Abstract
Objective: to estimate the prevalence and clinical-epidemiological features of acute respiratory infections of various etiology in children of the first three years of life, hospitalized to the intensive care unit of a children’sinfectious hospital.150 children of the first three years of life of the total number of patients, hospitalized to the intensive care unit of the Republican Clinical Infectious Diseases Hospital of Kazan with a severe ARI, were randomly selected. The design of the research was consistent with the observational analytic.Results: the etiology of ARI was interpreted in 74% (95% CI 67–81), 111/150 cases. Rhinovirus infection is the main cause of development of severe forms of ARI in young children; in second place – influenza viruses – 13.9-28.7% in different age groups. Clinically significant in all age groups were respiratory syncitial viruses (7.1–16.7%), in children up to one year – parainfluenza viruses (13.9% (95% CI 6–21.8), 10/72, and in patients older than 2 years – adenoviruses (12–14.2%). Seasonal rise in the incidence of ARI was noted in the cold season. It was caused by influenza viruses, respiratory syncitial viruses, parainfluenza viruses. In the summer months, the rhino-, metapneumo- and adenoviruses were most common. The expressed general toxic effects that caused hospitalization were recorded in 66% (95% CI 58.4–73.6), 99/150 of the examined patients, manifestations of respiratory failure was detected in 58% (95% CI 50.1–65.9), 87/150.Conclusions: the leading causes of development of severe forms of ARI in young children are rhinoviruses, influenza viruses and the respiratory syncitial virus. They are associated with: respiratory tract diseases with respiratory failure, a symptom complex of toxicosis. Previously thought «harmless», rhinovirus infection is becoming a leader in the range of causes of severe forms of respiratory infections in young children.
Highlights
Objective: to estimate the prevalence and clinical-epidemiological features of acute respiratory infections of various etiology in children of the first three years of life, hospitalized to the intensive care unit of a children’s infectious hospital. 150 children of the first three years of life of the total number of patients, hospitalized to the intensive care unit of the Republican Clinical Infectious Diseases Hospital of Kazan with a severe ARI, were randomly selected
Results: the etiology of ARI was interpreted in 74%, 111/150 cases
Rhinovirus infection is the main cause of development of severe forms of ARI in young children; in second place – influenza viruses – 13.9-28.7% in different age groups
Summary
Средняя стоимость лечения одного пациента оценивается в 140–240 долларов США, причем она напрямую зависит от этиологии заболевания. Традиционно острые респираторные заболевания условно разделяют на инфекции верхних (ринит, синусит, отит, фарингит, тонзиллофарингит, эпиглоттид, ларингит) и нижних дыхательных путей (пневмония, бронхиолит; некоторые эксперты относят к этой группе острых респираторных заболеваний коклюш). При этом инфекции верхних дыхательных путей доминируют в спектре детской патологии и в подавляющем большинстве случаев ассоциированы с риновирусами и вирусом гриппа А [2]. К возбудителям инфекций нижних дыхательных путей относят респираторно-синцитиальный вирус, метапневмовирус, вирусы гриппа А и ряд бактерий: Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae. На долю инфекций нижних дыхательных путей приходится около 30% всех острых респираторных заболеваний [3]. Цель исследования: оценить распространенность и клинико-эпидемиологические особенности острых респираторных инфекций разной этиологии у детей первых трех лет жизни, госпитализированных в отделение интенсивной терапии детского инфекционного стационара
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