Resumo

BELLO, OSVALDO et al. Infecciones graves por virus respiratorio sincicial en lactantes menores de tres meses: Incidencia en pacientes sin factores de riesgo clásicos. Arch. Pediatr. Urug. [online]. 2001, vol.72, suppl.1, pp.S20-S25. ISSN 1688-1249.

Introduction: respiratory syncytial virus (RSV) is the most frequently detected viral pathogen in infants hospitalized due to acute lower respiratory infections (LRIs). Guidelines for prophylaxis have been issued that identify infants at high-risk for serious RSV disease. We hypothesized that infants with no risk factors may also develop severe RSV disease. Objectives: the objectives of the current research were to determine the incidence of severe acute RSV LRI in infants <90 days of age, and to evaluate this population´s characteristics. Methods: this was a prospective, descriptive study conducted from 04/01/2000 to 09/30/2000. All patients <90 days of age that were admitted to the PER at the PRH for acute LRI, and transferred to the RSU with respiratory failure were included in the study. No child receiving prophylaxis was included in the study. Nasopharyngeal aspirate (NPA) samples were tested by direct immunofluorescence and cell culture to identify RSV. Results: A total of 61 patients were enrolled; RSV was detected in NPA in 34 of them (56%). Three premature infants were excluded to focus the analysis on children with risk factors (n=31). Demographic data were as follows: male gender, 21/31 (68%); age range (median) 6-90 (40) days, 8/31 (26%) were<29 days; birth weight 1510-4160 g (2990 g); gestational age:33-40 (38) weeks; exclusively breast fed, 14/31 (45%); deficient socioeconomic environment, 26/31 (84%); well nourished, 25/31 (81%); weight 2500-6600 g (4300 g) +RSV cultures 13/31 (42%); referred to ICU 24/31 (77%) [22 without pathologic background; 2l full term; 18 well nourished; 8 under 29 days of age; 16 over 29 days of age (p=0.052)]; ICU average stay 6.7 days; MV 12/31 (39%); mortality 0/31. Conclusions: in our series, RSV is responsible for more than half (56%) the acute LRI in infants under 90 days of age admitted to the hospital in serious respiratory distress. Serious acute RSV infections not only affect high-risk infants, but also full term, previously healthy, well-controlled, eutrophic, exclusively breast-fed infants, coming from a deficient socio-economic environment and receiving care at a public hospital.

Palavras-chave : RESPIRATORY SYNCYTIAL VIRUSES; PALIVIZUMAB [therapeutic use].

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