Poor outcome of acute respiratory infection in young children with underlying health condition in Brazil.
OBJECTIVE
It is well established that respiratory viruses are an important cause of hospitalizations in young children worldwide, but data are limited on the contribution of specific viruses to severe illness in South America. We describe clinical and laboratory findings from prospective surveillance for acute respiratory infections at a tertiary hospital in São Paulo, Brazil.


METHODS
We screened children < 2 years old with acute respiratory tract infections admitted to an urban tertiary hospital for respiratory viruses from March 2008 through February 2010, using polymerase chain reaction assays.


RESULTS
Respiratory viruses were identified in 378 (53%) of the 715 samples analyzed. Respiratory syncytial virus was the most commonly identified virus (52%), followed by adenovirus (27%) and Human metapneumovirus (12%). More than one virus was identified in 19% of specimens. Almost half of the samples (46%) were from children with underlying health conditions. We demonstrated that compared to the previously healthy group, those with comorbidities had a worse outcome in terms of severity, with prolonged hospital stay and more need of intensive care.


CONCLUSIONS
Identification of this high-risk population along with strategies for fast diagnosis might each help to reduce morbidity and mortality in this group.
Department of Pediatrics, Santa Casa de Misericórdia Hospital, São Paulo, Brazil. R. Dr. Cesário Motta Jr, 112, Vl. Buarque, São Paulo, SP Brazil, zip code: 01220-020; Infectious Diseases Division, Children's Institute University of São Paulo, HC-FMUSP, Brazil. Av. Dr, Enéas Carvalho Aguiar, 647. São Paulo, SP, Brazil. zip code: 05403-000; Department of Microbiology, Institute of Biomedical Science, University of São Paulo, Brazil. Av. Prof. Lineu Prestes, 1374 - Ed. Biomédicas II Cidade Universitária - São Paulo - SP - Brazil zip code 05508-900. Electronic address: giuliana.durigon@gmail.com.
Giuliana Stravinskas
GS
Durigon
Department of Microbiology, Institute of Biomedical Science, University of São Paulo, Brazil. Av. Prof. Lineu Prestes, 1374 - Ed. Biomédicas II Cidade Universitária - São Paulo - SP - Brazil zip code 05508-900. Electronic address: danibruna@gmail.com.
Danielle Bruna Leal
DB
Oliveira
Department of Pediatrics, Santa Casa de Misericórdia Hospital, São Paulo, Brazil. R. Dr. Cesário Motta Jr, 112, Vl. Buarque, São Paulo, SP Brazil, zip code: 01220-020. Electronic address: carolcalahani@hotmail.com.
Maria Carolina Calahani
MC
Felicio
Department of Pediatrics, Santa Casa de Misericórdia Hospital, São Paulo, Brazil. R. Dr. Cesário Motta Jr, 112, Vl. Buarque, São Paulo, SP Brazil, zip code: 01220-020. Electronic address: cfinelli@bol.com.br.
Cristiane
C
Finelli
Department of Pediatrics, Santa Casa de Misericórdia Hospital, São Paulo, Brazil. R. Dr. Cesário Motta Jr, 112, Vl. Buarque, São Paulo, SP Brazil, zip code: 01220-020; Infectious Diseases Division, Children's Institute University of São Paulo, HC-FMUSP, Brazil. Av. Dr, Enéas Carvalho Aguiar, 647. São Paulo, SP, Brazil. zip code: 05403-000. Electronic address: fernandabadue@uol.com.br.
Maria Fernanda Badue
MF
Pereira
Department of Pediatrics, Santa Casa de Misericórdia Hospital, São Paulo, Brazil. R. Dr. Cesário Motta Jr, 112, Vl. Buarque, São Paulo, SP Brazil, zip code: 01220-020. Electronic address: juliana.storni@gmail.com.
Juliana Gamo
JG
Storni
Department of Microbiology, Institute of Biomedical Science, University of São Paulo, Brazil. Av. Prof. Lineu Prestes, 1374 - Ed. Biomédicas II Cidade Universitária - São Paulo - SP - Brazil zip code 05508-900. Electronic address: biogirl8@gmail.com.
Raquel Negrão
RN
Caldeira
Statistics consultant. Av. Roberto Lorenz, 482, Jd Guedala, São Paulo, SP Brazil, zip code: 05611-050. Electronic address: reniberezin@hotmail.com.
Reni Chehter
RC
Berezin
Department of Microbiology, Institute of Biomedical Science, University of São Paulo, Brazil. Av. Prof. Lineu Prestes, 1374 - Ed. Biomédicas II Cidade Universitária - São Paulo - SP - Brazil zip code 05508-900. Electronic address: eldurigo@usp.br.
Edison Luiz
EL
Durigon
Department of Pediatrics, Santa Casa de Misericórdia Hospital, São Paulo, Brazil. R. Dr. Cesário Motta Jr, 112, Vl. Buarque, São Paulo, SP Brazil, zip code: 01220-020. Electronic address: eberezin2003@yahoo.com.
Eitan Naaman
EN
Berezin
D000208:Acute Disease; D000256:Adenoviridae / Q000302:isolation & purification*; D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008403:Mass Screening; D029121:Metapneumovirus / Q000302:isolation & purification*; D018184:Paramyxoviridae Infections / Q000175:diagnosis / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000453:epidemiology*; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification*; D012306:Risk; D012621:Seasons
Acute respiratory tract infection; Children; Respiratory virus; underlying disease