Poster Presentations: Tuesday, November 2, 2010 |

Acute Viral Bronchiolitis: Etiology and Treatment Implications in a Population That May Be HIV-Coinfected FREE TO VIEW

Robin J. Green, PhD; Teshni Moodley, MD; Piet Becker, PhD; Omolemo P. Kitchin, MD; Refiloe Masekela, MD
Author and Funding Information

University of Pretoria, Pretoria, South Africa

Chest. 2010;138(4_MeetingAbstracts):326A. doi:10.1378/chest.9346
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PURPOSE: Bronchiolitis, due to Respiratory Syncytial Virus (RSV) is a disease of young infants in developed countries but there is a suggestion of a later age of involvement in the developing world. Bronchiolitis is frequently incorrectly managed with antibiotic therapy because diagnostic testing is misused. The aims of this study were: 1.To describe the microbiological profile of children with bronchiolitis in Pretoria, South Africa. 2.To assess the rate of bacterial co-infection in bronchiolitis. 3.To seek laboratory (biochemical; immunological) parameters that predict mixed (both viral and bacterial) infection.

METHODS: This was a prospective longitudinal study of all children (under 2 years of age) admitted to Steve Biko (Pretoria) Academic Hospital with bronchiolitis during a two year period (January 2006 - December 2007). Virological, bacteriological, biochemical and immunological parameters were assessed.

RESULTS: HIV was clinically suspected in 41 patients (38.7%) and then proven in 14 patients (13.2%). The mean age of bronchiolitis in these children was 8 months, as opposed to the HIV-uninfected children where the mean age was 5.8 months. The HIV-infected bronchiolitics isolated the same viral organisms as the HIV-uninfected children, but the percentage composition was different. A positive bacterial blood culture was found in 18 patients (28.1%). However most organisms were deemed to be contaminants. No correlation was found between CRP, white cell count, neutrophil count and positive blood cultures in the group.

CONCLUSION: RSV Bronchiolitis in children in Pretoria has a different age distribution to developed countries. There are no readily done laboratory tests which predict bacterial co-infection in bronchiolitis.

CLINICAL IMPLICATIONS: HIV co-infection changes the expression of common Paediatric conditions. Antibiotic therapy should be carefully considered in bronchiolitis in children.

DISCLOSURE: Robin Green, Grant monies (from industry related sources) Unrestricted educational grant from Abbott Laboratories; No Product/Research Disclosure Information

12:45 PM - 2:00 PM




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