Association between multiple respiratory viral infections and pediatric intensive care unit admission among infants with bronchiolitis

被引:21
作者
Tsou, P. [1 ]
Vadivelan, A. [1 ]
Kovvuri, M. [1 ]
Garg, N. [1 ]
Thangavelu, M. [1 ]
Wang, Y. [1 ]
Raj, S. [2 ]
机构
[1] Texas A&M Coll Med, Driscoll Childrens Hosp, Dept Pediat, 3533 S Alameda St, Corpus Christi, TX 78411 USA
[2] Texas A&M Coll Med, Driscoll Childrens Hosp, Dept Crit Care Med, Corpus Christi, TX 78411 USA
来源
ARCHIVES DE PEDIATRIE | 2020年 / 27卷 / 01期
关键词
Bronchiolitis; Infants; Pediatric intensive care; Multiple respiratory viral; INCREASED DISEASE SEVERITY; SYNCYTIAL VIRUS; CHILDREN; HOSPITALIZATIONS; ETIOLOGY; IMPACT; DURATION; TRACT; AGE; PCR;
D O I
10.1016/j.arcped.2019.11.006
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: It is unclear whether multiple respiratory viral infections are associated with more severe bronchiolitis requiring pediatric intensive care unit (PICU) admission. We aimed to identify the association between multiple respiratory viral infections and PICU admission among infants with bronchiolitis. Methods: We performed a 1:1 case-control study enrolling previously healthy full-term infants (<= 12 months) with bronchiolitis admitted to the PICU as cases and those to the general pediatric ward as controls from 2015 to 2017. Multiplex polymerase chain reaction (PCR) was used for detection of the respiratory viruses. We summarized the characteristics of infants admitted to the PICU and the general pediatric unit. Multivariable logistic regression analysis was used to fit the association between multiple respiratory viral infections (>= 2 strains) and PICU admission. Results: A total of 135 infants admitted to the PICU were compared with 135 randomly selected control infants admitted to the general pediatric unit. The PICU patients were younger (median: 2.2 months, interquartile range: 1.3-4.2) than the general ward patients (median: 3.2 months, interquartile range: 1.6-6.4). Respiratory syncytial virus (74.1%), rhinovirus (28.9%), and coronavirus (5.9%) were the most common viruses for bronchiolitis requiring PICU admission. Patients with bronchiolitis admitted to the PICU tended to have multiple viral infections compared with patients on the general ward (23.0% vs. 10.4%, P < 0.001). In the multivariable logistic regression analysis, bronchiolitis with multiple viral infections was associated with higher odds of PICU admission (adjusted odds ratio: 2.56, 95% confidence interval: 1.17-5.57, P = 0.02). Conclusion: Infants with multiviral bronchiolitis have higher odds of PICU admission compared with those with a single or nondetectable viral infection. (C) 2019 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:39 / 44
页数:6
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