Infección extra e intrahospitalaria por virus sincicial respiratorio en lactantes

Abstract

Respiratory syncytial virus infection in infants and children Clinical aspects of respiralory syncytial virus (RSV) infection were studied in 131 infants under age two years who were admited to hospital fof acute lower respiratory tract infection (ALRI) during the cold seasons of year 1988 at Sanliago, Chile. Two daily samples of nasopharyngeal aspirates for RSV inmunofluorescent assay and viral isolation in Hep-2 cell culture, blood cells count and chest X ray were performed at admission. Fifty three of these patients showed positive immunofluorescense for RSV at admission. Nasopharyngeal samples were also ptospectively taken to 251 infants admited (o two hospital rooms at the cold seasons of years 1988 throughout 1989, at admission for viral isolation and immunofluorescent assay and in alternate days for this late assay, along their hospital stays. Nasopharyngeal samples obtained after admission allowed detection of 42 cases of RSV nosocomial infections. No differences were found in clinical, hematologicat and radiological features among patients with and without RSV infections. Nosocomial RSV infection rate was ] 6,7% and 76% of coses occurred in the first week after admission. That rate was not related to intensity of RSV contacts neither lenght of hospital stay. Since there are no known specific differential features between viral and bacterial respiratory infection, rapid methods for viral identification ore highly recommended for better management of acute lower respiratory trocl infections. (Key words: respiratory syncytial viruses, virus diseases, respiratory tract infections, infant.) Las infecciones respiratorias agudas bajas (IRAB) son la causa mas frecuente de hospitali-zaci6n en lactantes, especialmente en la estacio-nes frias, y de muerte de niflos entre un mes y cuatro aflos de edad 1 ' 3. En Chile los virus respi-ratorios son la primera causa de IRAB en lactantes y, entre ellos, el virus respiratorio sincicial (VRS) ocupa un rol preponderant, detectandose con frecuencias de 42% a 70%, dependiendo de la forma de estudio 4 " 9. Estos hallazgos son seme-jantes a los comunicados en otros pafses 10-n. La posibilidad de realizar un diagnostico etio-16gico rapido ha aumentado al disponer de te*cni-cas de inmunofluorescencia 5-7 ' 9> 12 ' 13. La deten-ci6n de VRS en nifios sanos es poco frecuente,