Moreno Laura, Montanaro Patricia, Bujedo Elizabeth, Cámara Jorge, Abilar C, Terzoni M, Romano M, Marqués Inés, Quiroga Daniel, Orecchini Alejandra, Jacome Javier, Ferrero Fernando
Rev Fac Cien Med Univ Nac Cordoba. 2013;70(2):63-9.
Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination.
Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction.
Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was performed by calculating OR with 95% CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential
We included 174 infants, 72 (41%) BP and 102 (59%) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87% vs. 6%, OR: 14.8 p <0.01), apnea (38% vs. 3%, OR: 13.4 p <0.01) and vomiting (26% vs. 5% , OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95% CI :0,64-0, 81).
In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections.
由百日咳博德特氏菌（BP）引起的百日咳，即百日咳，在我们的环境中是一个重新出现的问题。尽管一般认为该疾病相对容易识别，但呼吸道合胞病毒（RSV）感染在婴儿中可表现出类似症状，仍然难以鉴别。
比较急性呼吸道感染（ARI）住院婴儿中由BP感染和RSV感染的入院时临床症状及辅助检查，以确定能够进行早期临床预测的标志物。
进行观察性、分析性、病例交叉研究，比较2007年至2012年因疑似ARI和百日咳住院的6个月以下婴儿，其中通过（PCR和培养）鉴定出BP和/或RSV（鼻分泌物免疫荧光法）。排除合并感染。通过计算95%置信区间的OR进行双变量分析。p<0.05被认为具有显著性。研究的变量包括年龄、性别、痉挛性咳嗽、发绀、呕吐、呼吸暂停、喘息以及血常规分类。
我们纳入了174名婴儿，72名（41%）为BP感染，102名（59%）为RSV感染。年龄为2±1个月（范围：1至6个月）。两组均有咳嗽和喘息记录（OR分别为：1.2（0.9至1.5），p：0.1；OR = 0.9（0.8至1.06），p：0.2）。BP感染婴儿中发绀（87%对6%，OR：14.8，p<0.01）、呼吸暂停（38%对3%，OR：13.4，p<0.01）和呕吐（26%对5%，OR：3.4，p<0.01）更为常见。BP感染儿童的绝对淋巴细胞计数显著更高（9387±6317对5127±2766，p<0.01）。通过ROC曲线确定9000个细胞/ml为区分RSV和BP的最佳点（AUC = 0.73，95%置信区间：0.64至0.81）。
在因ARI入院的6个月以下婴儿中，呼吸暂停、发绀和淋巴细胞增多的存在有助于显著预测百日咳与RSV感染之间的差异。
