Clinical characteristics of lower respiratory tract infection in low birth weight children

PURPOSE: Lower respiratory tract infection (LRTI) is one of the most common causes of hospitalization in the pediatric population. In this study, we investigated the clinical characteristics of LRTI, particularly in low birth weight children. METHODS: We reviewed medical records of children at ages 0–6 years with LRTI in Korea University Anam Hospital between January and December of 2014. Clinical data including age, sex, birth history, viral pathogens, blood test results, and clinical courses were collected. RESULTS: In the 828 eligible cases, 617 (74.5%) were pneumonia and followed by bronchiolitis 180 (21.7%) and bronchitis 31 (3.7%). The median age of the subjects was 17 months (interquartile range [IQR], 7–28 months), the median gestational age was 39.0 weeks (IQR, 38.0–40.0 weeks) and the median birth weight was 3,200 g (IQR, 2,900–3,480 g). Sixty-four children (7.7%) were low birth weight (< 2,500 g) and their median gestational age and birth weight were 33.0 weeks (IQR, 30.0–36.0 weeks) and 2,045 g (IQR, 1,565–2,300 g), respectively. The rates of oxygen supplement (17.2% vs. 4.6%, P < 0.001) and systemic steroid use (20.3% vs. 4.7%, P < 0.001) were significantly higher in low birth weight children than normal birth weight children. Respiratory viruses were identified in 82.6% (519 of 628 subjects); RSV was detected in 240 subjects (38.2%), followed by rhinovirus 168 (26.8%) and adenoviruses 75 (11.9%). The distribution of respiratory viruses was not different between normal birth weight children and low birth weight children. CONCLUSION: Low birth weight children show more severe clinical manifestations than normal birth weight children during hospitalization for LRTI, although respiratory viral pathogens were not different. Clinicians should be aware that the severity may be increased when low birth weight children were hospitalized due to low respiratory tract infection.

Immunogenicity and Safety of Inactivated Influenza Vaccine in Healthy Korean Children and Adolescent

PURPOSE: This study aimed to evaluate the immunogenicity and safety of a trivalent inactivated influenza vaccine (TIV) among healthy Korean children and adolescents. METHODS: From October to December 2008, 65 healthy patients aged 6 months to 18 years who visited Korea University Ansan Hospital for influenza vaccination were enrolled in this study. We measured the hemagglutinin inhibition antibody titers at baseline and 30 days after vaccinating enrollees with split influenza vaccine and calculated the seroprotection rates, geometric mean titers, and seroconversion rates. Local and systemic adverse events were assessed after vaccination. RESULTS: The seroprotection rates against all three viral strains (A/H1N1, A/H3N2, B) were 87.7%, 89.2%, and 89.2% (≥70%), respectively; seroconversion rates were 44.6%, 73.8%, and 63.1% (≥40%), respectively; and seroconversion factors were 4.5, 8.4, and 10.5 (>2.5), respectively. The TIV immunogenicity was acceptable according to the CPMP (Committee for Proprietary Medicinal Products) criteria. Although 48 patients (73.8%) reported one or more adverse events, no severe adverse events such as anaphylaxis and convulsion were observed. Forty-two patients (64.6%) reported a local skin reaction, including redness (29.2%), pain (43.1%), or swelling (41.5%) of the injected site, and 26 (40.0%) reported a systemic reaction: fatigue (23.1%), myalgia (20.0%), headache (10.8%), arthralgia (10.8%), chills (9.2%), or fever (7.7%). CONCLUSIONS: This study shows that the immunogenicity of the TIV vaccine is acceptable. As there were no serious adverse events aside from local reactions and mild systemic reactions, this vaccine can be safely used among healthy Korean children and adolescents.

Association Between Sensitization to Mold and Impaired Pulmonary Function in Children With Asthma

PURPOSE: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. In this study, we investigated the relationships between sensitization to mold and lung function parameters in children with asthma. METHODS: We retrospectively reviewed clinical data from 551 asthmatic subjects. We selected subjects who met clinical diagnostic criteria of asthma. Their spirometry, methacholine challenge tests, and measurements of blood eosinophils, serum IgE, eosinophil cationic protein (ECP) and fractional exhaled nitric oxide (FeNO) results were included. Skin prick testing (SPT) results with 13 common aeroallergens in Korea including house dust mites, animal dander, pollen, cockroach and mold were reviewed. Subjects were divided into 3 groups according to their SPT results. Subjects who showed no positive result to any aeroallergen were designated as group 1 (non-sensitized). Group 2 represented subjects who were sensitized to aeroallergens other than mold (other allergen-sensitized) and group 3 included subjects who were sensitized to mold allergens (mold-sensitized). RESULTS: Among the 551 asthmatic subjects, 67 (12.2%) were sensitized to mold and 366 (66.4%) were sensitized to other aeroallergens. The log mean IgE levels were higher in groups 2 (5.96±1.14 IU/mL) and 3 (5.81±0.97 IU/mL) compared to group 1 (3.88±1.68 IU/mL). Blood eosinophils, ECP and FeNO concentrations were significantly higher in groups 2 and 3, but no significant difference was found between the 2 groups. The mean FEV1 value was significantly lower in group 3 (86.9±12.1%pred) than in groups 2 (92.0±14.8%pred) and 1 (93.4±15.4%pred). The log mean methacholine PC20 was significantly lower in group 3 (0.08±1.91 mg/mL) than in groups 2 (1.31±1.69 mg/mL) and 1 (2.29±1.66 mg/mL). CONCLUSIONS: We observed a differential association between mold and other aeroallergen sensitization, and severity of asthma. Sensitization to mold is associated with lower lung function and increased airway hyper-responsiveness in children with asthma. Mold sensitization could be an important factor determining asthma severity particularly airflow limitation in children.

Prevalence of atopic dermatitis and its associated factors for elementary school children in Gyeonggi-do province

PURPOSE: This study aimed to investigate the prevalence of atopic dermatitis (AD) and associated factors for AD in a total of 2,077 children from 5 elementary schools in Gyeonggi-do province. METHODS: AD was defined when parents answered "Yes" to a question in the on International Study of Asthma and Allergies in Childhood questionnaire "Has your child ever has itchy rashes with xax and wane pattern for at least 6 months?" in October 2012. SCORing Atopic Dermatitis index, skin prick testing and blood testing, were evaluated. RESULTS: The prevalence of AD was 25.9% among 2,077 elementary school children in Gyeonggi-do province. Proportions of obesity (8.0% vs. 4.5%, P=0.004) and breast-feeding over 6 months (46.6% vs. 41.3%, P=0.035) were significantly higher in children with AD than those without. No significant differences were found in terms of sex, age, body mass index, history of breast-feeding ever and mode of delivery beween AD and non-AD children. obesity (adjusted odds ration [aOR], 1.80; 95% confidence interval [CI], 1.13–2.75; P=0.006) and breast-feeding over 6 months (aOR, 1.35; 95% CI, 1.03–1.77; P=0.029) were found as significant associated factors for AD. When stratified by sex, obesity in boys (aOR, 2.67; 95% CI, 1.53–4.66; P=0.001) and breast-feeding history in girls (aOR, 1.47; 95% CI, 1.03–2.11; P=0.034) were independently considered significant associated factors for AD. We found more boys (66.7%, P=0.028) than girls among the severe AD cases. Male sex was considered an associated factor of having severe AD (aOR, 2.23; 95% CI, 1.01–4.73; P=0.048). CONCLUSION: The prevalence of AD was 25.9% in elementary school children in Gyeonggi-do. province obesity and breast-feeding over 6 months were found as associated factors of having AD. Male sex was considered an associated factor for severe AD.