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An Outbreak of RSV Infections in the Neonatology Clinic of the University Obstetrics and Gynecology Hospital, Sofia, 2019 – a Case Series
Liliya Vakrilova
Obstetrics and Gynecology Hospital "Maichin Dom", Medical University of Sofia
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6586-8623
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Background: Respiratory syncytial virus (RSV) is the predominant cause of lower respiratory tract infections (LRTI) in infancy. Preterm infants with bronchopulmonary dysplasia (BPD) are at the highest risk of severe RSV-LRTI. We report retrospectively a nosocomial outbreak of RSV-infections in the Neonatology of the University O&G hospital, Sofia.
Methods: Two groups of infants without contact between them were diagnosed with RSV-infection: 14 infants who were treated in the Department for healthy newborns, and 7 preterm infants, treated in the NICU. The detection of RSV was performed using Real-Time PCR in nasal/throat swabs.
Results: Respiratory symptoms occurred 2-5 days after discharge in 14 of 148 healthy term infants born from 5 to 18 February 2019; 12 babies were re-hospitalized with LRTI and recovered in a few days. In 6 infants the RSV-PCR was positive, in the others, RSV etiology was suggested due to similar symptoms and contact between them.
The first NICU-patient with RSV-LRTI was a 26 gestational weeks (GW) twin with BPD. From 19 February to 15 March 26 babies, 26-34 GW at birth were tested for RSV (33 nasal/throat swabs). They received a first or subsequent palivisumab-injection. We identified 11 positive samples in 7 of the babies. Six of them were with symptoms of LRTI, two needed mechanical ventilation. In 4 babies despite the recovery, the second RSV-PCR remained positive. After stabilization 6 babies were discharged home, one was transferred to the Paediatric department for further treatment of BPD.
Conclusions: The reported outbreak of RSV-infections in neonates was the most serious since the RSV-PCR diagnostic in Bulgaria was introduced. The course of RSV-LRTI was severe in extremely preterm newborns with underlying BPD. So routine in-hospital RSV-prophylaxis with palivizumab should be considered for infants at the highest risk.
Keywords
RSV-infections, preterm infants, term infants, NICU, Palivisumab
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This preprint is under consideration at Italian Journal of Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
An Outbreak of RSV Infections in the Neonatology Clinic of the University Obstetrics and Gynecology Hospital, Sofia, 2019 – a Case Series
Liliya Vakrilova
Obstetrics and Gynecology Hospital "Maichin Dom", Medical University of Sofia
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6586-8623
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 11 Jan, 2021
No community comments so far
Reviewers invited
Invitations sent on 11 Jan, 2021
Editor assigned
On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
Submission checks complete
On 06 Jan, 2021
First submitted
On 04 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Respiratory syncytial virus (RSV) is the predominant cause of lower respiratory tract infections (LRTI) in infancy. Preterm infants with bronchopulmonary dysplasia (BPD) are at the highest risk of severe RSV-LRTI. We report retrospectively a nosocomial outbreak of RSV-infections in the Neonatology of the University O&G hospital, Sofia.
Methods: Two groups of infants without contact between them were diagnosed with RSV-infection: 14 infants who were treated in the Department for healthy newborns, and 7 preterm infants, treated in the NICU. The detection of RSV was performed using Real-Time PCR in nasal/throat swabs.
Results: Respiratory symptoms occurred 2-5 days after discharge in 14 of 148 healthy term infants born from 5 to 18 February 2019; 12 babies were re-hospitalized with LRTI and recovered in a few days. In 6 infants the RSV-PCR was positive, in the others, RSV etiology was suggested due to similar symptoms and contact between them.
The first NICU-patient with RSV-LRTI was a 26 gestational weeks (GW) twin with BPD. From 19 February to 15 March 26 babies, 26-34 GW at birth were tested for RSV (33 nasal/throat swabs). They received a first or subsequent palivisumab-injection. We identified 11 positive samples in 7 of the babies. Six of them were with symptoms of LRTI, two needed mechanical ventilation. In 4 babies despite the recovery, the second RSV-PCR remained positive. After stabilization 6 babies were discharged home, one was transferred to the Paediatric department for further treatment of BPD.
Conclusions: The reported outbreak of RSV-infections in neonates was the most serious since the RSV-PCR diagnostic in Bulgaria was introduced. The course of RSV-LRTI was severe in extremely preterm newborns with underlying BPD. So routine in-hospital RSV-prophylaxis with palivizumab should be considered for infants at the highest risk.