Infección por adenovirus en hospital de niños con enfermedades respiratorias crónicas

Abstract

Introduction: Intrahospital adenovirus infections spread rapidly in closed environments causing outbreaks associated with high morbidity and mortality. Objectives: To identify the attack rate (AR) of adenovirus in a hospital treating children with Chronic Respiratory Diseases (CRD) and to evaluate associated factors that facilitate infection. Patients and Methods: Fifty children with CRD were evaluated between June 2010 and October 2010 at Josefna Martinez Hospital. They were exposed to patients with acute lower respiratory infection during winter. Patients with CRD symptoms (fever and change in basal nasal mucus) underwent Viral Direct Immunofuorescence (DIF). The case was defned as "symptomatic patient with positive DIF for Adenovirus". Primary, secondary and global ARs were evaluated. Variables such as gender, age, tracheostomy and gastrostomy were analyzed looking for associations with the cases. Results: 44% of patients were infants; 68% of children had tracheostomy and 54% had gastrostomy. The frst patient with Adenovirus was admitted in June and the primary case was reported two weeks later. 25 cases presented secondary AR corresponding to 51%. Global AR was 52% overall. No mortality was reported. The risk was three times higher in infants than older children (OR 3.31 [IC95% 1.02-10.72; p = 0.046]). No signifcant associations with tracheostomy, gastrostomy and gender were found. Conclusions: The rapid spread of adenovirus infection in closed environments requires extreme prevention measures especially regarding infants.