title: Etiology of acute respiratory tract infections among children in a combined community and hospital study in Rio de Janeiro.
abstract: We reviewed data collected between January 1987 and December 1989 on the etiology of acute respiratory infections (ARI) among 827 children in two low-income communities and a hospital in Rio de Janeiro. Respiratory syncytial virus was identified in 38% of cases of ARI, influenza A virus in 1%, parainfluenza 3 virus in 1%, and multiple viruses in 1%. Respiratory syncytial virus was most prevalent among hospitalized children, with seasonal increases in the late fall and winter. The principal bacterial pathogens were Staphylococcus aureus, gram-negative bacteria, Streptococcus pneumoniae, and alpha-hemolytic streptococci. Specimens that were most often positive were pleural fluid (46%) and specimens from other normally sterile sites (24%); normally sterile sites included the CSF, trachea, and lungs. Urine counterimmunoelectrophoresis for S. pneumoniae and Haemophilus influenzae polysaccharide antigens was positive in 3% and 2% of cases, respectively. Pharyngeal cultures yielded low numbers of S. pneumoniae and H. influenzae organisms and higher numbers of gram-negative bacteria. This study demonstrates the high incidence of ARI (4.5 cases per 100 child-weeks) among children in Rio de Janeiro and the high morbidity associated with the illness (ARI is responsible for 25%-50% of all pediatric hospitalizations) and the fact that continued attention must be paid to both viral and bacterial agents of ARI.
authors.affiliation: Evandro Chagas Hospital (Oswaldo Cruz Institute), Rio de Janeiro, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Sutmöller
authors.forename: Z P
authors.initials: ZP
authors.lastname: Ferro
authors.forename: M D
authors.initials: MD
authors.lastname: Asensi
authors.forename: V
authors.initials: V
authors.lastname: Ferreira
authors.forename: I S
authors.initials: IS
authors.lastname: Mazzei
authors.forename: B L
authors.initials: BL
authors.lastname: Cunha
mesh_terms: D000208:Acute Disease; D001938:Brazil; D002675:Child, Preschool; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*