COVID-19 大流行后因水痘并发细菌性超级感染而住院治疗的儿童的治疗结果及其预测因素--对波兰真实数据的多中心回顾性分析。

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES European Journal of Clinical Microbiology & Infectious Diseases Pub Date : 2024-12-01 Epub Date: 2024-09-21 DOI:10.1007/s10096-024-04944-2
Maria Pokorska-Śpiewak, Leszek Szenborn, Maja Pietrzak, Magdalena Marczyńska, Anna Mania, Lidia Stopyra, Justyna Moppert, Kacper Toczyłowski, Artur Sulik, Filip Szenborn, Jolanta Jasonek, Inga Barańska-Nowicka, Adrianna Buciak, Ewa Majda-Stanisławska, Przemysław Ciechanowski, Katarzyna Karny, Ernest Kuchar, Magdalena Figlerowicz, Małgorzata Pawłowska
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引用次数: 0

摘要

目的:本研究旨在分析 COVID-19 大流行后因水痘并发细菌性超级感染而住院治疗的儿童的治疗结果及其预测因素:这项回顾性研究分析了波兰 9 家三级医疗机构住院中心的多中心、全国性观察数据库中收集的数据,该数据库专门用于因水痘细菌并发症而住院的 0-17 岁儿童。这项研究的主要终点是住院治疗结束后的治疗效果,以4分制进行评估。次要终点定义为手术干预的必要性:共有 458 名患者,中位年龄为 4 岁(IQR 2-6 岁)。治疗结束后,319 名患者(69%)完全康复;132 名患者(29%)出现一过性并发症;2 名患者(0.5%)出现持续性并发症;1 名患儿(0.5%)死亡。多变量分析显示,在水痘患儿治疗前使用布洛芬与治疗后并发症风险增加 4.07 倍(2.50-6.60)相关,与手术干预必要性风险增加 2.87 倍(1.39-5.89)相关。对于其他院前干预措施(使用阿昔洛韦、抗生素或抗组胺药),未观察到明显影响。GAS感染使手术干预的必要性增加了7.51(3.64-15.49)倍:结论:三分之一接受水痘细菌并发症治疗的患者在治疗后会出现并发症,其中大部分为一过性并发症。GAS感染会增加手术干预的必要性。在治疗水痘时使用布洛芬会显著增加并发症的风险和手术干预的必要性。
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Treatment outcomes and their predictors in children hospitalized with varicella complicated by bacterial superinfections after pandemic of COVID-19 - a retrospective multicenter analysis of real-life data in Poland.

Purpose: The aim of this study was to analyze treatment outcomes and their predictors in children hospitalized due to varicella complicated by bacterial superinfections after pandemic of COVID-19.

Methods: This retrospective study analyzed data collected in a multicenter, nationwide, observational database dedicated for children aged 0-17 years hospitalized due to bacterial complications of varicella in 9 Polish tertiary healthcare inpatient centers. The primary endpoint of this study was the treatment outcome established after the end of hospital management assessed at a 4-point scale. The secondary endpoint was defined as the necessity of surgical intervention.

Results: There were 458 patients with a median age of 4 (IQR 2-6) years. After the completed treatment, 319 (69%) participants were found fully recovered; 132 (29%) had transient complications; 2 (0.5%) had persistent complications; and 1 child (0.5%) died. Multivariate analysis revealed that implementation of ibuprofen in pre-treatment management of a child with varicella was associated with a 4.07-fold (2.50-6.60) increase in risk of complications after the treatment and it was associated with 2.87 times (1.39-5.89) higher risk of surgical intervention necessity. For other pre-hospital interventions (implementation of acyclovir, antibiotics or antihistaminics) no significant impact was observed. GAS infection increased the necessity of surgical intervention by 7.51 (3.64-15.49) times.

Conclusions: One-third of patients treated for bacterial complications of varicella have post-treatment complications, most of them transient. GAS infection increases the need for surgical intervention. The use of ibuprofen in the treatment of varicella significantly increases the risk of complications and the need for surgical intervention.

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来源期刊
CiteScore
10.40
自引率
2.20%
发文量
138
审稿时长
1 months
期刊介绍: EJCMID is an interdisciplinary journal devoted to the publication of communications on infectious diseases of bacterial, viral and parasitic origin.
期刊最新文献
Comparison of performances of laboratory methods in diagnosing pulmonary cryptococcosis in 1508 patients having lung biopsy tissues collected: a 6-year retrospective study. Treatment outcomes and their predictors in children hospitalized with varicella complicated by bacterial superinfections after pandemic of COVID-19 - a retrospective multicenter analysis of real-life data in Poland. Vaginal microbiota stability over 18 months in young student women in France. Carbapenem resistant Campylobacter jejuni bacteremia in a Bruton's X-linked agammaglobulinemia patient. Clinical experience with ceftazidime/avibactam for the treatment of extensively drug-resistant or pandrug-resistant Klebsiella pneumoniae in neonates and children.
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