https://scholars.lib.ntu.edu.tw/handle/123456789/603201
標題: | RSV pneumonia with or without bacterial co-infection among healthy children | 作者: | Lin, Hsiao-Chi Liu, Yun-Chung Hsing, Tzu-Yun Chen, Li-Lun Liu, Yu-Cheng TING-YU YEN CHUN-YI LU LUAN-YIN CHANG JONG-MIN CHEN PING-ING LEE LI-MIN HUANG FEI-PEI LAI |
關鍵字: | Children; Co-infection; Critical illness; Pneumonia; Respiratory syncytial virus | 公開日期: | 2022 | 出版社: | Elsevier B.V. | 卷: | 121 | 期: | 3 | 起(迄)頁: | 687-693 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background: Respiratory syncytial virus (RSV) is a common cause of childhood pneumonia, but there is limited understanding of whether bacterial co-infections affect clinical severity. Methods: We conducted a retrospective cohort study at National Taiwan University Hospital from 2010 to 2019 to compare clinical characteristics and outcomes between RSV with and without bacterial co-infection in children without underlying diseases, including length of hospital stay, intensive care unit (ICU) admission, ventilator use, and death. Results: Among 620 inpatients with RSV pneumonia, the median age was 1.33 months (interquartile range, 0.67–2 years); 239 (38.6%) under 1 year old; 366 (59.0%) males; 201 (32.4%) co-infected with bacteria. The three most common bacteria are Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae. The annually seasonal analysis showed that spring and autumn were peak seasons, and September was the peak month. Compared with single RSV infection, children with bacterial co-infection were younger (p = 0.021), had longer hospital stay (p < 0.001), needed more ICU care (p = 0.02), had higher levels of C-reactive protein (p = 0.009) and more frequent hyponatremia (p = 0.013). Overall, younger age, bacterial co-infection (especially S. aureus), thrombocytosis, and lower hemoglobin level were associated with the risk of requiring ICU care. Conclusion: RSV related bacterial co-infections were not uncommon and assoicated with ICU admission, especially for young children, and more attention should be given. For empirical antibacterial treatment, high-dose amoxicillin-clavulanic acid or ampicillin-sulbactam was recommended for non-severe cases; vancomycin and third-generation cephalosporins were suggested for critically ill patients requiring ICU care. © 2021 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85113385482&doi=10.1016%2fj.jfma.2021.08.012&partnerID=40&md5=4dbccc2fea1611eff601016257b7b374 https://scholars.lib.ntu.edu.tw/handle/123456789/603201 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2021.08.012 | SDG/關鍵字: | Article; artificial ventilation; autumn; child; clinical decision rule; clinical feature; clinical outcome; cohort analysis; coinfection; controlled study; death; demographics; disease severity; female; Haemophilus influenzae; hemoglobin blood level; hospital admission; hospital patient; hospitalization; human; Human respiratory syncytial virus; hyponatremia; infant; intensive care unit; laboratory test; length of stay; major clinical study; male; nonhuman; normal human; patient risk; pneumonia; preschool child; protein expression; respiratory syncytial virus infection; retrospective study; risk factor; spring; Staphylococcus aureus; Streptococcus pneumoniae; Taiwan; thorax radiography; thrombocytosis; university hospital; vital sign; bacterium; coinfection; complication; virus pneumonia; Bacteria; Child; Child, Preschool; Coinfection; Hospitalization; Humans; Infant; Male; Pneumonia, Viral; Retrospective Studies; Staphylococcus aureus |
顯示於: | 醫學系 |
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