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Pleșca VȘ, Streinu-Cercel A, Săndulescu O, Drăgănescu AC, Hainăroșie R, Pleșca AD. Incidence and Characteristics of Pediatric Patients with Acute Otitis Hospitalized in a Romanian Infectious Diseases Hospital. CHILDREN (BASEL, SWITZERLAND) 2024; 11:832. [PMID: 39062281 PMCID: PMC11274892 DOI: 10.3390/children11070832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/24/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. METHODS We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and 2023, with the aim of quantifying the incidence and impact of acute otitis (AO) according to pediatric age subgroups. RESULTS A total of 1118 cases diagnosed with AO were eligible and included in the analysis. Acute congestive otitis media was the most common subtype, identified in 53.3% of cases, followed by acute purulent otitis media (APOM) in 26.7% of children. The majority of AO cases (69.9%) were diagnosed in the pre-pandemic period (2018-2019), and infants (10.6%), toddlers (49.4%), and preschoolers (29.2%) were the most affected age groups. A viral infection associated with the AO episode was documented in 49.6% of cases. Influenza viruses were most commonly reported (20.5%), followed by SARS-CoV-2 (5.8%), and adenovirus (4.9%). A total of 38 cases of AO were identified in children with measles. In 15.9% of APOM cases, Streptococcus pneumoniae was isolated by culture from otic secretions. The duration of hospitalization was longer in children with APOM and acute otitis externa compared to the other subtypes of AO (p < 0.001). CONCLUSIONS Our study highlights the importance of ENT (ear, nose, and throat) monitoring in children hospitalized for acute infectious diseases, as the majority of AO cases occur in the context of a viral infection. These findings emphasize the necessity for tailored assessment and intervention in suspected cases of AO, especially in young children under 5 years of age.
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Affiliation(s)
- Vlad Ștefan Pleșca
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Anca Streinu-Cercel
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
- Academy of Romanian Scientists (AOSR), 050045 Bucharest, Romania
| | - Oana Săndulescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
- Academy of Romanian Scientists (AOSR), 050045 Bucharest, Romania
| | - Anca Cristina Drăgănescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Răzvan Hainăroșie
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Doina Pleșca
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Miron VD, Săndulescu O, Streinu-Cercel A, Florea D, Paraschiv S, Bănică L, Vlaicu O, Oțelea D, Bilașco A, Pițigoi D, Streinu-Cercel A, Drăgănescu AC. Age, comorbidity burden and late presentation are significant predictors of hospitalization length and acute respiratory failure in patients with influenza. Sci Rep 2024; 14:15563. [PMID: 38971866 PMCID: PMC11227496 DOI: 10.1038/s41598-024-66550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 07/02/2024] [Indexed: 07/08/2024] Open
Abstract
Influenza viruses are responsible for a high number of infections and hospitalizations every year. In this study, we aimed to identify clinical and host-specific factors that influence the duration of hospitalization and the progression to acute respiratory failure (ARF) in influenza. We performed an analysis of data from a prospective active influenza surveillance study that was conducted over five seasons (2018/19 to 2022/23). A total of 1402 patients with influenza were included in the analysis, the majority of which (64.5%) were children (under 18 years), and 9.1% were elderly. At least one chronic condition was present in 29.2% of patients, and 9.9% of patients developed ARF. The median hospital stay was 4 days (IQR: 3, 6 days). The most important predictors of prolonged hospital stay and development of ARF were extremes of age (infants and elderly), presence of chronic diseases, particularly the cumulus of at least 3 chronic diseases, and late presentation to hospital. Among the chronic diseases, chronic obstructive pulmonary disease, cardiovascular disease, cancer, diabetes, obesity, and chronic kidney disease were strongly associated with a longer duration of hospitalization and occurrence of ARF. In this context, interventions aimed at chronic disease management, promoting influenza vaccination, and improving awareness and access to health services may contribute to reducing the impact of influenza not only in Romania but globally. In addition, continued monitoring of the circulation of influenza viruses is essential to limit their spread among vulnerable populations.
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Affiliation(s)
- Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania.
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Dragoș Florea
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Simona Paraschiv
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Leontina Bănică
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Ovidiu Vlaicu
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Dan Oțelea
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Anuța Bilașco
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Daniela Pițigoi
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Adrian Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
| | - Anca Cristina Drăgănescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania
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Pleșca VȘ, Miron VD, Marinescu AG, Drăgănescu AC, Pleșca AD, Săndulescu O, Voiosu C, Hainăroșie R, Streinu-Cercel A. Hospitalizations for Acute Otitis and Sinusitis in Patients Living with HIV: A Retrospective Analysis of a Tertiary Center in Romania. J Clin Med 2024; 13:3346. [PMID: 38893057 PMCID: PMC11172890 DOI: 10.3390/jcm13113346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/18/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Acute or chronic ear, nose and throat (ENT) conditions in people living with HIV can lead to hospitalization and affect their quality of life. The aim of our study was to determine the frequency and characteristics of hospitalizations for acute sinusitis (AS) and acute otitis (AO) in people living with HIV. Methods: We performed a retrospective analysis over the course of six years (from January 2018 to December 2023), assessing all hospitalizations for AS and/or AO occurring in patients living with HIV, at the largest infectious diseases hospital in Romania. Results: We identified a total of 179 cases, among which 149 cases (83.2%) were attributed to AS and 41 cases (22.9%) were due to AO. Among cases of AS, maxillary sinuses were most frequently involved (n = 140/149, 94.0%), and among cases of AO, acute congestive otitis media (n = 14, 34.1%) and acute purulent otitis media (n = 13, 31.7%) were the most common forms. The underlying HIV infection was classified as stage C3 in 57.5% of cases. In 19.6% of cases, it was possible to identify either the trigger or the etiological agent, and the most frequent bacterial pathogens were Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa. Conclusions: In conclusion, this study highlights that hospitalizations due to acute sinus and ear involvement are not isolated events in people living with HIV. A prospective follow-up is needed to gain a deeper and more dynamic understanding of how ENT health is affected in people with HIV infection. Furthermore, promoting prevention through vaccination may reduce to a certain extent the burden of ENT infections in this population.
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Affiliation(s)
- Vlad Ștefan Pleșca
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Adrian Gabriel Marinescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Anca Cristina Drăgănescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
| | - Anca Doina Pleșca
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
- Academy of Romanian Scientists (AOSR), 050044 Bucharest, Romania
| | - Cătălina Voiosu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
| | - Răzvan Hainăroșie
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
| | - Anca Streinu-Cercel
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania (V.D.M.)
- National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, 021105 Bucharest, Romania
- Academy of Romanian Scientists (AOSR), 050044 Bucharest, Romania
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Chirila S, Hangan T, Gurgas L, Costache MG, Vlad MA, Nitu BF, Bittar SM, Craciun A, Condur L, Bjørklund G. Pharmacy-Based Influenza Vaccination: A Study of Patient Acceptance in Romania. Risk Manag Healthc Policy 2024; 17:1005-1013. [PMID: 38690537 PMCID: PMC11059623 DOI: 10.2147/rmhp.s459369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
Background This study explores patient acceptance of influenza vaccination administered by pharmacists in Romania during the 2023 season, considering it a novel strategy to address gaps in knowledge. Pharmacy-based vaccination deviates from traditional methods, providing high-risk patients with full reimbursement and others with 50% reimbursement, allowing a choice between family doctors and pharmacies for vaccine administration. Material and Method The survey includes 15 questions covering socio-demographic data, health information, vaccination preferences, and perceptions of pharmacy-based vaccinations. Results Respondents showed a positive inclination toward pharmacy-based vaccination, with 68% expressing favorable sentiments, but an awareness gap exists, as only 36% were aware of pharmacy-based vaccination availability. Conclusion Challenges include a lack of patient awareness and understanding of benefits, emphasizing the need for structured pharmacist-patient dialogues. Legal changes, a defined funding mechanism, and collaboration are crucial for successful implementation. The study provides valuable insights into patient perceptions, contributing to discussions on optimizing influenza vaccination coverage in Romania and beyond and recognizing pharmacies' potential in achieving broader vaccination goals.
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Affiliation(s)
- Sergiu Chirila
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Tony Hangan
- Department of Dermatology, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Leonard Gurgas
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | | | | | | | - Sara Melek Bittar
- Department of Dermatology, County Clinical Emergency Hospital of Constanta, Constanta, Romania
| | - Aurora Craciun
- Department of Biochemistry, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Laura Condur
- Department of Family Medicine, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
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Pleșca VȘ, Marinescu AG, Voiosu C, Drăgănescu AC, Streinu-Cercel A, Vilaia A, Hainăroșie R, Pleșca DA, Săndulescu O. Occurrence of acute otitis and sinusitis in patients hospitalized for influenza. Germs 2024; 14:38-44. [PMID: 39169978 PMCID: PMC11333841 DOI: 10.18683/germs.2024.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 08/23/2024]
Abstract
Introduction Acute otitis and sinusitis are common complications in patients with influenza and are responsible for increased hospitalization rates. Methods A five-year retrospective study (2018-2023) was conducted including all patients hospitalized for influenza (etiologic diagnosis by RT-PCR) to identify the incidence and characteristics of cases complicated with otitis and/or sinusitis. Cases associated with other viral co-infections were excluded from the analysis. Results We identified a cumulative rate of 20.6% (324 cases) of acute otitis (AO) and acute sinusitis (AS) among patients with influenza. Of these, 62.3% had AO, 28.1% AS, and 9.6% concomitant AO and AS. Cases of AO were predominant in the pediatric population (97.0%), while cases of AS were more common in adults (56.1%). Influenza A viruses were identified in 67.2% of patients. The infection with influenza B viruses increased the risk of acute congestive otitis media 2.1-fold (p=0.020), and influenza A viruses increased the risk of acute maxillary sinusitis 2.7-fold (p=0.029). Late presentation to the hospital, with a median of 4 days from the onset of influenza symptoms, was identified as a factor in the occurrence of AO and AS. Conclusions The risk of AO and AS is increased in patients with influenza, especially in the pediatric population and in late hospital presentations. These findings highlight the importance of proper monitoring and management of patients with influenza to prevent the development of complications, as well as the need to better understand the mechanisms whereby influenza viruses contribute to these secondary conditions.
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Affiliation(s)
- Vlad Ștefan Pleșca
- MD, PhDc, Carol Davila University of Medicine and Pharmacy Bucharest, Romania and National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Adrian Gabriel Marinescu
- MD, PhDc, Carol Davila University of Medicine and Pharmacy Bucharest, Romania and National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Cătălina Voiosu
- MD, PhD, Lecturer, Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu street, Bucharest, Romania
| | - Anca Cristina Drăgănescu
- MD, PhD, Assoc. Prof., Carol Davila University of Medicine and Pharmacy Bucharest, Romania and National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Anca Streinu-Cercel
- MD, PhD, Prof., Carol Davila University of Medicine and Pharmacy Bucharest, Romania and National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
| | - Alexandra Vilaia
- MD, PhDc, Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu street, Bucharest, Romania
| | - Răzvan Hainăroșie
- MD, PhD, Assoc. Prof., Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu street, Bucharest, Romania
| | - Doina Anca Pleșca
- MD, PhD, Prof., Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu street, Bucharest, Romania
| | - Oana Săndulescu
- MD, PhD, Prof., Carol Davila University of Medicine and Pharmacy Bucharest, Romania and National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania
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Miron VD, Bar G, Filimon C, Craiu M. From COVID-19 to Influenza-Real-Life Clinical Practice in a Pediatric Hospital. Diagnostics (Basel) 2022; 12:diagnostics12051208. [PMID: 35626363 PMCID: PMC9140149 DOI: 10.3390/diagnostics12051208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 01/30/2023] Open
Abstract
The COVID-19 pandemic, through the restrictions and the non-pharmaceutical interventions implemented, has importantly impacted the circulation and epidemiology of respiratory viruses. Specifically, the 2020/21 season was entirely dominated by SARS-CoV-2, while influenza activity reached an all-time low, despite initial warnings that a double concurrent epidemic could be possible. The current season, 2021/22, started with the shift of circulating SARS-CoV-2 variants from delta to omicron, which then rapidly spread globally, as most countries, including Romania, removed all restrictions and compulsory non-pharmaceutical interventions. In this report we present the clinical reality observed in March 2022 in a tertiary paediatric hospital in Bucharest, Romania, where we observed a sudden surge in influenza cases, after two consecutive years (March 2020 to March 2022) when influenza had stopped circulating in our country. Thus, in March 2022 the positivity rate of rapid influenza antigen tests unexpectedly increased to 33.5%, paralleled by a decrease to 7.5% in the positivity rate of rapid SARS-CoV-2 antigen tests. This significant increase in the influenza attack rate was observed from the first week (14.9% positivity rate), through the fourth week of March (42.1% positivity rate, p < 0.001), while the COVID-19 attack rate displayed a significant decreasing trend (from 11.2% to 4.8%, p < 0.001). These data serve as a warning about relaxing restrictions in a precipitous approach with minimised vigilance. The evolution of these observations needs to be followed very carefully in all countries, particularly in settings where epidemiological interactions and non-pharmaceutical interventions have so far led to the extensive circulation of only one of these viruses, and we should now be prepared to perform a correct differential diagnosis between influenza and COVID-19, in order to ensure the best quality of care and personalized management of each case of respiratory infection. The results of active influenza surveillance studies for the whole 2021/22 season are awaited, in order to quantify the joint influenza—COVID-19 burden among children.
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Affiliation(s)
- Victor Daniel Miron
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
- Correspondence:
| | - Gabriela Bar
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.F.); (M.C.)
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania;
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