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Comparing of two different epidemic seasons of bronchiolitis

Simonetta Picone1, Adele Fabiano2, Davide Roma2

  • 1NICU Casilino General Hospital, Rome, Italy. simpico@libero.it.

Italian Journal of Pediatrics
|January 18, 2018
PubMed

Insights

New guidelines limiting palivizumab (PLV) prophylaxis may increase severe bronchiolitis hospitalizations in preterm infants. This study observed higher rates of hospitalization, mechanical ventilation, and earlier onset of illness in infants born between 29-32 weeks gestational age.

Area of Science:

  • Pediatrics
  • Neonatology
  • Infectious Diseases

Background:

  • Acute bronchiolitis is a leading cause of infant hospitalization.
  • Preventive strategies are crucial for managing this condition.
  • Recent changes in palivizumab (PLV) prophylaxis guidelines have restricted its use.

Purpose of the Study:

  • To compare bronchiolitis incidence and severity in preterm infants (30-32 weeks gestational age) before and after palivizumab prophylaxis guideline changes.
  • To analyze trends in bronchiolitis-related hospitalizations and associated morbidities.

Main Methods:

  • A single-center analysis of preterm infants aged <12 months with gestational age between 30 and 32 weeks.
  • Comparison of two consecutive epidemic seasons (S1 vs S2) following updated prophylaxis guidelines.
  • Evaluation of hospitalization rates, mechanical ventilation use, and age at hospitalization.

Main Results:

  • A rising trend in bronchiolitis and related hospitalizations was observed from S1 to S2.
  • Hospitalized infants in S2 showed increased morbidity, including a higher rate of mechanical ventilation.
  • Hospitalizations occurred at a younger chronological age in S2 compared to S1.

Conclusions:

  • The findings suggest an increase in the incidence, severity, and earlier onset of bronchiolitis in preterm infants (29-32 weeks gestational age) after changes in national prophylaxis guidelines.
  • Further multi-center studies with larger sample sizes are warranted to validate these observations.
  • The results highlight potential implications of restricted palivizumab prophylaxis on vulnerable preterm populations.

Keywords:
BronchiolitisPalivizumabPretermProphylaxis

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