[Respiratory viral infections during episodes of fever in children undergoing hematopoietic stem cell transplantation]. / Infecciones respiratorias virales en episodios de fiebre en niños con trasplante de precursores hematopoyéticos.
Rev Chilena Infectol
; 37(4): 371-382, 2020 08.
Article
en Es
| MEDLINE
| ID: mdl-33399657
ABSTRACT
BACKGROUND:
Children undergoing hematopoietic stem cell transplant (HSCT) can develop respiratory viral infections (RVI) during fever episodes. There are few data about clinical outcomes in RVI and compared to bacterial infections (BI) in this population.AIM:
To determine clinical outcome of RVI, compared to BI in children with HSCT.METHODS:
Prospective study, patients ≤ 18 years with cancer and HSCT admitted with fever at a National Bone Marrow Transplant Center (Hospital Calvo Mackenna), Chile, (April-2016 to May-2019). Clinical assessment, laboratory tests, blood cultures, nasopharyngeal sample for multiplex-PCR (Filmarray®), viral loads by PCR and cytokine panel (Luminex®, 38 cytokines) were performed. The following outcomes were evaluated upper/lower respiratory tract disease (RTD), admission to ICU, mechanical ventilation, mortality and antimicrobial withdrawal.RESULTS:
Of 56 febrile episodes, 35 (63%) were RVI, 12 (21%) BI and 9 (16%) with unknown etiology (UE). Median of age was 8.5 years, 62% male gender. Rhinovirus (54%) and coronavirus (15%) were the more frequent detected viruses. No significant differences in cytokine levels were observed between RVI and BI. 94% of RVI patients had symptomatic RTD, versus 33% in BI and 33% in UE group (p < 0.001), with lower-RTD in 69% of RVI group (p < 0,001). Admission to ICU was 11% in RVI, 17% in BI and 11% in UE group (p = 0.88); only 2 patients required mechanical ventilation (p = 0.37) and no mortality was reported. After an RVI was detected by PCR, antimicrobials were withdrawal in 26% of patients with RVI (p 0.04).CONCLUSION:
RVI are frequent etiologic agents in febrile episodes of patients with HSCT. Viral detection might help to rationalize the use of antimicrobials in this population.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Infecciones del Sistema Respiratorio
/
Virosis
/
Trasplante de Células Madre Hematopoyéticas
/
Fiebre
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
Límite:
Child
/
Female
/
Humans
/
Male
País/Región como asunto:
America do sul
/
Chile
Idioma:
Es
Revista:
Rev Chilena Infectol
Año:
2020
Tipo del documento:
Article
País de afiliación:
Chile