Miranda-Choque Edwin, Ramírez Carlos, Candela-Herrera Jorge, Díaz Javier, Fernández Ana, Kolevic Lenka, Segura Eddy R, Farfán-Ramos Sonia
Servicio de Infectología, Instituto Nacional de Salud del Niño, Lima, Perú.
Rev Peru Med Exp Salud Publica. 2011 Dec;28(4):610-6.
To determine the clinical and demographic characteristics of pneumonia with influenza virus AH1N1/2009 pandemic at the National Institute of Child.
Retrospective case series in children hospitalized for influenza pneumonia pandemic AH1N1/2009 in a pediatric hospital. Reviewed the medical records between the months of June to September 2009. All cases had virological confirmation, we describe the clinical characteristics and conditions of severity.
A total of 74 children of pneumonia with influenza virus AH1N1/2009 pandemic (NVIp), of those 50 were community acquire pneumonia viral (NACv) and 24 pneumonia nosocomial viral (NNv), 16 required mechanical ventilation. 12 died, all had preexisting factors. NN cases showed statistical association with mortality. The most frequent factors were malnutrition, respiratory infections, congenital heart disease and neurological deficits In NACv cases the children under 6 years accounted for 72% (36/50). The median disease duration was 5 days. The most frequent symptoms were fever, cough, runny nose. Received oseltamivir 82%. The chest radiograph 48% of cases showed patchy infiltrates and 44% interstitial infiltrate on chest radiograph. Protein c reactive (CRP) more than 10mg / L was significantly associated with respiratory failure (p <0.05).
Cases of NN found who had more mortality, even those who had the highest PCR and those with preexisting condition.
确定国家儿童研究所2009年甲型H1N1流感大流行所致肺炎的临床和人口统计学特征。
对一家儿科医院因2009年甲型H1N1流感大流行导致的流感肺炎住院儿童进行回顾性病例系列研究。回顾2009年6月至9月期间的病历。所有病例均有病毒学确诊，我们描述其临床特征和严重程度情况。
共有74例2009年甲型H1N1流感大流行所致肺炎患儿（NVIp），其中50例为社区获得性病毒性肺炎（NACv），24例为医院获得性病毒性肺炎（NNv），16例需要机械通气。12例死亡，均有基础疾病。NN病例与死亡率存在统计学关联。最常见的因素是营养不良、呼吸道感染、先天性心脏病和神经功能缺损。在NACv病例中，6岁以下儿童占72%（36/50）。疾病中位持续时间为5天。最常见的症状是发热、咳嗽、流鼻涕。82%的患儿接受了奥司他韦治疗。胸部X线片48%的病例显示斑片状浸润，44%显示间质性浸润。蛋白C反应（CRP）大于10mg/L与呼吸衰竭显著相关（p<0.05）。
发现NN病例死亡率更高，即使是那些PCR值最高的病例以及有基础疾病的病例。
