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714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand

BACKGROUND: Influenza infection in children can be severe, resulting in complications such as pneumonia, but may be mitigated by early recognition and administration of antivirals. In this study, we identified risk factors for hospitalization and pneumonia in a pediatric population presenting with i...

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Autores principales: Sawani, Ali, Suwanpakdee, Detchvijitr, Watanaveeradej, Veerachai, Weg, Alden, Ellison, Damon, Klungthong, Chonticha, Phonpakobsin, Thipwipha, Kerdpanich, Phirangkul, Phiboonbanakit, Danabhand, Gibbons, Robert, Fernandez, Stefan, Macareo, Louis, Yoon, In Kyu, Jarman, Rick, Simasthien, Sriluck, Anderson, Kathryn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253966/
http://dx.doi.org/10.1093/ofid/ofy210.721
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author Sawani, Ali
Suwanpakdee, Detchvijitr
Watanaveeradej, Veerachai
Weg, Alden
Ellison, Damon
Klungthong, Chonticha
Phonpakobsin, Thipwipha
Kerdpanich, Phirangkul
Phiboonbanakit, Danabhand
Gibbons, Robert
Fernandez, Stefan
Macareo, Louis
Yoon, In Kyu
Jarman, Rick
Simasthien, Sriluck
Anderson, Kathryn
author_facet Sawani, Ali
Suwanpakdee, Detchvijitr
Watanaveeradej, Veerachai
Weg, Alden
Ellison, Damon
Klungthong, Chonticha
Phonpakobsin, Thipwipha
Kerdpanich, Phirangkul
Phiboonbanakit, Danabhand
Gibbons, Robert
Fernandez, Stefan
Macareo, Louis
Yoon, In Kyu
Jarman, Rick
Simasthien, Sriluck
Anderson, Kathryn
author_sort Sawani, Ali
collection PubMed
description BACKGROUND: Influenza infection in children can be severe, resulting in complications such as pneumonia, but may be mitigated by early recognition and administration of antivirals. In this study, we identified risk factors for hospitalization and pneumonia in a pediatric population presenting with influenza-like illness (ILI) in Thailand. METHODS: Our study included pediatric patients (age < 18 years) presenting with ILI to inpatient and outpatient departments at a public hospital in Bangkok, Thailand, from 2009 to 2016. ILI was defined as fever plus cough or sore-throat, and pneumonia was defined as either lung radiographic or pulmonary examination abnormalities. Demographic and clinical data, as well as nasal and throat swabs, were collected during a one-time interview with patients presenting with ILI. Influenza infections were confirmed via RT-PCR testing of respiratory specimens. Retrospective chart review was used to collect data on individuals with influenza admitted for inpatient care. RESULTS: 5,968 children (33.6%) were enrolled with ILI, of whom 1,530 (25.6%) were confirmed to be influenza by RT-PCR, of which 25.5% were influenza A(H1N1)pdm09, 31.5% influenza A(H3N2), and 43.0% influenza B. 124 (8.1%) patients were admitted, and 41 of these children (33.1%) developed pneumonia. Predictors of hospitalization included younger age (4.1 yrs for inpatients vs. 5.6 yrs) and higher presenting temperature (38.6C for inpatient vs. 38.0C) (both P < 0.05). Among children hospitalized with influenza, influenza subtype was not associated with pneumonia risk. Co-detection of Klebsiella pneumoniae was associated with an increased risk of pneumonia (P < 0.05. Patients with pneumonia were younger (4.1 yrs with vs. 6.4 yrs, P = NS), had a longer interval from fever onset to presentation at the hospital, and required longer hospital stays. Risk of pneumonia was decreased in patients who received oseltamivir within 48 hours of fever onset (odds ratio 0.36, 95% confidence interval 0.16–0.91). CONCLUSION: Post viral pneumonia is a potentially serious complication of influenza, requiring longer hospitalization stay and affecting more than one-third of hospitalized pediatric patients with influenza. The risk of pneumonia can be reduced with early presentation for clinical care and prompt administration of oseltamivir following fever onset. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62539662018-11-28 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand Sawani, Ali Suwanpakdee, Detchvijitr Watanaveeradej, Veerachai Weg, Alden Ellison, Damon Klungthong, Chonticha Phonpakobsin, Thipwipha Kerdpanich, Phirangkul Phiboonbanakit, Danabhand Gibbons, Robert Fernandez, Stefan Macareo, Louis Yoon, In Kyu Jarman, Rick Simasthien, Sriluck Anderson, Kathryn Open Forum Infect Dis Abstracts BACKGROUND: Influenza infection in children can be severe, resulting in complications such as pneumonia, but may be mitigated by early recognition and administration of antivirals. In this study, we identified risk factors for hospitalization and pneumonia in a pediatric population presenting with influenza-like illness (ILI) in Thailand. METHODS: Our study included pediatric patients (age < 18 years) presenting with ILI to inpatient and outpatient departments at a public hospital in Bangkok, Thailand, from 2009 to 2016. ILI was defined as fever plus cough or sore-throat, and pneumonia was defined as either lung radiographic or pulmonary examination abnormalities. Demographic and clinical data, as well as nasal and throat swabs, were collected during a one-time interview with patients presenting with ILI. Influenza infections were confirmed via RT-PCR testing of respiratory specimens. Retrospective chart review was used to collect data on individuals with influenza admitted for inpatient care. RESULTS: 5,968 children (33.6%) were enrolled with ILI, of whom 1,530 (25.6%) were confirmed to be influenza by RT-PCR, of which 25.5% were influenza A(H1N1)pdm09, 31.5% influenza A(H3N2), and 43.0% influenza B. 124 (8.1%) patients were admitted, and 41 of these children (33.1%) developed pneumonia. Predictors of hospitalization included younger age (4.1 yrs for inpatients vs. 5.6 yrs) and higher presenting temperature (38.6C for inpatient vs. 38.0C) (both P < 0.05). Among children hospitalized with influenza, influenza subtype was not associated with pneumonia risk. Co-detection of Klebsiella pneumoniae was associated with an increased risk of pneumonia (P < 0.05. Patients with pneumonia were younger (4.1 yrs with vs. 6.4 yrs, P = NS), had a longer interval from fever onset to presentation at the hospital, and required longer hospital stays. Risk of pneumonia was decreased in patients who received oseltamivir within 48 hours of fever onset (odds ratio 0.36, 95% confidence interval 0.16–0.91). CONCLUSION: Post viral pneumonia is a potentially serious complication of influenza, requiring longer hospitalization stay and affecting more than one-third of hospitalized pediatric patients with influenza. The risk of pneumonia can be reduced with early presentation for clinical care and prompt administration of oseltamivir following fever onset. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253966/ http://dx.doi.org/10.1093/ofid/ofy210.721 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Sawani, Ali
Suwanpakdee, Detchvijitr
Watanaveeradej, Veerachai
Weg, Alden
Ellison, Damon
Klungthong, Chonticha
Phonpakobsin, Thipwipha
Kerdpanich, Phirangkul
Phiboonbanakit, Danabhand
Gibbons, Robert
Fernandez, Stefan
Macareo, Louis
Yoon, In Kyu
Jarman, Rick
Simasthien, Sriluck
Anderson, Kathryn
714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand
title 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand
title_full 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand
title_fullStr 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand
title_full_unstemmed 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand
title_short 714. Predictors of Influenza-Associated Hospitalization and Pneumonia in a Pediatric Population in Bangkok, Thailand
title_sort 714. predictors of influenza-associated hospitalization and pneumonia in a pediatric population in bangkok, thailand
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253966/
http://dx.doi.org/10.1093/ofid/ofy210.721
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