Nenna Raffaella, Frassanito Antonella, Petrarca Laura, Di Mattia Greta, Midulla Fabio
Department of Maternal, Infantile, and Urological Sciences, Sapienza University of Rome, Rome, Italy.
Front Pediatr. 2020 Apr 20;8:144. doi: 10.3389/fped.2020.00144. eCollection 2020.
The most frequent cause of lower respiratory tract infection in infants is bronchiolitis. Up to now there is no agreement on the upper limit age of bronchiolitis. Our aim was to identify if there are clinical differences in infants hospitalized for bronchiolitis between 0-6 months and 6-12 months of age. A secondary aim was to establish whether there was differences in terms of recurrent wheezing at 12, 24, and 36 months of follow-up. We retrospectively analyzed clinical and virological records of 824 infants hospitalized for bronchiolitis during 11 consecutive epidemic seasons. From each infant at admission to the hospital nasopharyngeal washing was collected, clinical severity was assessed and clinical data were extracted from a structured questionnaire. At 12-24-36 months after discharge, parents were interviewed seeking information on recurrent wheezing. A total of 773 infants (Group1) were ≤6 months of age, while 51 were >6 months (Group 2). No differences between family history for atopy and passive smoking exposure were observed between the two groups. Respiratory syncyzial virus was detected more frequently in Group 1 and human bocavirus in Group 2. The clinical severity score ( = 0.011) and the use of intravenous fluids ( = 0.0001) were higher in Group 1 with respect to Group 2 infants. At 36 months follow-up 163/106 (39.4%) Group 1 and 9/9 Group 2 infants experienced recurrent wheezing ( = 0.149). We demonstrated that 0-6 months old infants bronchiolitis differs from > 6 months bronchiolitis.
婴儿下呼吸道感染最常见的病因是细支气管炎。目前对于细支气管炎的年龄上限尚无定论。我们的目的是确定0至6个月和6至12个月因细支气管炎住院的婴儿在临床方面是否存在差异。次要目的是确定在12、24和36个月随访时复发性喘息方面是否存在差异。我们回顾性分析了连续11个流行季节因细支气管炎住院的824例婴儿的临床和病毒学记录。从每个入院婴儿采集鼻咽冲洗液，评估临床严重程度，并从结构化问卷中提取临床数据。出院后12至24至36个月，对家长进行访谈，了解复发性喘息的信息。共有773例婴儿（第1组）年龄≤6个月，而51例年龄>6个月（第2组）。两组在特应性家族史和被动吸烟暴露方面未观察到差异。第1组更频繁检测到呼吸道合胞病毒，第2组更频繁检测到人类博卡病毒。第1组婴儿的临床严重程度评分（P = 0.011）和静脉输液的使用情况（P = 0.0001）高于第2组。在36个月随访时，第1组163/106（39.4%）和第2组9/9例婴儿出现复发性喘息（P = 0.149）。我们证明，0至6个月大婴儿的细支气管炎与>6个月婴儿的细支气管炎不同。
