Palabras clave
Técnicas de diagnóstico molecular
Prevalencia
Niño
Estado asmático Virus
Molecular diagnostic techniques
Prevalence
Child
Status asthmaticus
Cómo citar
Resumen
Introducción: los virus respiratorios son la causa principal de crisis de asma en niños y adultos. Nuestro objetivo fue determinar la prevalencia de infecciones por virus mediante técnicas moleculares en niños de 2-15 años con crisis de asma. Metodología: estudio analítico transversal que incluye análisis de datos demográficos, clínicos y de pruebas moleculares (Reacción en Cadena de Polimerasa y PCR de Transcripción Reversa), usadas para detección de virus ADN y ARN, respectivamente. Pruebas T, Chi cuadrado y Fisher sirvieron para comparar grupos con y sin virus. Resultados: la prevalencia de virus en la población estudiada (n=175) fue 83.4%. Su distribución fue de la siguiente manera: Rhinovirus: 71.4% (Subtipo tipo C: 47.4%, A: 20.6% y B: 3.4%); Influenza A: 27.4%, VSR: 8%, Parainfluenza (P) P1: 5.7%, P2: 0% y P3: 1.7%, Enterovirus: 1.7%. Adenovirus: 1.7%. No hubo diferencias entre los grupos en variables como sexo, índice de masa corporal y severidad de la crisis, sugiriendo que éstos por si solos no están relacionados con un incremento de la severidad de los síntomas y la necesidad de hospitalización. Debido al bajo número de detecciones de Adenovirus y Enterovirus-68 no fue posible concluir acerca de asociaciones de estos agentes con exacerbaciones severas descritas en la literatura. Conclusiones: la detección de virus fue frecuente en niños de 2 -15 años con crisis de asma en nuestro medio y similar a la descrita en la literatura. La prevalencia de virus en general y de Rhinovirus en particular, fue semejante a la descrita en la literatura.
Citas
GINA. Global Strategy for Asthma Management and Prevention. NIH Publication: 2011.
Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, et al. Global strategy for asthma management and prevention: GINA executive summary. The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. 2008 Jan;31(1):143-78. PubMed PMID: 18166595. Epub 2008/01/02. eng. https://doi.org/10.1183/09031936.00138707
Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006 Aug 26;368(9537):733-43. PubMed PMID: 16935684. Epub 2006/08/29. eng. https://doi.org/10.1016/S0140-6736(06)69283-0
Dennis R, Caraballo L, García E, Caballero A, Aristizabal G, Córdoba H, et al. Asthma and other allergic conditions in Colombia: a study in 6 cities. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2004 Dec;93(6):568- 74. PubMed PMID: 15609767. Epub 2004/12/22. eng. https://doi.org/10.1016/S1081-1206(10)61265-3
Dennis R, Caraballo L, García E, Rojas MX, Rondón MA, Pérez A, et al. Prevalence of asthma and other allergic conditions in Colombia 2009-2010: a cross-sectional study. BMC pulmonary medicine. 2012 May 2;12(1):17. PubMed PMID: 22551171. Epub 2012/05/04. Eng. https://doi.org/10.1186/1471-2466-12-17
GINA. obal Strategy for Diagnosis and Management of asthma in children 5 years and younger. 2011.
Dougherty RH, Fahy JV. Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 2009 Feb;39(2):193-202. PubMed PMID: 19187331. Pubmed Central PMCID: 2730743. Epub 2009/02/04. eng.
https://doi.org/10.1111/j.1365-2222.2008.03157.x
Carroll KN, Hartert TV. The impact of respiratory viral infection on wheezing illnesses and asthma exacerbations. Immunology and allergy clinics of North America. 2008 Aug;28(3):539-61, viii. PubMed PMID: 18572106. Pubmed Central PMCID: PMC2504766. Epub 2008/06/24. eng. https://doi.org/10.1016/j.iac.2008.03.001
Busse WW, Lemanske RF, Jr., Gern JE. Role of viral respiratory infections in asthma and asthma exacerbations. Lancet. 2010 Sep 4;376(9743):826- 34. PubMed PMID: 20816549. Pubmed Central PMCID: PMC2972660. Epub 2010/09/08. eng. https://doi.org/10.1016/S0140-6736(10)61380-3
Murray CS, Poletti G, Kebadze T, Morris J, Woodcock A, Johnston SL, et al. Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children. Thorax. 2006 May;61(5):376-82. PubMed PMID: 16384881. Pubmed Central PMCID: PMC2111190. Epub 2005/12/31. eng. https://doi.org/10.1136/thx.2005.042523
Nicholson KG, Kent J, Ireland DC. Respiratory viruses and exacerbations of asthma in adults. BMJ (Clinical research ed). 1993 Oct 16;307(6910):982-6. PubMed PMID: 8241910. Pubmed Central PMCID: PMC1679193. Epub 1993/10/16. eng. https://doi.org/10.1136/bmj.307.6910.982
Khetsuriani N, Kazerouni NN, Erdman DD, Lu X, Redd SC, Anderson LJ, et al. Prevalence of viral respiratory tract infections in children with asthma. J Allergy Clin Immunol. 2007 Feb;119(2):314-21. PubMed PMID: 17140648. Epub 2006/12/05. eng. https://doi.org/10.1016/j.jaci.2006.08.041
Maffey AF, Barrero PR, Venialgo C, Fernandez F, Fuse VA, Saia M, et al. Viruses and atypical bacteria associated with asthma exacerbations in hospitalized children. Pediatric pulmonology. 2010 Jun;45(6):619-25. PubMed PMID: 20503289. Epub 2010/05/27. eng. https://doi.org/10.1002/ppul.21236
British Thoracic Society., Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma : a national clinical guideline. Edinburgh, Scotland: SIGN; 2008. 121 leaves p.
Dueñas-Meza E. Crisis de asma en niños. En: García E CL, editores. Asma. Bogotá: Editorial Médica Panamericana; 2005. p. 473-92. Crisis de asma en niños. In: García E CL, editores, editor. Asma. Bogota: Editorial Médica Panamericana; 2005. p. 473-92.
Birken CS, Parkin PC, Macarthur C. Asthma severity scores for preschoolers displayed weaknesses in reliability, validity, and responsiveness. Journal of clinical epidemiology. 2004 Nov;57(11):1177-81. PubMed PMID: 15567635. Epub 2004/11/30. eng. https://doi.org/10.1016/j.jclinepi.2004.02.016
Ducharme FM, Chalut D, Plotnick L, Savdie C, Kudirka D, Zhang X, et al. The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers. The Journal of pediatrics. 2008 Apr;152(4):476-80, 80 e1. PubMed PMID: 18346499. Epub 2008/03/19. eng. https://doi.org/10.1016/j.jpeds.2007.08.034
Hsu P, Lam LT, Browne G. The pulmonary index score as a clinical assessment tool for acute childhood asthma. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2010 Dec;105(6):425-9. PubMed PMID: 21130379. Epub 2010/12/07. eng. https://doi.org/10.1016/j.anai.2010.10.009
Bellau-Pujol S, Vabret A, Legrand L, Dina J, Gouarin S, Petitjean-Lecherbonnier J, et al. Development of three multiplex RT-PCR assays for the detection of 12 respiratory RNA viruses. Journal of Virological Methods. 2005;126(1-2):53-63. https://doi.org/10.1016/j.jviromet.2005.01.020
Gern JE. The ABCs of rhinoviruses, wheezing, and asthma. Journal of virology. 2010 Aug;84(15):7418-26. PubMed PMID: 20375160. Pubmed Central PMCID: 2897627. Epub 2010/04/09. eng. https://doi.org/10.1128/JVI.02290-09
Lee SL, Chiu SS, Malik PJ, Chan KH, Wong HS, Lau YL. Is respiratory viral infection really an important trigger of asthma exacerbations in children? European journal of pediatrics. 2011 Oct;170(10):1317-24. PubMed PMID: 21448631. Pubmed Central PMCID: PMC3175036. Epub 2011/03/31. eng. https://doi.org/10.1007/s00431-011-1446-1
Johnston NW, Johnston SL, Duncan JM, Greene JM, Kebadze T, Keith PK, et al. The September epidemic of asthma exacerbations in children: a search for etiology. J Allergy Clin Immunol. 2005 Jan;115(1):132-8. PubMed PMID: 15637559. Epub 2005/01/08. eng. https://doi.org/10.1016/j.jaci.2004.09.025
Gern JE, Busse WW. Association of rhinovirus infections with asthma. Clinical microbiology reviews. 1999 Jan;12(1):9-18. PubMed PMID: 9880472. Pubmed Central PMCID: 88904. Epub 1999/01/09. eng. https://doi.org/10.1128/CMR.12.1.9
Miller EK, Edwards KM, Weinberg GA, Iwane MK, Griffin MR, Hall CB, et al. A novel group of rhinoviruses is associated with asthma hospitalizations. J Allergy Clin Immunol. 2009 Jan;123(1):98-104 e1. PubMed PMID: 19027147. Epub 2008/11/26. eng. https://doi.org/10.1016/j.jaci.2008.10.007
Khetsuriani N, Lu X, Teague WG, Kazerouni N, Anderson LJ, Erdman DD. Novel human rhinoviruses and exacerbation of asthma in children. Emerging infectious diseases. 2008 Nov;14(11):1793-6. PubMed PMID: 18976575. Pubmed Central PMCID: 2630738. Epub 2008/11/04. eng. https://doi.org/10.3201/eid1411.080386
Jackson DJ, Sykes A, Mallia P, Johnston SL. Asthma exacerbations: origin, effect, and prevention. Journal of Allergy and Clinical Immunology. 2011;128(6):1165-74. https://doi.org/10.1016/j.jaci.2011.10.024
Oliver BG, Lim S, Wark P, Laza-Stanca V, King N, Black JL, et al. Rhinovirus exposure impairs immune responses to bacterial products in human alveolar macrophages. Thorax. 2008;63(6):519-25. https://doi.org/10.1136/thx.2007.081752
Imamura T, Fuji N, Suzuki A, Tamaki R, Saito M, Aniceto R, et al. Enterovirus 68 among children with severe acute respiratory infection, the Philippines. Emerging infectious diseases. 2011;17(8). https://doi.org/10.3201/eid1708.101328
Ucrós S, Dueñas E, Gutiérrez M. Calendario y variación estacional de las afecciones respiratorias en Santa Fe de Bogotá. Rev colomb neumol. 1997;9(3):124-32.