TY - JOUR
T1 - Respiratory syncytial virus infection in 406 hospitalized premature infants
T2 - Results from a prospective German multicentre database
AU - Simon, Arne
AU - Ammann, Roland A.
AU - Wilkesmann, Anja
AU - Eis-Hübinger, Anna M.
AU - Schildgen, Oliver
AU - Weimann, Edda
AU - Peltner, Hans U.
AU - Seiffert, Peter
AU - Süss-Grafeo, Angela
AU - Groothuis, Jessie R.
AU - Liese, Johannes
AU - Pallacks, Ralf
AU - Müller, Andreas
N1 - Funding Information:
Potential conflict of interest The development of the DSM RSV Paed software tool was supported by an educational grant from Abbott GmbH, Wiesbaden, Germany.
Funding Information:
Acknowledgement We gratefully acknowledge the contribution of all local investigators (see attachment) of the participating centres. In addition, this work was partially supported by grants from the Else Kröner-Fresenius Foundation (grant no. A 01/05//F 00) and the BONFOR programme of the Medical Faculty of the University of Bonn (grant no. O-151.0028).
PY - 2007/12
Y1 - 2007/12
N2 - Premature birth, chronic lung disease of prematurity (CLD), congenital heart disease and immunodeficiency predispose to a higher morbidity and mortality in respiratory syncytial virus (RSV) infection. This study describes the preterms hospitalised with RSV infection from the prospective German DSM RSV Paed database. The DMS RSV Paed database was designed for the prospective multicentre documentation and analysis of clinically relevant aspects of the management of inpatients with RSV infection. This study covers six consecutive RSV seasons (1999-2005); the surveillance took place in 14 paediatric hospitals in Germany. Of the 1,568 prospectively documented RSV infections, 26% (n=406) were observed in preterms [vs. 1,162 children born at term (74%)] and 3% (n=50) had CLD, of which 49 had received treatment in the last 6 months ('CLDplus'). A significantly higher proportion in the preterm group had congenital heart disease, nosocomial infection, and neuromuscular impairment. There were significantly more children older than 24 months in the preterm group. The attributable mortality was 0.2% (n=2) in children born at term vs. 1.2% (n=5) in the preterm group (p=0.015) [preterm plus CLD 8.0% (n=4 of 50); McIntosh grade 1, 8.6% (n=3 of 35) and McIntosh Grade 4, 15% (n=3 of 20)]. Eight patients were categorized as 'palivizumab failures'. In the multivariate analysis, premature birth, CLDplus, and nosocomial infection were significantly and independently associated with the combined outcome 'complicated course of disease'. In conclusion, this is the first prospective multicentre study from Germany that confirms the increased risk for severe RSV disease in preterms, in particular in those with CLD treated in the last 6 months before the onset of the infection. From the perspective of our results, the statements of the German Society of Paediatric Infectious Diseases considering the use of passive immunisation (2003) seem reasonable.
AB - Premature birth, chronic lung disease of prematurity (CLD), congenital heart disease and immunodeficiency predispose to a higher morbidity and mortality in respiratory syncytial virus (RSV) infection. This study describes the preterms hospitalised with RSV infection from the prospective German DSM RSV Paed database. The DMS RSV Paed database was designed for the prospective multicentre documentation and analysis of clinically relevant aspects of the management of inpatients with RSV infection. This study covers six consecutive RSV seasons (1999-2005); the surveillance took place in 14 paediatric hospitals in Germany. Of the 1,568 prospectively documented RSV infections, 26% (n=406) were observed in preterms [vs. 1,162 children born at term (74%)] and 3% (n=50) had CLD, of which 49 had received treatment in the last 6 months ('CLDplus'). A significantly higher proportion in the preterm group had congenital heart disease, nosocomial infection, and neuromuscular impairment. There were significantly more children older than 24 months in the preterm group. The attributable mortality was 0.2% (n=2) in children born at term vs. 1.2% (n=5) in the preterm group (p=0.015) [preterm plus CLD 8.0% (n=4 of 50); McIntosh grade 1, 8.6% (n=3 of 35) and McIntosh Grade 4, 15% (n=3 of 20)]. Eight patients were categorized as 'palivizumab failures'. In the multivariate analysis, premature birth, CLDplus, and nosocomial infection were significantly and independently associated with the combined outcome 'complicated course of disease'. In conclusion, this is the first prospective multicentre study from Germany that confirms the increased risk for severe RSV disease in preterms, in particular in those with CLD treated in the last 6 months before the onset of the infection. From the perspective of our results, the statements of the German Society of Paediatric Infectious Diseases considering the use of passive immunisation (2003) seem reasonable.
KW - Illness severity
KW - Nosocomial infection
KW - Palivizumab
KW - Preterm infants
KW - Respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=35148830413&partnerID=8YFLogxK
U2 - 10.1007/s00431-007-0426-y
DO - 10.1007/s00431-007-0426-y
M3 - Article
C2 - 17943313
AN - SCOPUS:35148830413
SN - 0340-6199
VL - 166
SP - 1273
EP - 1283
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 12
ER -
