|Conţinutul numărului revistei|
| SM ISO690:2012|
SAVOSCHIN, Dorina. Aspecte practice ale utilizării metodelor de diagnostic etiologic la copiii cu sindrom bronşiolar acut de tip obstructiv. In: Buletin de Perinatologie. 2014, nr. 2(62), pp. 182-185. ISSN 1810-5289.
|Buletin de Perinatologie|
|Numărul 2(62) / 2014 / ISSN 1810-5289|
Background. Annually more than 2-3% of children with acute Respiratory Syncytial Virus (RSV) bronchiolitis require hospitalization, and the role of this infection in asthma exacerbations is still unclear. Etiologic diagnosis of the Respiratory Syncytial Virus infection would reduce unnecessary administration of antibiotic therapy and early initiation of epidemiological measures required to limit the spread of the infection. Material and methods. The case-control clinical study included 244 children: group I - 150 children with acute bronchial obstruction of infectious etiology, hospitalized to the Pulmonology Unit of the Institute for Maternal and Child Healthcare; group II (controls) - 94 patients with persistent asthma, hospitalized to the Allergy Unit with asthma exacerbation. Diagnosis of the RSV infection was performed by three methods - detection of the RSV antigen in nasopharyngeal swab tests using rapid assay (RSV STICK Test One Step Assay); detection of virus RNA in nasopharyngeal exudates by polymerase chain reaction (PCR); assessment of anti-RSV antibodies titers (IgM and IgG) by the enzyme-linked immunosorbent assay. Rezults and discussion. Out of 58 samples of naso-pharyngeal exudates examined for RSV infection using PCR and/or rapid test methods, more than half of children (60.3%) were identifi ed as having Respiratory Syncytial Virus infection. Most positive results were found in the winter months (83% cases). The clinical trial results showed persistence in maintaining the permeability of airways in the group of children who were administred hypertonic saline solution inhalations. This was demonstrated by improvement of the Respiratory Distress Assessment Instrument score in the basic group of children with obstructive bronchitis who received hypertonic saline solution inhalations (3% NaCl) comparing to controls (on Salbutamol treatment) at 12 hours of follow-up (36.3% vs. 22.2%, respectively, p<0.05) and 24 hours of follow-up (18.2% vs. 11.1%, p>0.05). Conclusions. Rapid diagnosis of the RSV infection does not influence the natural history of the disease, but it is necessary to avoid unnecessary antibiotic treatment. Clinical trial results showed that in cases with bronchial obstruction of infectious genesis in children, especially caused by the Respiratory Syncytial Virus, hypertonic saline solution inhalation three times a day are effective in maintaining the airways permeability.
Respiratory Syncytial Virus infection, polymerase chain reaction, inhalation therapy, Respiratory Distress Assessment Instrument,
children, asthma, Antigen