PandemieGrippaleV1, Main, Curation, bibRecord, 002556

Critically Ill Children During the 2009–2010 Influenza Pandemic in the United States

Identifieur interne : 002556 ( Main/Curation ); précédent : 002555; suivant : 002557

Critically Ill Children During the 2009–2010 Influenza Pandemic in the United States

Auteurs : Adrienne G. Randolph [États-Unis] ; Frances Vaughn [États-Unis] ; Ryan Sullivan [États-Unis] ; Lewis Rubinson [États-Unis] ; B. Taylor Thompson [États-Unis] ; Grace Yoon [États-Unis] ; Elizabeth Smoot [États-Unis] ; Todd W. Rice [États-Unis] ; Laura L. Loftis [États-Unis] ; Mark Helfaer [États-Unis] ; Allan Doctor [États-Unis] ; Matthew Paden [Géorgie (pays)] ; Heidi Flori [États-Unis] ; Christopher Babbitt [États-Unis] ; Ana Lia Graciano [États-Unis] ; Rainer Gedeit [États-Unis] ; Ronald C. Sanders [États-Unis] ; John S. Giuliano [États-Unis] ; Jerry Zimmerman [États-Unis] ; Timothy M. Uyeki [Géorgie (pays)]

Source :

Pediatrics [ 0031-4005 ] ; 2011.

RBID : PMC:3387899

Descripteurs français

KwdFr :
- Adolescent, Enfant, Enfant d'âge préscolaire, Femelle, Grippe humaine (), Grippe humaine (diagnostic), Grippe humaine (épidémiologie), Humains, Jeune adulte, Maladie grave, Mâle, Nourrisson, Pandémies, Sous-type H1N1 du virus de la grippe A, États-Unis d'Amérique (épidémiologie), Études rétrospectives.
MESH :
- diagnostic : Grippe humaine.
- épidémiologie : Grippe humaine, États-Unis d'Amérique.
- Adolescent, Enfant, Enfant d'âge préscolaire, Femelle, Grippe humaine, Humains, Jeune adulte, Maladie grave, Mâle, Nourrisson, Pandémies, Sous-type H1N1 du virus de la grippe A, Études rétrospectives.
Wicri :
- geographic : États-Unis.

English descriptors

KwdEn :
- Adolescent, Child, Child, Preschool, Critical Illness, Female, Humans, Infant, Influenza A Virus, H1N1 Subtype, Influenza, Human (complications), Influenza, Human (diagnosis), Influenza, Human (epidemiology), Male, Pandemics, Retrospective Studies, United States (epidemiology), Young Adult.
MESH :
- geographic , epidemiology : United States.
- complications : Influenza, Human.
- diagnosis : Influenza, Human.
- epidemiology : Influenza, Human.
- Adolescent, Child, Child, Preschool, Critical Illness, Female, Humans, Infant, Influenza A Virus, H1N1 Subtype, Male, Pandemics, Retrospective Studies, Young Adult.

Abstract

BACKGROUND:

The 2009 pandemic influenza A (H1N1) (pH1N1) virus continues to circulate worldwide. Determining the roles of chronic conditions and bacterial coinfection in mortality is difficult because of the limited data for children with pH1N1-related critical illness.

METHODS:

We identified children (<21 years old) with confirmed or probable pH1N1 admitted to 35 US PICUs from April 15, 2009, through April 15, 2010. We collected data on demographics, baseline health, laboratory results, treatments, and outcomes.

RESULTS:

Of 838 children with pH1N1 admitted to a PICU, the median age was 6 years, 58% were male, 70% had ≥1 chronic health condition, and 88.2% received oseltamivir (5.8% started before PICU admission). Most patients had respiratory failure with 564 (67.3%) receiving mechanical ventilation; 162 (19.3%) received vasopressors, and 75 (8.9%) died. Overall, 71 (8.5%) of the patients had a presumed diagnosis of early (within 72 hours after PICU admission) Staphylococcus aureus coinfection of the lung with 48% methicillin-resistant S aureus (MRSA). In multivariable analyses, preexisting neurologic conditions or immunosuppression, encephalitis (1.7% of cases), myocarditis (1.4% of cases), early presumed MRSA lung coinfection, and female gender were mortality risk factors. Among 251 previously healthy children, only early presumed MRSA coinfection of the lung (relative risk: 8 [95% confidence interval: 3.1–20.6]; P < .0001) remained a mortality risk factor.

CONCLUSIONS:

Children with preexisting neurologic conditions and immune compromise were at increased risk of pH1N1-associated death after PICU admission. Secondary complications of pH1N1, including myocarditis, encephalitis, and clinical diagnosis of early presumed MRSA coinfection of the lung, were mortality risk factors.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387899

DOI: 10.1542/peds.2011-0774
PubMed: 22065262
PubMed Central: 3387899

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PMC:3387899

Le document en format XML

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<author><name sortKey="Doctor, Allan" sort="Doctor, Allan" uniqKey="Doctor A" first="Allan" last="Doctor">Allan Doctor</name>
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<author><name sortKey="Paden, Matthew" sort="Paden, Matthew" uniqKey="Paden M" first="Matthew" last="Paden">Matthew Paden</name>
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<author><name sortKey="Flori, Heidi" sort="Flori, Heidi" uniqKey="Flori H" first="Heidi" last="Flori">Heidi Flori</name>
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<author><name sortKey="Babbitt, Christopher" sort="Babbitt, Christopher" uniqKey="Babbitt C" first="Christopher" last="Babbitt">Christopher Babbitt</name>
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<author><name sortKey="Graciano, Ana Lia" sort="Graciano, Ana Lia" uniqKey="Graciano A" first="Ana Lia" last="Graciano">Ana Lia Graciano</name>
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<author><name sortKey="Gedeit, Rainer" sort="Gedeit, Rainer" uniqKey="Gedeit R" first="Rainer" last="Gedeit">Rainer Gedeit</name>
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<author><name sortKey="Sanders, Ronald C" sort="Sanders, Ronald C" uniqKey="Sanders R" first="Ronald C." last="Sanders">Ronald C. Sanders</name>
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<author><name sortKey="Giuliano, John S" sort="Giuliano, John S" uniqKey="Giuliano J" first="John S." last="Giuliano">John S. Giuliano</name>
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<author><name sortKey="Zimmerman, Jerry" sort="Zimmerman, Jerry" uniqKey="Zimmerman J" first="Jerry" last="Zimmerman">Jerry Zimmerman</name>
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<author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name>
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<wicri:regionArea>Influenza Division, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Critically Ill Children During the 2009–2010 Influenza Pandemic in the United States</title>
<author><name sortKey="Randolph, Adrienne G" sort="Randolph, Adrienne G" uniqKey="Randolph A" first="Adrienne G." last="Randolph">Adrienne G. Randolph</name>
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<author><name sortKey="Sullivan, Ryan" sort="Sullivan, Ryan" uniqKey="Sullivan R" first="Ryan" last="Sullivan">Ryan Sullivan</name>
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<author><name sortKey="Rubinson, Lewis" sort="Rubinson, Lewis" uniqKey="Rubinson L" first="Lewis" last="Rubinson">Lewis Rubinson</name>
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<author><name sortKey="Thompson, B Taylor" sort="Thompson, B Taylor" uniqKey="Thompson B" first="B. Taylor" last="Thompson">B. Taylor Thompson</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Yoon, Grace" sort="Yoon, Grace" uniqKey="Yoon G" first="Grace" last="Yoon">Grace Yoon</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Department of Anesthesia, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, Massachusetts;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Smoot, Elizabeth" sort="Smoot, Elizabeth" uniqKey="Smoot E" first="Elizabeth" last="Smoot">Elizabeth Smoot</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Rice, Todd W" sort="Rice, Todd W" uniqKey="Rice T" first="Todd W." last="Rice">Todd W. Rice</name>
<affiliation wicri:level="2"><nlm:aff id="aff5">Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt, Tennessee;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Tennessee</region>
</placeName>
<wicri:cityArea>Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt</wicri:cityArea>
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<author><name sortKey="Loftis, Laura L" sort="Loftis, Laura L" uniqKey="Loftis L" first="Laura L." last="Loftis">Laura L. Loftis</name>
<affiliation wicri:level="2"><nlm:aff id="aff6">Department of Pediatrics, Texas Children's Hospital, Houston, Texas;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Texas Children's Hospital, Houston</wicri:cityArea>
</affiliation>
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<author><name sortKey="Helfaer, Mark" sort="Helfaer, Mark" uniqKey="Helfaer M" first="Mark" last="Helfaer">Mark Helfaer</name>
<affiliation wicri:level="2"><nlm:aff id="aff7">Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
<wicri:cityArea>Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia, Philadelphia</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Doctor, Allan" sort="Doctor, Allan" uniqKey="Doctor A" first="Allan" last="Doctor">Allan Doctor</name>
<affiliation wicri:level="2"><nlm:aff id="aff8">Department of Pediatrics, St Louis Children's Hospital, St Louis, Missouri;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Missouri (État)</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, St Louis Children's Hospital, St Louis</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Paden, Matthew" sort="Paden, Matthew" uniqKey="Paden M" first="Matthew" last="Paden">Matthew Paden</name>
<affiliation wicri:level="1"><nlm:aff id="aff9">Department of Pediatrics, Children's Healthcare of Atlanta at Egleston, Atlanta, Georgia;</nlm:aff>
<country xml:lang="fr">Géorgie (pays)</country>
<wicri:regionArea>Department of Pediatrics, Children's Healthcare of Atlanta at Egleston, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Flori, Heidi" sort="Flori, Heidi" uniqKey="Flori H" first="Heidi" last="Flori">Heidi Flori</name>
<affiliation wicri:level="2"><nlm:aff id="aff10">Department of Pediatrics, Children's Hospital Oakland, Oakland, California;</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Children's Hospital Oakland, Oakland</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Babbitt, Christopher" sort="Babbitt, Christopher" uniqKey="Babbitt C" first="Christopher" last="Babbitt">Christopher Babbitt</name>
<affiliation wicri:level="2"><nlm:aff id="aff11">Department of Pediatrics, Miller Children's Hospital, Long Beach, California;</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Miller Children's Hospital, Long Beach</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Graciano, Ana Lia" sort="Graciano, Ana Lia" uniqKey="Graciano A" first="Ana Lia" last="Graciano">Ana Lia Graciano</name>
<affiliation wicri:level="2"><nlm:aff id="aff12">Department of Pediatrics, Children's Hospital of Central California, Madera, California;</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Children's Hospital of Central California, Madera</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Gedeit, Rainer" sort="Gedeit, Rainer" uniqKey="Gedeit R" first="Rainer" last="Gedeit">Rainer Gedeit</name>
<affiliation wicri:level="2"><nlm:aff id="aff13">Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, Wisconsin;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Wisconsin</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sanders, Ronald C" sort="Sanders, Ronald C" uniqKey="Sanders R" first="Ronald C." last="Sanders">Ronald C. Sanders</name>
<affiliation wicri:level="2"><nlm:aff id="aff14">Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Arkansas</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Arkansas Children's Hospital, Little Rock</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Giuliano, John S" sort="Giuliano, John S" uniqKey="Giuliano J" first="John S." last="Giuliano">John S. Giuliano</name>
<affiliation wicri:level="2"><nlm:aff id="aff15">Department of Pediatrics, Yale Children's Hospital, New Haven, Connecticut;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Connecticut</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Yale Children's Hospital, New Haven</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Zimmerman, Jerry" sort="Zimmerman, Jerry" uniqKey="Zimmerman J" first="Jerry" last="Zimmerman">Jerry Zimmerman</name>
<affiliation wicri:level="2"><nlm:aff wicri:cut="; and" id="aff16">Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, Seattle, Washington</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name>
<affiliation wicri:level="1"><nlm:aff id="aff17">Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff>
<country xml:lang="fr">Géorgie (pays)</country>
<wicri:regionArea>Influenza Division, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea>
<wicri:noRegion>Atlanta</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Pediatrics</title>
<idno type="ISSN">0031-4005</idno>
<idno type="eISSN">1098-4275</idno>
<imprint><date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Critical Illness</term>
<term>Female</term>
<term>Humans</term>
<term>Infant</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Influenza, Human (complications)</term>
<term>Influenza, Human (diagnosis)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Male</term>
<term>Pandemics</term>
<term>Retrospective Studies</term>
<term>United States (epidemiology)</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Femelle</term>
<term>Grippe humaine ()</term>
<term>Grippe humaine (diagnostic)</term>
<term>Grippe humaine (épidémiologie)</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Maladie grave</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Pandémies</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
<term>États-Unis d'Amérique (épidémiologie)</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>United States</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Grippe humaine</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term>
<term>États-Unis d'Amérique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Critical Illness</term>
<term>Female</term>
<term>Humans</term>
<term>Infant</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Male</term>
<term>Pandemics</term>
<term>Retrospective Studies</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Enfant</term>
<term>Enfant d'âge préscolaire</term>
<term>Femelle</term>
<term>Grippe humaine</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Maladie grave</term>
<term>Mâle</term>
<term>Nourrisson</term>
<term>Pandémies</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>États-Unis</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND:</title>
<p>The 2009 pandemic influenza A (H1N1) (pH1N1) virus continues to circulate worldwide. Determining the roles of chronic conditions and bacterial coinfection in mortality is difficult because of the limited data for children with pH1N1-related critical illness.</p>
</sec>
<sec><title>METHODS:</title>
<p>We identified children (<21 years old) with confirmed or probable pH1N1 admitted to 35 US PICUs from April 15, 2009, through April 15, 2010. We collected data on demographics, baseline health, laboratory results, treatments, and outcomes.</p>
</sec>
<sec><title>RESULTS:</title>
<p>Of 838 children with pH1N1 admitted to a PICU, the median age was 6 years, 58% were male, 70% had ≥1 chronic health condition, and 88.2% received oseltamivir (5.8% started before PICU admission). Most patients had respiratory failure with 564 (67.3%) receiving mechanical ventilation; 162 (19.3%) received vasopressors, and 75 (8.9%) died. Overall, 71 (8.5%) of the patients had a presumed diagnosis of early (within 72 hours after PICU admission) <italic>Staphylococcus aureus</italic>
 coinfection of the lung with 48% methicillin-resistant <italic>S aureus</italic>
 (MRSA). In multivariable analyses, preexisting neurologic conditions or immunosuppression, encephalitis (1.7% of cases), myocarditis (1.4% of cases), early presumed MRSA lung coinfection, and female gender were mortality risk factors. Among 251 previously healthy children, only early presumed MRSA coinfection of the lung (relative risk: 8 [95% confidence interval: 3.1–20.6]; <italic>P</italic>
 < .0001) remained a mortality risk factor.</p>
</sec>
<sec><title>CONCLUSIONS:</title>
<p>Children with preexisting neurologic conditions and immune compromise were at increased risk of pH1N1-associated death after PICU admission. Secondary complications of pH1N1, including myocarditis, encephalitis, and clinical diagnosis of early presumed MRSA coinfection of the lung, were mortality risk factors.</p>
</sec>
</div>
</front>
</TEI>
</record>

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Critically Ill Children During the 2009–2010 Influenza Pandemic in the United States

Critically Ill Children During the 2009–2010 Influenza Pandemic in the United States

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