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The impact of RSV , adenovirus, influenza, and parainfluenza infection in pediatric patients receiving stem cell transplant, solid organ transplant, or cancer chemotherapy
Author(s) -
Lo Mindy S.,
Lee Grace M.,
Gunawardane Nilanthi,
Burchett Sandra K.,
Lachenauer Catherine S.,
Lehmann Leslie E.
Publication year - 2013
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12022
Subject(s) - medicine , chemotherapy , hematopoietic stem cell transplantation , retrospective cohort study , cancer , adenovirus infection , respiratory system , immunology , transplantation , virus
RVI s are a significant cause of morbidity and mortality in immunocompromised children. We analyzed the characteristics and outcomes of infection by four respiratory viruses ( RSV , adenovirus, influenza, and parainfluenza) treated at a pediatric tertiary care hospital in a retrospective cohort of patients who had received cancer chemotherapy, hematopoietic stem cell, or SOT . A total of 208 infections were studied among 166 unique patients over a time period of 1993–2006 for transplant recipients, and 2000–2005 for patients with cancer. RSV was the most common respiratory virus identified. There were 17 (10% of all patients) deaths overall, of which 12 were at least partly attributed to the presence of a RVI . In multivariate models, LRT symptoms in the absence of upper respiratory symptoms on presentation ( OR 10.2 [2.3, 45.7], p = 0.002) and adenoviral infection ( OR 3.7 [1.1, 12.6], p = 0.034) were significantly associated with poor outcome, defined as death or disability related to RVI . All of the deaths occurred in patients who had received either solid organ or HSCT . There were no infections resulting in death or disability in the cancer chemotherapy group.