Are there any differences in the community acquired pneumonias admitted to hospital over the past decade?
Estarão diferentes as pneumonias agudas adquiridas na comunidade com internamento hospitalar em idade pediátrica na última década?
Cláudia Calado1,
, Pedro Nunes2, Luísa Pereira3, Teresa Nunes3, Celeste Barreto3, Teresa Bandeira3
Corresponding author
claudiasilvacalado@hotmail.com
Correspondence to/Correspondência: Hospital de Faro EPE. Serviço de Pediatria, Rua Penedo Leão, 8000 Faro.
Correspondence to/Correspondência: Hospital de Faro EPE. Serviço de Pediatria, Rua Penedo Leão, 8000 Faro.
1 Hospital de Faro EPE. Serviço de Pediatria. Director: Dr. José Maio/Hospital de Faro EPE. Paediatrics Unit. Director Dr. José Maio
2 Hospital Fernando da Fonseca. Serviço de Pediatria. Director: Dra Helena Carreiro/Hospital Fernando da Fonseca. Paediatrics Unit. Director Dr. Helena Carreiro
3 Hospital de Santa Maria, Centro Hospitalar Lisboa Norte. Unidade de Pneumologia Pediátrica. Clínica Univ ersitária de Pediatria. Departamento da Criança e da Família. Director: Prof. Doutor J C Gomes Pedro/Hospital de Santa Maria, Centro Hospitalar Lisboa Norte. Paediatric Pulmonology Unit. University Paediatrics Clinic. Child and Family Department. Director Prof. Doctor J C Gomes Pedro
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Serviço de Pediatria, Rua Penedo Leão, 8000 Faro." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Estarão diferentes as pneumonias agudas adquiridas na comunidade com internamento hospitalar em idade pediátrica na última década?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-03-31" "fechaAceptado" => "2009-07-23" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec160698" "palabras" => array:5 [ 0 => "Pneumonia" 1 => "hospital admission" 2 => "empyema" 3 => "vaccine" 4 => "<span class="elsevierStyleItalic">Streptococcus pneumoniae</span>" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec160699" "palabras" => array:5 [ 0 => "Pneumonia" 1 => "internamento" 2 => "empiema" 3 => "vacina" 4 => "<span class="elsevierStyleItalic">Streptococcus pneumoniae</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The past few years have seen a decline in community acquired pneumonia (CAP) in children in the western world, although this has gone hand-in-hand with more serious cases needing hospital admission. Our study characterises cases of CAP admitted to hospital and compares this data with a 2001 study.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We collected data on 63 admissions over a six-month period. The majority were aged 0–2 years old. Chest X-ray showed consolidation/atelectasy in 58 (92.1%) and pleural effusion (PE) in 17 (27.0%), of which 11 were empyema (17.4% of all admissions). The bacterial agent was isolated in five cases: <span class="elsevierStyleItalic">Streptococcus pyogenes</span> (two, pleural fluid), <span class="elsevierStyleItalic">Streptococcus pneumoniae</span> (two, blood culture) and Haemophilus influenzae (one, blood culture). Sixty-one children (96.8%) were prescribed antibiotherapy. The median length of hospital stay was five days. Patients with PE were older, had a longer course of fever, higher inflammatory parameters, longer hospital stay and longer course of iv antibiotics. Compared to the prior study we found greater severity of CAP, with higher prevalence of PE and empyema. Nevertheless there was a shorter course of fever during hospital stay and shorter hospital stay. We also noticed less antibiotic prescription prior to admission and greater prescription of ampicillin during hospital stay.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In the literature, the higher severity of CAP has been partially attributed to the emergence of more aggressive serotypes of <span class="elsevierStyleItalic">Stretococcus pneumoniae</span> not included in the heptavalent vaccine. There is therefore a greater interest in new vaccines containing them. Complicated CAP should be referred to centres specialising in its diagnosis and management.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nos últimos anos tem sido descrita, no mundo ocidental, uma redução da incidência da pneumonia aguda da comunidade (PAC) nas crianças, parodoxalmente associada a maior gravidade dos casos internados. O presente estudo pretendeu caracterizar os casos de PAC internados e compará-los com um estudo anterior a 2001.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Recolhemos dados referentes a 63 internamentos, durante seis meses. Houve predomínio do grupo dos 0–2 anos. Na radiografia torácica, em 58 casos (92,1%) detectou-se condensação/atelectasia e em 17 (27,0%) derrame pleural (DP). Onze dos DP corresponderam a empiema (17,4% dos internamentos). Isolou-se agente bacteriano em cinco casos: <span class="elsevierStyleItalic">Streptococcus pyogenes</span> (dois, líquido pleural), <span class="elsevierStyleItalic">Streptococcus pneumoniae</span> (dois, hemocultura) e Haemophilus influenzae (um, hemocultura). Foi prescrita antibioticoterapia em 61 (96,8%) crianças. A duração mediana de internamento foi de cinco dias. Constatou-se, nos casos de DP, idade superior, maior duração de febre, proteína C reactiva mais alta e maior duração de internamento e de antibioticoterapia endovenosa. Comparativamente com o estudo anterior, constatou-se haver maior gravidade dos casos internados, traduzida por maior incidência de DP e empiema; paradoxalmente, registou-se menor duração da febre em meio hospitalar e menor duração do internamento.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">No estudo actual houve menor prescrição antibiótica prévia à admissão e maior prescrição de ampicilina durante o internamento. Na literatura, a maior gravidade das pneumonias internadas nos últimos anos tem sido associada à emergência de serotipos mais agressivos de <span class="elsevierStyleItalic">Stretococcus pneumoniae</span> não integrados na vacina heptavalente, assumindo interesse crescente a introdução de vacinas que os incluam. As pneumonias complicadas devem ser orientadas para centros de referência com experiência no seu diagnóstico e tratamento.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:59 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pneumonia aguda da comunidade na criança – Decisão terapêutica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Quintas" 1 => "A. Boto" 2 => "L. Pereira" 3 => "C. Barreto" 4 => "L. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 3 | 5 |
| 2024 October | 17 | 27 | 44 |
| 2024 September | 33 | 20 | 53 |
| 2024 August | 36 | 28 | 64 |
| 2024 July | 33 | 30 | 63 |
| 2024 June | 23 | 29 | 52 |
| 2024 May | 28 | 32 | 60 |
| 2024 April | 21 | 28 | 49 |
| 2024 March | 26 | 26 | 52 |
| 2024 February | 30 | 21 | 51 |
| 2024 January | 17 | 27 | 44 |
| 2023 December | 17 | 24 | 41 |
| 2023 November | 14 | 29 | 43 |
| 2023 October | 15 | 27 | 42 |
| 2023 September | 17 | 30 | 47 |
| 2023 August | 13 | 24 | 37 |
| 2023 July | 21 | 28 | 49 |
| 2023 June | 16 | 10 | 26 |
| 2023 May | 20 | 21 | 41 |
| 2023 April | 11 | 8 | 19 |
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