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Published on: February 23, 2014
Respiratory pathogens in infants less than two months old hospitalized with acute respiratory infection
Débora N Marcone1, Guadalupe Carballal1, Noelia Reyes1
1Virology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, CONICET, Buenos Aires City, Argentina.
Insights
Respiratory viruses like RSV and Rhinovirus/Enterovirus cause most infant acute respiratory infections (ARI). Community-acquired infections are common, while nosocomial infections prolong hospital stays in infants under two months.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Lower acute respiratory infections (ARI) are a significant cause of infant illness and death.
- Respiratory viruses are the primary pathogens responsible for ARI in infants.
Purpose of the Study:
- To determine the frequency of respiratory pathogens in infants under two months old hospitalized with ARI.
- To analyze the clinical characteristics and outcomes of these hospitalized infants.
- To differentiate between community-acquired and nosocomial ARI in this age group.
Main Methods:
- A retrospective study analyzed data from 2008-2011 and 2014-2016.
- The FilmArray-Respiratory Panel was used to detect respiratory viruses and atypical bacteria.
- Demographic, clinical, hospitalization, and outcome data were collected and evaluated.
Main Results:
- A high pathogen positivity rate (94.9%) was found in community-acquired ARI cases, with Respiratory Syncytial Virus (RSV) and Rhinovirus/Enterovirus (RV/EV) being most common.
- Nosocomial ARI showed a lower positivity rate (20.0%), but these infants had a significantly longer median length of stay (LOS).
- Coinfections were present in a quarter of infants, most commonly RSV-RV/EV.
Conclusions:
- Respiratory viruses, particularly RSV and RV/EV, are the main causes of community-acquired ARI in hospitalized infants <2 months old.
- While less frequent, nosocomial infections in this group can lead to prolonged hospitalizations.
- Understanding pathogen prevalence is crucial for managing ARI in vulnerable infants.
Abstract:
Lower acute respiratory infections (ARI) are a frequent cause of morbidity and mortality in infants, respiratory viruses being the major causative agents. The aim of this work was to determine the respiratory pathogen frequency, the clinical characteristics and the outcome in infants <2 months old hospitalized with ARI. A retrospective study was performed during a five-year period (2008-2011, 2014-2016). Respiratory viruses and atypical bacteria were studied using the FilmArray-Respiratory Panel. Demographic and clinical characteristics, hospitalization course and outcomes were evaluated. Of the 137 infants <2 months old hospitalized with ARI studied, a 94.9% positivity rate as determined in 117 infants with community-acquired infection and 20.0% in 20 infants who acquired the infection during their birth hospitalization in the neonatal intensive care units (NICU) (nosocomial ARI) (p<0.001). In infants with community-acquired infection, Respiratory syncytial virus (RSV) (52.1%) and Rhinovirus/Enterovirus (RV/EV) (41.0%) were the most frequent detected pathogens. Coinfections were determined in one quarter of the infants, RSV-RV/EV being the most frequent combination. In infants with nosocomial infection, RV/EV, RSV or Parainfluenza-3 were detected as single pathogens. Most infants with community-acquired infection presented lower ARI (81.2%) while most infants in the NICU had upper ARI (55.0%). The median length of stay (LOS) in infants with community-acquired ARI was 4 days (IQR: 2-6). Positive infants with nosocomial infection had longer median LOS (71 days [IQR:42-99]) compared to negative infants (58 days [IQR: 49-71]) (p=0.507). Respiratory viruses were detected as the major causative agents of community-acquired infection in hospitalized infants <2-months old, RSV and RV/EV being the most frequently detected. Although a low pathogen positivity rate was observed in infants with nosocomial infection, they may prolong the LOS.
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