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Community- and hospital-acquired respiratory syncytial virus infections in Chile
L F Avendaño1, C Larrañaga, M A Palomino
1Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Chile, Santiago.
Insights
Respiratory syncytial virus (RSV) is a major cause of acute respiratory infections and hospital-acquired infections in young children in Santiago. Rapid viral diagnosis is crucial as symptoms alone cannot distinguish between viral and bacterial infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Acute respiratory infections (ARIs) are a leading cause of hospitalization in infants and young children.
- Differentiating viral from bacterial ARIs based on clinical presentation can be challenging.
Purpose of the Study:
- To investigate the role of respiratory syncytial virus (RSV) in hospital admissions for ARIs.
- To determine the incidence of nosocomial RSV infections in a pediatric ward.
Main Methods:
- Prospective study of 614 children under 2 years hospitalized with ARIs in Santiago, Chile.
- Nasopharyngeal aspirates collected on admission and serially during hospitalization.
- Diagnosis of RSV using indirect monoclonal immunofluorescent assay and HEp-2 cell culture.
Main Results:
- RSV was detected in 39% of admitted patients, with seasonal peaks.
- 15% of nosocomial infections were attributed to RSV during the study period.
- Pneumonia and wheezing bronchitis were common diagnoses regardless of RSV status.
Conclusions:
- RSV is a significant contributor to both community-acquired and hospital-acquired ARIs in young children in Santiago.
- Clinical symptoms are insufficient for differentiating viral (RSV) from bacterial ARIs.
- Emphasizes the importance of rapid viral diagnostic methods for effective management.
Abstract:
Nasopharyngeal aspirates were obtained on admission from 614 patients younger than 2 years of age who were hospitalized in a ward for acute respiratory infections from June 1988 through October, 1989, in Santiago, Chile. Patients in two rooms were followed during the cold seasons by sampling aspirates every other day during the child's entire hospital stay. Clinical features were recorded daily. Indirect monoclonal immunofluorescent assay and isolation in HEp-2 were used for respiratory syncytial virus (RSV) diagnosis. The mean RSV detection rate was 39% at the time of admission, ranging from 8% in April, 1989, to 62% in July, 1988. During the cold months 43 of 288 (15%) nosocomial RSV cases were detected. Pneumonia and wheezing bronchitis were the principal diagnoses of both groups admitted, whether they were shedding RSV or not. It is concluded that RSV plays a major role in admissions for acute respiratory infections, as well as in nosocomial infections, in Santiago. Because clinical features do not allow one to differentiate viral from bacterial acute respiratory infections, the importance of rapid viral diagnosis is emphasized.