El Basha Noussa, Marzouk Huda, Sherif May, El Kholy Amani
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Egypt Public Health Assoc. 2017 Sep 1;92(3):188-194.
The rate of admissions to hospital with bronchiolitis has increased over the past years. The reasons for this are likely to be multifactorial including improved survival of preterm infants.
To assess the severity of viral bronchiolitis in preterm compared with term infants admitted at a tertiary hospital in Cairo, Egypt, based on the outcome.
This prospective study was conducted throughout a 3-year period from September 2011 to October 2014. It included 153 infants, 74 healthy preterm and 79 healthy term infants, admitted with clinical diagnosis of bronchiolitis at a tertiary hospital in Cairo, Egypt. Bronchiolitis severity score (BSS) was recorded, and nasopharyngeal swabs were obtained from each patient at the time of presentation. Viruses were identified using reverse transcription PCR. The clinical course and patient's outcome were recorded.
This study recorded a significantly more severe BSS for preterm compared with term infants. The preterm group had an increased mean length of hospital stay and oxygen therapy and were more likely to need ICU admission and mechanical ventilation compared with the term group. The mean ±SD BSS for infections with human metapneumovirus, respiratory syncytial virus, parainfluenza 3 was more significantly severe in preterm compared with term infants. Bacterial co-infection was significantly correlated with severity scoring in both groups.
Prematurity significantly affects the severity of bronchiolitis, and this underscores the importance of early categorization of these infants as a high-risk group on their first visit. Physician should be aware that their illness runs a more severe course, even if they have no underlying disorders.
在过去几年中，因细支气管炎入院的比率有所上升。其原因可能是多方面的，包括早产儿存活率的提高。
根据结局评估埃及开罗一家三级医院收治的早产儿与足月儿病毒性细支气管炎的严重程度。
这项前瞻性研究在2011年9月至2014年10月的3年期间进行。研究纳入了153名婴儿，其中74名健康早产儿和79名健康足月儿，他们在埃及开罗的一家三级医院因临床诊断为细支气管炎而入院。记录细支气管炎严重程度评分（BSS），并在每个患者就诊时采集鼻咽拭子。使用逆转录聚合酶链反应鉴定病毒。记录临床病程和患者结局。
该研究记录到，与足月儿相比，早产儿的BSS明显更严重。与足月儿组相比，早产儿组的平均住院时间和吸氧治疗时间增加，且更有可能需要入住重症监护病房和进行机械通气。与足月儿相比，早产儿感染人偏肺病毒、呼吸道合胞病毒、副流感病毒3的平均±标准差BSS更严重。两组中细菌合并感染均与严重程度评分显著相关。
早产显著影响细支气管炎的严重程度，这突出了在这些婴儿首次就诊时将其归类为高危组的重要性。医生应意识到，即使这些婴儿没有潜在疾病，其病情发展也更为严重。
