Risk Factors and Outcomes for Respiratory Syncytial Virus–related Infections in Immunocompromised Children
- 1 October 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Pediatric Infectious Disease Journal
- Vol. 32 (10), 1073-1076
- https://doi.org/10.1097/inf.0b013e31829dff4d
Abstract
Respiratory syncytial virus (RSV) is associated with significant morbidity and mortality in immunocompromised children. Data on the risk factors for acquisition and outcomes from RSV infections in this population are limited. This cohort study (2006 to 2011) included RSV-positive immunocompromised pediatric inpatients. Nasopharyngeal swabs were tested for RSV by direct immunofluorescence. Purposeful multiple regression was used to assess risk factors associated with community-acquired RSV (CA-RSV) infections and their outcomes compared with nosocomial (N-RSV) infections. Means and medians were compared using Student's t test and a nonparametric test, respectively. Proportions were compared using χ(2) or Fisher's exact test, as appropriate. There were 117 RSV-positive patients of whom 42 (35.9%) presented with (N-RSV) infection. Overall, more than a third presented with lower respiratory tract infections, which resulted in a 28% admission rate to the intensive care unit and a mortality rate of 5%; the latter solely among patients with community-acquired infection. Subjects with CA-RSV presented with more advanced clinical evidence of lower tract disease with respiratory distress (eg, intercostal recession; odds ratio 2.5; 95% confidence interval: 1.1-5.6; P = 0.03) compared with those with N-RSV. Subjects with CA-RSV infections were less likely to have a prolonged hospital admission (odds ratio 0.7; 95% confidence interval: 0.5-0.8; P < 0.0001) relative to those with N-RSV infections. RSV-related infections in immunocompromised children may result in poor outcomes, including mortality. Differences in mortality rates among those with CA-RSV compared with N-RSV warrant further study, with enhanced opportunities for prevention and early detection of infection.Keywords
This publication has 20 references indexed in Scilit:
- Management of RSV infections in adult recipients of hematopoietic stem cell transplantationBlood, 2011
- Intravenous Palivizumab and Ribavirin Combination for Respiratory Syncytial Virus Disease in High-Risk Pediatric PatientsThe Pediatric Infectious Disease Journal, 2007
- Randomized Controlled Multicenter Trial of Aerosolized Ribavirin for Respiratory Syncytial Virus Upper Respiratory Tract Infection in Hematopoietic Cell Transplant RecipientsClinical Infectious Diseases, 2007
- Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000The Journal of Pediatrics, 2003
- RESPIRATORY TRACT VIRAL INFECTIONS IN BONE MARROW TRANSPLANT PATIENTSTransplantation, 2003
- An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatmentBone Marrow Transplantation, 2003
- The outcome of 26 patients with respiratory syncytial virus infection following allogeneic stem cell transplantationBone Marrow Transplantation, 1999
- Community Respiratory Virus Infections Among Hospitalized Adult Bone Marrow Transplant RecipientsClinical Infectious Diseases, 1996
- Improved outcome of respiratory syncytial virus infection in a high-risk hospitalized population of Canadian childrenThe Journal of Pediatrics, 1992
- An Outbreak of Respiratory Syncytial Virus in a Bone Marrow Transplant CenterThe Journal of Infectious Diseases, 1992