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Efficacy of palivizumab prophylaxis on the frequency of RSV-associated lower respiratory tract infections in preterm infants: determination of the ideal target population for prophylaxis

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Abstract

Respiratory syncytial virus (RSV) prophylaxis in high-risk infants is an effective intervention for the prevention of severe disease. The aim of this study was to determine the ideal target preterm population that might benefit from palivizumab prophylaxis by establishing the main risk factors for acute RSV-related infections. Former premature infants born with a gestational age ≤37 weeks and ≤1 year of age at the beginning of the RSV season and admitted with respiratory infection were included. RSV status was evaluated by RSV strip test in all infants. RSV-positive and -negative infants were compared in terms of demographic features, risk factors, requirement of hospitalisation and palivizumab administration. A total of 202 preterm infants under 1 year of age were enrolled. The RSV test was positive in 34 (16.8%) infants. Maternal age was significantly lower in RSV-positive infants compared with RSV-negative infants (p = 0.03). RSV-positive infants were found to be significantly discharged during the RSV season (p = 0.03). RSV-positive infants required significantly higher rates of hospitalisation and need for mechanical ventilation. Of the RSV-positive infants, 28 (82%) had a gestational age ≥29 weeks. Seventeen (77%) RSV-positive infants that required hospitalisation were ≥29 weeks of gestation. All infants with a gestational age ≥29 weeks and without palivizumab prophylaxis developed RSV infection. Palivizumab prophylaxis should be implemented into guidelines to cover preterm infants with a gestational age >29 weeks. Palivizumab prophylaxis should also be considered in high-risk infants ≤6 months of age during the RSV season.

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References

  1. Abraha HY, Lanctôt KL, Paes B (2015) Risk of respiratory syncytial virus infection in preterm infants: reviewing the need for prevention. Expert Rev Respir Med 9(6):779–799

    Article  CAS  PubMed  Google Scholar 

  2. Habibi MS, Patel S, Openshaw P (2011) Hot topics in the prevention of respiratory syncytial virus disease. Expert Rev Vaccines 10(3):291–293

    Article  PubMed  Google Scholar 

  3. Paes BA, Mitchell I, Banerji A, Lanctôt KL, Langley JM (2011) A decade of respiratory syncytial virus epidemiology and prophylaxis: translating evidence into everyday clinical practice. Can Respir J 18(2):e10–e19

    Article  PubMed  PubMed Central  Google Scholar 

  4. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ et al (2010) Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet 375(9725):1545–1555

    Article  PubMed  PubMed Central  Google Scholar 

  5. GBD 2013 Mortality and Causes of Death Collaborators (2013) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 385(9963):117–171

    Google Scholar 

  6. Langley GF, Anderson LJ (2011) Epidemiology and prevention of respiratory syncytial virus infections among infants and young children. Pediatr Infect Dis J 30(6):510–517

    PubMed  Google Scholar 

  7. American Academy of Pediatrics Committee on Infectious Diseases; American Academy of Pediatrics Bronchiolitis Guidelines Committee (2014) Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 134(2):e620–e628

    Article  Google Scholar 

  8. Wegzyn C, Toh LK, Notario G, Biguenet S, Unnebrink K, Park C, Makari D, Norton M (2014) Safety and effectiveness of palivizumab in children at high risk of serious disease due to respiratory syncytial virus infection: a systematic review. Infect Dis Ther 3(2):133–158

    Article  PubMed  PubMed Central  Google Scholar 

  9. Figueras Aloy J, Carbonell Estrany X; Comité de Estándares de la Sociedad Española de Neonatología (2010) Recommendations for the use of palivizumab in the prevention of respiratory syncytial virus infection in late preterm infants (32(1) to 35(0) weeks of gestation). An Pediatr (Barc) 73(2):98.e1–98.e4

    Article  CAS  Google Scholar 

  10. Rogovik AL, Carleton B, Solimano A, Goldman RD (2010) Palivizumab for the prevention of respiratory syncytial virus infection. Can Fam Physician 56(8):769–772

    PubMed  PubMed Central  Google Scholar 

  11. American Academy of Pediatrics Committee on Infectious Diseases; American Academy of Pediatrics Bronchiolitis Guidelines Committee (2014) Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 134(2):415–420

    Article  Google Scholar 

  12. Horn SD, Smout RJ (2003) Effect of prematurity on respiratory syncytial virus hospital resource use and outcomes. J Pediatr 143(5 Suppl):S133–S141

    Article  PubMed  Google Scholar 

  13. Helfrich AM, Nylund CM, Eberly MD, Eide MB, Stagliano DR (2015) Healthy late-preterm infants born 33–36+6 weeks gestational age have higher risk for respiratory syncytial virus hospitalization. Early Hum Dev 91(9):541–546

    Article  PubMed  Google Scholar 

  14. Resch B, Paes B (2011) Are late preterm infants as susceptible to RSV infection as full term infants? Early Hum Dev 87(Suppl 1):S47–S49

    Article  PubMed  Google Scholar 

  15. Alan S, Erdeve O, Cakir U, Akduman H, Zenciroglu A, Akcakus M et al (2016) Outcome of the respiratory syncytial virus related acute lower respiratory tract infection among hospitalized newborns: a prospective multicenter study. J Matern Fetal Neonatal Med 29(13):2186–2193

    Article  CAS  PubMed  Google Scholar 

  16. Oncel MY, Arayici S, Simsek GK, Calisici E, Erdeve O, Uras N et al (2013) Risk factors for hospitalization due to lower respiratory tract infection in preterm infants on palivizumab prophylaxis. Iran J Pediatr 23(6):693–700

    PubMed  PubMed Central  Google Scholar 

  17. Hacımustafaoğlu M, Celebi S, Bozdemir SE, Ozgür T, Ozcan I, Güray A et al (2013) RSV frequency in children below 2 years hospitalized for lower respiratory tract infections. Turk J Pediatr 55(2):130–139

    PubMed  Google Scholar 

  18. Turkish Neonatal Society (2012) The seasonal variations of respiratory syncytial virus infections in Turkey: a 2-year epidemiological study. Turk J Pediatr 54(3):216–222

    Google Scholar 

  19. Piedimonte G (2015) RSV infections: state of the art. Cleve Clin J Med 82(11 Suppl 1):S13–S18

    Article  PubMed  Google Scholar 

  20. Blanken MO, Koffijberg H, Nibbelke EE, Rovers MM, Bont L; Dutch RSV Neonatal Network (2013) Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants: a multicenter birth cohort study. PLoS One 8(3):e59161

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Straňák Z, Saliba E, Kosma P, Posfay-Barbe K, Yunis K, Farstad T et al (2016) Predictors of RSV LRTI hospitalization in infants born at 33 to 35 weeks gestational age: a large multinational study (PONI). PLoS One 11(6):e0157446

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ambrose CS, Anderson EJ, Simões EA, Wu X, Elhefni H, Park CL, Sifakis F, Groothuis JR (2014) Respiratory syncytial virus disease in preterm infants in the U.S. born at 32–35 weeks gestation not receiving immunoprophylaxis. Pediatr Infect Dis J 33(6):576–582

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mauskopf J, Margulis AV, Samuel M, Lohr KN (2016) Respiratory syncytial virus hospitalizations in healthy preterm infants: systematic review. Pediatr Infect Dis J 35(7):e229–e238

    Article  PubMed  PubMed Central  Google Scholar 

  24. Farber HJ, Buckwold FJ, Lachman B, Simpson JS, Buck E, Arun M et al (2016) Observed effectiveness of palivizumab for 29–36-week gestation infants. Pediatrics 138(2):e20160627. doi:10.1542/peds.2016-0627

    Article  PubMed  Google Scholar 

  25. Silvestri M, Marando F, Costanzo AM, di Luzio Paparatti U, Rossi GA (2016) Respiratory syncytial virus-associated hospitalization in premature infants who did not receive palivizumab prophylaxis in Italy: a retrospective analysis from the Osservatorio Study. Ital J Pediatr 42:40. doi:10.1186/s13052-016-0252-9

    Article  PubMed  PubMed Central  Google Scholar 

  26. Hall CB, Weinberg GA, Blumkin AK, Edwards KM, Staat MA, Schultz AF et al (2013) Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 132(2):e341–e348

    Article  PubMed  Google Scholar 

  27. Anderson EJ, Krilov LR, DeVincenzo JP, Checchia PA, Halasa N, Simões EA et al (2017) SENTINEL1: an observational study of respiratory syncytial virus hospitalizations among U.S. infants born at 29 to 35 weeks’ gestational age not receiving immunoprophylaxis. Am J Perinatol 34(1):51–61

    Article  PubMed  Google Scholar 

  28. Rajah B, Sánchez PJ, Garcia-Maurino C, Leber A, Ramilo O, Mejias A (2017) Impact of the updated guidance for palivizumab prophylaxis against respiratory syncytial virus infection: a single center experience. J Pediatr 181:183–188.e1

    Article  CAS  PubMed  Google Scholar 

  29. Cilla G, Sarasua A, Montes M, Arostegui N, Vicente D, Pérez-Yarza E, Pérez-Trallero E (2006) Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain. Epidemiol Infect 134(3):506–513

    Article  CAS  PubMed  Google Scholar 

  30. Figueras-Aloy J, Manzoni P, Paes B, Simões EA, Bont L, Checchia PA, Fauroux B, Carbonell-Estrany X (2016) Defining the risk and associated morbidity and mortality of severe respiratory syncytial virus infection among preterm infants without chronic lung disease or congenital heart disease. Infect Dis Ther 5(4):417–452

    Article  PubMed  PubMed Central  Google Scholar 

  31. Shi T, Balsells E, Wastnedge E, Singleton R, Rasmussen ZA, Zar HJ et al (2015) Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: systematic review and meta-analysis. J Glob Health 5(2):020416. doi:10.7189/jogh.05.020416

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hervás D, Reina J, Yañez A, del Valle JM, Figuerola J, Hervás JA (2012) Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis 31(8):1975–1981

    Article  PubMed  Google Scholar 

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Acknowledgements

The RSV strip test was sponsored by AbbVie.

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Authors and Affiliations

  1. Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey

    M. Cetinkaya, T. K. Oral, S. Karatekin, B. Cebeci, A. Babayigit & Y. Yesil

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  1. M. Cetinkaya
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  2. T. K. Oral
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  3. S. Karatekin
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  4. B. Cebeci
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  5. A. Babayigit
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  6. Y. Yesil
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Correspondence to M. Cetinkaya.

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The authors report no conflict of interest.

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The study was approved by the local ethics committee.

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Informed consent was obtained from all parents.

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Cetinkaya, M., Oral, T.K., Karatekin, S. et al. Efficacy of palivizumab prophylaxis on the frequency of RSV-associated lower respiratory tract infections in preterm infants: determination of the ideal target population for prophylaxis. Eur J Clin Microbiol Infect Dis 36, 1629–1634 (2017). https://doi.org/10.1007/s10096-017-2976-x

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  • DOI: https://doi.org/10.1007/s10096-017-2976-x

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