title: [Value of routine identification of respiratory infectious agents in children hospitalized with an acute asthma exacerbation].
abstract: BACKGROUND
  Asthma is the most common chronic disease in childhood. With its high economic burden, it is considered a disease of major public health importance by the World Health Organization. The link between respiratory tract infections and acute exacerbation has been recognized for a long time. The aim of this retrospective study in routine care was to evaluate our practices concerning microbiological prescriptions in children hospitalized for asthma exacerbation.
  
  
  METHODS
  All children aged from 2 to 15 years hospitalized for asthma exacerbation between January 2010 and December 2011 in our unit were included in the study. Microbiological prescriptions, their indications, their results, and their cost were studied.
  
  
  RESULTS
  One hundred ninety-seven children were included in the study. A potential causative agent was sought in 79.7% of the children (n=157) by immunofluorescence assay (IFA) and/or polymerase chain reaction (PCR). The main indications were upper airway infections, hypoxemia, and pneumonia. Viruses were detected in 23.8% of them (30/126). Mycoplasma pneumoniae was detected by PCR in only 3.2% of these patients (4/125). No other bacterial agent was identified. There was no correlation between the severity of asthma exacerbation and the microbiological diagnosis of infection. The results did not influence the therapy given. These prescriptions represented a substantial cost for each child.
  
  
  CONCLUSIONS
  These analyses do not seem to have a real advantage for the patient except for epidemiology. It would be important to conduct a new study analyzing the role of rhinovirus, and of other viruses such as coronavirus, bocavirus, and enterovirus, not routinely investigated in our hospital, and to question the value of these costly microbiological tests.
authors.affiliation: Service de spécialités pédiatriques et de médecine infantile, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: E
authors.initials: E
authors.lastname: Sauvaget
authors.affiliation: Service de spécialités pédiatriques et de médecine infantile, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: V
authors.initials: V
authors.lastname: Bresson
authors.affiliation: Service de spécialités pédiatriques et de médecine infantile, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: M
authors.initials: M
authors.lastname: Oudyi
authors.affiliation: Service de spécialités pédiatriques et de médecine infantile, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: E
authors.initials: E
authors.lastname: Bosdure
authors.affiliation: Unité d'aide méthodologique à la recherche clinique, laboratoire de santé publique, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex, France.
authors.forename: A-D
authors.initials: AD
authors.lastname: Loundou
authors.affiliation: Service de spécialités pédiatriques et de médecine infantile, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: B
authors.initials: B
authors.lastname: Chabrol
authors.affiliation: UMR_D 190 « émergence des pathologies virales », institut de recherche pour le développement (IRD), école des hautes études en santé publique (EHESP) & IHU méditerranée infection, hôpitaux de Marseille, Aix Marseille université, AP-HM, 13005 Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Charrel
authors.affiliation: Service de spécialités pédiatriques et de médecine infantile, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. Electronic address: jean-christophe.dubus@ap-hm.fr.
authors.forename: J-C
authors.initials: JC
authors.lastname: Dubus
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D016527:Drug Costs; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies; D013223:Statistics as Topic
chemical_list: D000900:Anti-Bacterial Agents