Prevalence of upper respiratory tract infections at a tertiary care hospital in the city of São Paulo

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Abstract

ABSTRACT Objective: To evaluate the prevalence of pathogens in the upper respiratory tract according to age at a tertiary care hospital in the city of São Paulo. Methods: A total of 6,144 biological material tests from upper respiratory airways were analyzed: 740 bacterial cultures, 726 virus screenings and 4,678 rapid tests for S. pyogenes. Results: The most frequently found etiological agent was respiratory syncytial virus (29.6%; 215/726). The main agents detected per age groups were: respiratory syncytial virus (25.34%; 184/726) in patients aged 28 days-3 years; S. pyogenes (9.5%; 70/740) in 3-12 year-old children; influenza virus (8.8%; 64/726) in adults (18-59 years). Conclusions: The etiologic agents of upper respiratory infections vary according to age and imply diverse clinical and therapeutic management.

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Guidelines for the use of antibiotics in acute upper respiratory tract infections.

Christopher Lowe, Daphne D Blumberg, Nathan D. Wong (2006)

To help physicians with the appropriate use of antibiotics in children and adults with upper respiratory tract infection, a multidisciplinary team evaluated existing guidelines and summarized key practice points. Acute otitis media in children should be diagnosed only if there is abrupt onset, signs of middle ear effusion, and symptoms of inflammation. A period of observation without immediate use of antibiotics is an option for certain children. In patients with sinus infection, acute bacterial rhinosinusitis should be diagnosed and treated with antibiotics only if symptoms have not improved after 10 days or have worsened after five to seven days. In patients with sore throat, a diagnosis of group A beta-hemolytic streptococcus pharyngitis generally requires confirmation with rapid antigen testing, although other guidelines allow for empiric therapy if a validated clinical rule suggests a high likelihood of infection. Acute bronchitis in otherwise healthy adults should not be treated with antibiotics; delayed prescriptions may help ease patient fears and simultaneously reduce inappropriate use of antibiotics.

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Population-based surveillance of invasive pyogenic streptococcal infection in a large Canadian region.

D Gregson, Nathan Ross, K Laupland … (2006)

Pyogenic streptococci are a major cause of invasive infection. This study presents the results of a population-based laboratory surveillance for invasive pyogenic streptococcal infections among residents of the Calgary Health Region (population 1 million) between 1 July 1999 and 30 June 2004. The overall annual incidence rate was 18.65/100,000 population, with isolates belonging to the Streptococcus milleri group forming the most important aetiology (incidence of 8.65/100,000 population). Invasive infection with groups A, B, G and C streptococci occurred at annual rates of 4.27, 3.13, 1.83 and 0.41/100,000 population, respectively. There was a close relationship between increasing age and development of an invasive pyogenic streptococcal infection, and the incidence of infection was higher among males than among females. Differences in the seasonal occurrence and focus of infection occurred between the different groups.

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Fatores ambientais e hospitalizações em crianças menores de cinco anos com infecção respiratória aguda

Clovis Botelho, Ademir Correia, Ageo Silva … (2003)

Considerando a hospitalização como um indicador de gravidade da Infecção Respiratória Aguda (IRA), objetiva-se estudar a associação de alguns fatores ambientais com a necessidade de tratamento hospitalar em crianças com diagnóstico de IRA. Foram analisados todos os prontuários de atendimento do Pronto Socorro Municipal de Cuiabá, das crianças menores de cinco anos, de ambos os sexos, agrupados por mês do atendimento. Obedecendo às características climáticas da região, dois períodos climáticos foram levados em conta: seco (maio a outubro) e chuvoso (novembro a abril). As variáveis: temperatura, umidade relativa do ar, o número de focos de calor (queimadas) foram cotejadas. A prevalência da IRA foi 49,8%; a necessidade de internação alcançou 7,6%, com percentual de internações maior no período seco. Conclui-se que o período seco e a umidade relativa do ar estão associados com as hospitalizações das crianças estudadas.