2009 신종 인플루엔자 감염으로 입원한 소아 환자들의 임상적 특성
Clinical Characteristics of Hospitalized Pediatric Patients with 2009 Novel Influenza A Infection
1
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
목 적:신종 인플루엔자 A 바이러스 감염의 대유행이 발생하였고 중증 감염으로 입원하는 환자들도 빠르게 증가하였다. 저자들은 신종 인플루엔자 A(H1N1)의 감염으로 입원한 소아 환자에서 그 임상적 특성을 분석하고자 본 연구를 시행하였다. 방 법:2009년 9월부터 2010년 2월까지 신종 인플루엔자 감염으로 동국대학교 일산병원에 입원한 만 16세 미만의 소아환자 128명의 의무기록을 분석하였다. 이들을 폐렴군과 비-폐렴군으로 나누어 임상적 특성을 비교하였고, Mycoplasma pneumoniae의 동시감염 여부와 폐렴의 중증도에 따른 임상적 특성의 차이를 조사하였다. 결 과:대상 환자의 남녀성비는 2.2:1이었으며 평균 나이는 6.2세였다. 이중 폐렴군이 65명(50.8%)이었고 평균 나이는 6.7세였다. 폐렴군은 비-폐렴군에 비해 입원기간과 총 백혈구수, 중성구의 비율, CRP에서 유의한 차이를 보였으나 다른 변수에서는 차이를 보이지 않았다. 폐렴군에서 중증 폐렴군은 20명(30.8%)이었으며, M. pneumoniae의 동시감염은 24.6%에서 동반되었으나 폐렴의 중증도에는 영향을 미치지 않았다. 중증 폐렴군에서 경증 폐렴군에 비해 천식과의 연관성이 높았으며, 사망한 환자는 없었다. 결 론:본 연구에서 2009 신종 인플루엔자 감염은 학동기 남아에서 발병률이 높았다. M. pnemoniae 감염의 빈도는 높았으나 폐렴의 중증도에는 영향을 미치지 않았다. 천식과 같은 만성호흡기 질환이 있는 환자에서 중증 폐렴의 발생이 좀 더 많은 경향을 보였다.
Abstract
Purpose:Novel influenza H1N1 A virus developed pandemic infection, and patients requiring hospitalization have rapidly increased because of severe clinical symptoms and signs. We describe the clinical features of hospitalized pediatric patients with novel influenza virus infection. Methods:We reviewed the medical charts of 128 pediatric patients under the age of 16 who were hospitalized in Dongguk University Ilsan Hospital between September 2009 and February 2010. We compared the clinical features of the pneumonia and non-pneumonia groups of patients, and analyzed clinical difference according to M. pneumoniae coinfection and severity of pneumonia. Results:The male to female sex ratio of the subjects was 2.2:1, and the average age was 6.2 years. Sixty-five patients (50.8%) had pneumonia and their average age was 6.7 years. Variables including duration of admission, total WBC counts, neutrophil percentage and CRP were significantly different between the 2 groups, however, the other variables were not. The number of patients diagnosed with severe pneumonia was 20 (30.8%). M. pneumoniae coinfection occurred in 24.6% of patients in the pneumonia group, however, it did not influence the severity of pneumonia. Underlying asthma was more significantly associated with severe pneumonia than with mild pneumonia. There was no death case. Conclusion:In this study, 2009 novel influenza infection was more prevalent in school-age boys. M. pneumoniae coinfection occurred frequently, however, it did not seem to influence disease severity. Patients with underlying asthma tend to develop severe pneumonia more frequently.
참고문헌 (24)
- Sullivan SJ, "2009 H1N1 influenza", Mayo Clin Proc., 85, pp.64~76 (2010)
- 이진아, "신종 H1N1 인플루엔자", Korean Journal of Pediatrics, 52(8), pp.862~868 (2009), 대한소아과학회
- Pollack MM, "PRISM III:an updated pediatric risk of mortality score", Crit Care Med, 24, pp.743~752 (1996)
- Lee PI, "Recommendations for the management of children with H1N1 novel influenza infection", Pediatr Neonatol, 51, pp.1~4 (2010)
- Cheon BC, "Epidemiology of pandemic novel H1N1 influenza", Korean J Fam Med, 30, pp.25~33 (2009)
- Rothberg MB, "Complications of seasonal and pandemic influenza", Crit Care Med, 38, pp.91~97 (2010)
- Bettinger JA, "Pandemic influenza in Canadian children:a summary of hospitalized pediatric cases", Vaccine, 28, pp.3180~3184 (2010)
- Cao B, "Clinical features of the initial cases of 2009 pandemic influenza A(H1N1)virus infection in China", N Engl J Med, 361, pp.2507~2517 (2009)
- Choi WJ, "Clinical characteristics of pneumonia in hospitalized patients with novel influenza A(H1N1)in Korea", Scand J Infect Dis, 42, pp.311~314 (2010)
- Costello BE, "Pandemic H1N1 influenza in the pediatric emergency department: A comparison with previous seasonal influenza outbreaks" (2010), In press
- Miroballi Y, "Novel influenza A(H1N1)in a pediatric health care facility in New York City during the first wave of the 2009 pandemic", Arch Pediatr Adolesc Med, 164, pp.24~30 (2010)
- Lee KH, "A clinical ananlysis on acute lower respiratory tract infections in children caused by influenza virus in children", J Korean Pediatr Soc, 41, pp.1623~1631 (1998)
- 권민경, "인플루엔자 바이러스에 의한 소아 급성 호흡기 감염증의 유행 및 임상 양상", Korean Journal of Pediatrics, 45(12), pp.8~1527 (2002), 대한소아과학회
- Renner ED, "Coinfections of Mycoplasma pneumoniae and Legionella pneumophila with influenza A virus", J Clin Microbiol, 17, pp.146~148 (1983)
- Campbell A, "Risk of severe outcomes among patients admitted to hospital with pandemic(H1N1)influenza", Can Med Assoc J, 182, pp.349~355 (2010)
- Morgan O, "Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1)disease", PLoS ONE, 5, pp.9694~9699 (2010)
- KCDC (Korea Centers for Disease Control and prevention), "Center of communicable disease surveilance and response, Division of Epidemic inteligence service. Epidemiologic characteristics of pediatric patients with influenza A (H1N1)", ~ (2009)
- Youn SS, "Epidemiology of severe pediatric patients with novel influenza A(H1N1)in Korea", Int J Infect Dis, 14, pp.2~190 (2010)
- O'Riordan S, "Risk factors and outcomes among children admitted to hospital with pandemic H1N1 influenza", Can Med Assoc J, 182, pp.39~44 (2009)
- Dominguez-Cherit G, "Critically ill patients with 2009 influenza A(H1N1)in Mexico", J Am Med Assoc, 302, pp.1880~1887 (2009)
- Kumar A, "Critically ill patients with 2009 influenza A(H1N1)infection in Canada", J Am Med Assoc, 302, pp.1872~1879 (2009)
- Libster R, "Pediatric hospitalizations associated with 2009 pandemic influenza A(H1N1)in Argentina", N Engl J Med, 362, pp.45~55 (2010)
- Louie J, "Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1)infection in California", J Am Med Assoc, 302, pp.1896~1902 (2009)
- Miller RR 3rd, "Clinical findings and demographic factors associated with ICU admission in Utah due to novel 2009 influenza A(H1N1)infection", Chest, 137, pp.752~758 (2010)