at least one comorbid condition in 48 patients (40%). Of these subjects in whom an agent could be identified, 21 were found to have co-morbidity, while 23 were free of comorbid conditions. Antibiotherapy had been started in 109 (90.8%) of the patients after initial assessment. Sixty-four patients were admitted, and two patients died. Conclusion: Polymerase chain reaction allowed rapid detection of agents responsible for acute RTIs. We believe that this technique may contribute to appropriate use of antibiotics in patients diagnosed with atypical bacterial infection and may prevent unnecessary antibiotherapy in infections caused by viral agents.


RESUMEN Objetivo: Evaluar los agentes bacterianos atípicos y los agentes virales utilizando la reacción en cadena de la polimerasa en pacientes que acuden con signos de infección aguda de las vías respiratorias (IVR) al Hospital de Docencia e Investigación Erzincan Mengucek Gazi, Turquía. Métodos: Se exploraron agentes bacterianos atípicos y agentes virales en pacientes que acudieron con IVR entre el 1 de febrero y 1 de junio de 2017. El aislamiento genómico se realizó con un sistema SolMag®12 de aislamiento de ácido nucleico totalmente automatizado y un Kit SolMag® de aislamiento de ácido nucleico viral. Las amplificaciones se realizaron utilizando un aparato termociclador SmartCycler-II (Cepheid) de acuerdo con las instrucciones proporcionadas por el fabricante. Resultados: De los 120 pacientes, se determinó que 44 (36.6%) tenían al menos un agente. La reacción en cadena de la polimerasa detectó virus de la influenza en 28 pacientes, virus sincitial respiratorio en siete, citomegalovirus (CMV) en seis, herpes virus simplex 1 (HSV1) en dos, Chlamydophila pneumoniae en dos, herpes virus humano 6 en uno, y herpes virus simplex 2 en uno. Por otro lado, se halló positividad coexistente de HSV1 y CMV en dos casos. Un paciente tuvo positividad tanto para la influenza A como para CMV. Entre los agentes bacterianos atípicos, se halló sólo dos pacientes con Chlamydophila pneumonia. Hubo al menos una condición comórbida en 48 pacientes (40%). De estos sujetos en los que se podía identificar un agente, se halló que 21 tenían comorbilidad, mientras que 23 estaban libres de condiciones comórbidas. La antibioterapia había comenzado en 109 (90.8%) de los pacientes después de la evaluación inicial. Sesenta y cuatro pacientes fueron ingresados, y dos pacientes murieron. Conclusión: La reacción en cadena de la polimerasa permitió la rápida de detección de agentes responsables de IVR aguda. Creemos que esta técnica puede contribuir al uso apropiado de antibióticos en pacientes diagnosticados con infección bacteriana atípica normal y puede evitar antibioterapias innecesarias en infecciones causadas por los agentes virales.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , Polymerase Chain Reaction , Acute Disease
15.
J. pediatr. (Rio J.) ; 94(5): 554-558, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-975983

ABSTRACT

Abstract Objective: Characterize the role of human parainfluenza virus and its clinical features in Brazilian children under 2 years of age presenting with acute lower respiratory tract infections. Methods: Real-time assays were used to identify strains of human parainfluenza virus and other common respiratory viruses in nasopharyngeal aspirates. One thousand and two children presenting with acute lower respiratory tract illnesses were enrolled from February 2008 to August 2010. Results: One hundred and four (10.4%) patients were human parainfluenza virus positive, of whom 60 (57.7%) were positive for human parainfluenza virus-3, 30 (28.8%) for human parainfluenza virus-4, 12 (11.5%) for human parainfluenza virus-1, and two (1.9%) for human parainfluenza virus-2. Seven (6.7%) patients had more than one strain of human parainfluenza virus detected. The most frequent symptoms were tachypnea and cough, similar to other viral respiratory infections. Clinical manifestations did not differ significantly between human parainfluenza virus-1, -2, -3, and -4 infections. Human parainfluenza virus-1, -3, and -4 were present in the population studied throughout the three years of surveillance, with human parainfluenza virus-3 being the predominant type identified in the first two years. Conclusion: Human parainfluenza viruses contribute substantially to pediatric acute respiratory illness (ARI) in Brazil, with nearly 30% of this contribution attributable to human parainfluenza virus-4.


Resumo Objetivo: Caracterizar o papel do VPH-4 e suas características clínicas em crianças brasileiras com menos de dois anos de idade com infecções agudas do trato respiratório inferior. Métodos: Ensaios em tempo real foram utilizados para identificar tipos de VPH e outros vírus respiratórios comuns em aspirados nasofaríngeos. Mil e duas crianças com doença aguda do trato respiratório inferior foram inscritas para participar de fevereiro de 2008 a agosto de 2010. Resultados: 104 (10,4%) pacientes eram VPH positivos, dos quais 60 (57,7%) eram positivos para VPH-3, 30 (28,8%) para VPH-4, 12 (11,5%) para VPH-1 e dois (1,9%) para VPH-2. Sete (6,7%) pacientes apresentaram mais de um tipo de VPH detectado. Os sintomas mais frequentes foram tosse e taquipneia, semelhantes a outras infecções respiratórias virais. As manifestações clínicas não diferiram de forma significativa entre as infecções por VPH-1, -2, -3 e -4. Os VPH-1, -3 e -4 estavam presentes na população estudada ao longo dos três anos de vigilância, e o VPH-3 foi o tipo predominante identificado nos primeiros dois anos. Conclusão: Os VPHs contribuem substancialmente para a DRA pediátrica no Brasil com quase 30% dessa contribuição atribuível ao VPH-4.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Respiratory Tract Infections/virology , Parainfluenza Virus 4, Human/genetics , Seasons , Nasopharynx/virology , Population Surveillance , Acute Disease , Reverse Transcriptase Polymerase Chain Reaction , Parainfluenza Virus 4, Human/isolation & purification , Real-Time Polymerase Chain Reaction
16.
Rev. Soc. Bras. Med. Trop ; 51(1): 30-38, Jan.-Feb. 2018. tab, graf
Article in English | LILACS, ColecionaSUS, CONASS, SES-RS | ID: biblio-897050

ABSTRACT

INTRODUCTION Infections caused by respiratory viruses are important problems worldwide, especially in children. Human metapneumovirus (hMPV) is a respiratory pathogen and causes severe infections with nonspecific symptoms. This study reports the hMPV occurrence and dissemination in southern Brazil and compares the frequency of occurrence of this virus and the human respiratory syncytial virus (hRSV) in the epidemiological weeks in a three-year period (2009-2011). METHODS: In total, 545 nasopharyngeal (NP) specimens from individuals with Severe Acute Respiratory Syndrome (SARS) who were negative for other seven respiratory viruses were analyzed for the presence of hMPV. Human metapneumovirus was detected by direct immunofluorescence and real-time reverse transcription polymerase chain reaction. RESULTS: hMPV was detected in 109 patients from the main geographic regions of the southernmost state of Brazil, presenting similar overall prevalence in males (46.8%) and females (53.2%). Among children who were less than six years old, hMPV was detected in 99 samples of all age groups, with a higher frequency in infants who were less than one year old (45.7%) compared to all other age groups until six years. hMPV and hRSV infection occurred in almost the same epidemiological weeks (EWs) of each year, with peaks of incidence between EW 31/37 and EW 26/38 for the years 2009 and 2011, respectively. hMPV was further detected in several cases of SARS and it was the only virus detected in three deaths. CONCLUSIONS These findings indicate that hMPV is in circulation in southern Brazil and highlight the importance of diagnosing hMPV for influenza-like illness in the population. (AU)


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Respiratory Tract Infections/transmission , Respiratory Tract Infections/virology , Respiratory Syncytial Virus Infections/virology , Metapneumovirus/pathogenicity , Epidemiological Monitoring , Adenoviruses, Human , Pneumovirinae/classification , Paramyxoviridae Infections/virology , Coronavirus , Enterovirus , Severe Acute Respiratory Syndrome , Influenza, Human , Human bocavirus
18.
Braz. j. infect. dis ; 21(4): 472-476, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-1039195

ABSTRACT

Abstract Human Bocavirus (HBoV) has been identified from feces and respiratory samples from cases of both acute gastroenteritis and respiratory illness as well as in asymptomatic individuals. The aim of this study was to detect and characterize HBoV from fecal samples collected from hospitalized children aged less than five years old with no symptoms of respiratory tract infection (RTI) or acute gastroenteritis (AGE). The study involved 119 children and one fecal sample was collected from each participant between 2014 and 2015. HBoV was detected using Nested-PCR, and the viral type identified by genomic sequencing. HBoV-4 was identified from one sample obtained from a hospitalized child with soft tissue tumor of the submandibular region. This is the first report of HBoV-4 identification in Brazil, but we consider that this type may be circulating in the country similar to the other types and new investigations are necessary.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Respiratory Tract Infections/virology , Parvoviridae Infections/virology , Human bocavirus/isolation & purification , Gastroenteritis/virology , Respiratory Tract Infections/complications , Respiratory Tract Infections/epidemiology , Soft Tissue Neoplasms/complications , Brazil/epidemiology , Mandibular Neoplasms/complications , Acute Disease , Parvoviridae Infections/complications , Parvoviridae Infections/epidemiology , Human bocavirus/classification , Gastroenteritis/complications , Gastroenteritis/epidemiology
20.
J. pediatr. (Rio J.) ; 93(3): 294-300, May.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-841355

ABSTRACT

Abstract Objectives: To report epidemiological features, clinical characteristics, and outcomes of human rhinovirus (HRV) infections in comparison with other community acquired respiratory virus (CRV) infections in patients hospitalized for two consecutive years. Methods: This was a cross-sectional study. Clinical, epidemiological, and laboratory data of patients hospitalized with acute respiratory syndrome in a tertiary care hospital from 2012 to 2013 were reviewed. Results: HRV was the most common CRV observed (36%, 162/444) and was present in the majority of viral co-detections (69%, 88/128), mainly in association with human enterovirus (45%). Most HRV-infected patients were younger than 2 years (57%). Overall, patients infected with HRV had a lower frequency of severe acute respiratory infection than those infected with other CRVs (60% and 84%, respectively, p = 0.006), but had more comorbidities (40% and 27%, respectively; p = 0.043). However, in the adjusted analysis this association was not significant. The mortality rate within the HRV group was 3%. Detection of HRV was more prevalent during autumn and winter, with a moderately negative correlation between viral infection frequency and temperature (r = −0.636, p < 0.001) but no correlation with rainfall (r = −0.036, p = 0.866). Conclusion: HRV is usually detected in hospitalized children with respiratory infections and is often present in viral co-detections. Comorbidities are closely associated with HRV infections. These infections show seasonal variation, with predominance during colder seasons.


Resumo Objetivos: Relatar as características epidemiológicas, as características clínicas e os resultados das infecções por rinovírus humano (RVH) em comparação a outras infecções por vírus respiratórios adquiridos na comunidade (VRCs) em pacientes internados por dois anos consecutivos. Métodos: Este foi um estudo transversal. Foram revisados os dados clínicos, epidemiológicos e laboratoriais de pacientes internados com síndrome respiratória aguda em um hospital terciário de 2012 a 2013. Resultados: O RVH foi o VRC mais comum observado (36%, 162/444) e esteve presente na maior parte das codetecções virais (69%, 88/128), principalmente em associação ao enterovírus humano (45%). A maioria dos pacientes infectados por RVH possuía menos de 2 anos (57%). De modo geral, os pacientes com RVH apresentaram uma menor frequência de infecção respiratória aguda grave que os pacientes infectados por outros VRCs (60% e 84%, respectivamente, p = 0,006), porém mais comorbidades (40% e 27%, respectivamente; p = 0,043). Contudo, em uma análise ajustada, essa associação não foi significativa. A taxa de mortalidade no grupo RVH foi 3%. A detecção de RVH foi mais prevalente durante o outono e inverno, com uma correlação negativa moderada entre a frequência de infecção viral e a temperatura (r = -0,636, p < 0,001), porém nenhuma correlação com a precipitação (r = −0,036, p = 0,866). Conclusão: O RVH é normalmente detectado em crianças internadas com infecções respiratórias e normalmente está presente em codetecções virais. As comorbidades estão estreitamente associadas a infecções por RVH. Essas infecçõesmostram variação sazonal, com predominância durante as estações mais frias.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Respiratory Tract Infections/epidemiology , Rhinovirus/isolation & purification , Picornaviridae Infections/epidemiology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/virology , Rhinovirus/classification , Seasons , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Picornaviridae Infections/diagnosis , Picornaviridae Infections/virology , Hospitalization
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