ANGELA ESPOSITO

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  • article 46 Citação(ões) na Scopus
    Severity of viral coinfection in hospitalized infants with respiratory syncytial virus infection
    (2011) PAULIS, Milena De; GILIO, Alfredo Elias; FERRARO, Alexandre Archanjo; FERRONATO, Angela Esposito; SACRAMENTO, Patricia Rossi do; BOTOSSO, Viviane Fongaro; OLIVEIRA, Danielle Bruna Leal de; MARINHEIRO, Juliana Cristina; HARSI, Charlotte Marianna; DURIGON, Edison Luiz; VIEIRA, Sandra Elisabete
    Objective: To compare the severity of single respiratory syncytial virus (RSV) infections with that of coinfections. Methods:A historical cohort was studied, including hospitalized infants with acute RSV infection. Nasopharyngeal aspirate samples were collected from all patients to detect eight respiratory viruses using molecular biology techniques. The following outcomes were analyzed: duration of hospitalization and of oxygen therapy, intensive care unit admission and need of mechanical ventilation. Results were adjusted for confounding factors (prematurity, age and breastfeeding). Results: A hundred and seventy six infants with bronchiolitis and/or pneumonia were included in the study. Their median age was 4.5 months. A hundred and twenty one had single RSV infection and 55 had coinfections (24 RSV + adenovirus, 16 RSV + human metapneumovirus and 15 other less frequent viral associations). The four severity outcomes under study were similar in the group with single RSV infection and in the coinfection groups, independently of what virus was associated with RSV. Conclusion: Virus coinfections do not seem to affect the prognosis of hospitalized infants with acute RSV infection.
  • article 29 Citação(ões) na Scopus
    Etiological diagnosis reduces the use of antibiotics in infants with bronchiolitis
    (2012) FERRONATO, Angela Esposito; GILIO, Alfredo Elias; FERRARO, Alexandre Archanjo; PAULIS, Milena de; VIEIRA, Sandra E.
    OBJECTIVE: Acute bronchiolitis is a leading cause of infant hospitalization and is most commonly caused by respiratory syncytial virus. Etiological tests are not required for its diagnosis, but the influence of viral screening on the therapeutic approach for acute bronchiolitis remains unclear. METHODS: A historical cohort was performed to assess the impact of viral screening on drug prescriptions. The study included infants up to one year of age who were hospitalized for bronchiolitis. Virus screening was performed using immunofluorescence assays in nasopharyngeal aspirates. The clinical data were obtained from the patients' medical records. Therapeutic changes were considered to be associated with viral screening when made within 24 hours of the release of the results. RESULTS: The frequency of prescriptions for beta agonists, corticosteroids and antibiotics was high at the time of admission and was similar among the 230 patients. The diagnosis of pneumonia and otitis was associated with the introduction of antibiotics but did not influence antibiotics maintenance after the results of the virus screening were obtained. Changes in the prescriptions were more frequent for the respiratory syncytial virus patients compared to patients who had negative viral screening results (p=0.004), especially the discontinuation of antibiotics (p<0.001). The identification of respiratory syncytial virus was associated with the suspension of antibiotics (p=0.003), even after adjusting for confounding variables (p=0.004); however, it did not influence the suspension of beta-agonists or corticosteroids. CONCLUSION: The identification of respiratory syncytial virus in infants with bronchiolitis was independently associated with the discontinuation of antibiotics during hospitalization.