Palomino María Angélica, Larrañaga Carmen, Villagra Eliecer, Camacho Jorge, Avendaño Luis F
Departamento de Pediatría, Facultad de Medecina Norte, Universidad de Chile, Hospital Roberto del Río, Zañartu 1085, Santiago, Chile.
Pediatr Infect Dis J. 2004 Apr;23(4):337-41. doi: 10.1097/00006454-200404000-00012.
In Chile respiratory syncytial virus (RSV) and adenovirus (AD) are the principal viruses detected in acute lower respiratory infections (ALRI) in infants. An overview of AD pneumonia in Chile to detect annual trends and to compare the severity of single AD or mixed RSV-AD infections is presented.
Surveillance in 4927 infants hospitalized for ALRI has been performed from 1989 to 2001 using immunofluorescence assay (IFA) and viral isolation. Clinical features in 117 infants with single genotyped AD and 81 infants with mixed RSV-AD infections were analyzed.
Adenovirus cases declined from 20% annually in the early 1990s to approximately 5% in the 2000 decade. Genotype 7h showed increasing prevalence in hospitalized cases. The mean annual burden of hospitalizations caused by AD in Santiago was estimated to be 0.6%. No difference was observed in duration of fever, oxygen requirement and hospital stay between groups. Lung consolidation was more frequent in AD cases than mixed cases (P < 0.01); interstitial pattern and hyperinflation prevailed in the mixed cases (P < 0.01). No child died. AD diagnosis was confirmed on admission by IFA in 17% of cases of RSV-AD and in 43% of cases of single AD ALRI. AD cases diagnosed early by IFA had worse clinical outcome than those diagnosed later by virus isolation (P < 0.05).
AD cases declined since 1989. Mixed RSV-AD infections were not more severe than single AD etiology. AD cases admitted with positive IFA had worse prognoses than AD infections diagnosed later by virus isolation.
在智利，呼吸道合胞病毒（RSV）和腺病毒（AD）是婴儿急性下呼吸道感染（ALRI）中检测到的主要病毒。本文概述了智利的腺病毒肺炎情况，以检测年度趋势，并比较单一腺病毒感染或呼吸道合胞病毒与腺病毒混合感染的严重程度。
1989年至2001年期间，对4927名因急性下呼吸道感染住院的婴儿进行了监测，采用免疫荧光测定法（IFA）和病毒分离技术。分析了117例单一基因分型腺病毒感染婴儿和81例呼吸道合胞病毒与腺病毒混合感染婴儿的临床特征。
腺病毒病例从20世纪90年代初的每年20%下降到21世纪第一个十年的约5%。7h基因型在住院病例中的患病率呈上升趋势。圣地亚哥由腺病毒引起的住院平均年负担估计为0.6%。两组之间在发热持续时间、氧气需求和住院时间方面未观察到差异。腺病毒感染病例中肺实变更为常见，而混合感染病例中以间质型和肺过度充气为主（P<0.01）。无儿童死亡。在呼吸道合胞病毒与腺病毒混合感染病例中，17%的病例在入院时通过免疫荧光测定法确诊为腺病毒感染，在单一腺病毒急性下呼吸道感染病例中，43%的病例确诊为腺病毒感染。通过免疫荧光测定法早期诊断的腺病毒病例临床结局比后期通过病毒分离诊断的病例更差（P<0.05）。
自1989年以来，腺病毒病例有所下降。呼吸道合胞病毒与腺病毒混合感染并不比单一腺病毒感染更严重。免疫荧光测定法检测为阳性而入院的腺病毒病例预后比后期通过病毒分离诊断的腺病毒感染病例更差。
