NOSOCOMIAL RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS IN PRETERM INFANTS: CHARACTERISTICS OF THE COURSE, TREATMENT АND PREVENTION IN CLINICAL PRACTICE

Cover Page


Cite item

Full Text

Abstract

Objective: to study the clinical, laboratory and radiological features of the course of nosocomial bronchiolitis respiratory syncytial viral (RSV ) etiology and effectiveness of the therapy in preterm infants in the neonatal hospital conditions. Patients and Methods: We analyzed case histories of 10 hospitalized patients who had RSV etiology bronchiolitis established by RIF / PCR in neonatal Moscow hospitals in  2011-2013. Results: RSV infection in hospitalized preterm infants with and without bronchopulmonary dysplasia runs hardly, requiring treatment in the intensive care unit, oxygen therapy and  lungs mechanical ventilation. The respiratory failure is the symptom of the of RSV bronchiolitis severity. X-ray picture of the disease is characterized by peribronchial changes, emphysematous swelling , segmental infiltration and bronchial obstruction (atelectasis, hypoventilation ). The frequency of bacterial complications of RSV bronchiolitis is low. In clinical practice newborns with severe RSV bronchiolitis are treated with antibiotics, bronchodilators, steroids. The timely isolation of patients can prevent the extention of the infection in the hospital. Conclusions: The preventive measures are needed to prevent the extention of RSV in neonatal hospitals, including specific immune prophylaxisof RSV infection in children at risk .


About the authors

D. Yu. Ovsyannikov

Russian Peoples’ Friendship University, Moscow, Russian Federation

Author for correspondence.
Email: mdovsyannikov@yahoo.com
PhD, Head of the Department of Pediatrics of FSBI People’s Friendship University of Russia. Address: 6, Miklukho-Maklaya Street, Moscow, RF, 117198; tel.: +7 (499) 236-11-52 Russian Federation

D. N. Degtyarev

V.I. Kulakov Scientific Center of Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation

Email: glav_neolog@yahoo.com
PhD, professor, Deputy Director for Scientific Research of FSBI “V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology”.Address: 4, Akad. Oparin Street, Moscow, RF, 117997; tel.: +7 (495) 531-44-44 Russian Federation

I. I. Ryumina

V.I. Kulakov Scientific Center of Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation

Email: i.ryumina@mail.ru

PhD, professor, Head of the Department of Pathology of Newborns and Premature neonates of FSBI “V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology”. Address: 4, Akad. Oparin Street, Moscow, RF, 117997; tel.: +7 (495) 531-44-44

Russian Federation

I. V. Krsheminskaya

Russian Peoples’ Friendship University, Moscow, Russian Federation

Email: spatira@mail.ru
assistant of the Department of Pediatrics of FSBI People’s Friendship University of Russia. Address: 6, Miklukho-Maklaya Street, Moscow, RF, 117198; tel.: +7 (499) 154-03-33 Russian Federation

I. V. Orlovskaya

V.I. Kulakov Scientific Center of Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation

Email: secretariat@oparina4.ru

MD, senior research scientist of the Department of Pathology of Newborns and Premature neonates of FSBI “V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology”. Address: 4, Akad. Oparin Street, Moscow, RF, 117997; tel.: +7 (495) 531-44-44

Russian Federation

References

  1. Dennehy P.H. Epidemiology and risk factors. In: Contemporary diagnosis and management of respiratory syncytial virus. L.E. Weisman, J.R. Groothuis (eds.). Newtown PA: Handbooks in Health Care Co. 2000. P. 37–71.
  2. Shay D.K., Holman R.C., Roosevelt G.E., Clarke M.J., Anderson L.J. Bronchiolitis-associated mortality and estimates of respiratory syncytial virus-associated deaths among US children, 1979–1997. J. Infect. Dis. 2001; 183(1): 16–22.
  3. Heilman C.A. From the National Institute of Allergy and Infectious Diseases and the World Health Organization. Respiratory syncytial and parainfluenza viruses. J. Infect. Dis. 1990; 161(3): 402–406.
  4. Welliver R., Cherry J.D. Bronchiolitis and infectious asthma. In: Textbook of pediatric infectious diseases, 2nd ed. R.D. Feigin, J.D. Cherry (eds.). Philadelphia: WB Saunders. 1987. P. 278–288.
  5. Murphy T.F., Henderson F.W., Clyde W.A., Jr, Collier A.M., Denny F.W. Pneumonia: an eleven-year study in a pediatric practice. Am. J. Epidemiol. 1981; 113 (1): 12–21.
  6. MacDonald NE, Hall CB, Suffin SC, Alexson C, Harris PJ, Manning JA. Respiratory syncytial viral infection in infants with congenital heart disease. N. Engl. J. Med. 1982; 307 (7): 397–400.
  7. Ovsyannikov D.Yu., Degtyareva E.A., Kuz'menko L.G.
  8. Group risk for severe respiratory syncytial virus infection in children: current opportunities for prevention. Detskie infektsii = Child infections. 2011; 10(2): 49–51.
  9. Boyce T.G., Mellen B.G., Mitchel E.F. Jr., Wright P.F., Griffin M.R. Rates of hospitalization for respiratory syncytial virus infection among children in medicaid. J. Pediatr. 2000; 137 (6): 865–870.
  10. Greenough A. Role of ventilation in RSV disease: CPAP, ventilation, HFO, ECMO. Ped. Resp. Rev. 2009; 1 (10): 26–28.
  11. Simon A., Ammann R.A., Wilkesmann A., Eis-Hübinger A.M., Schildgen O., Weimann E. et al. Respiratory syncytial virus infection in 406 hospitalised premature infants: results from a prospective German multicentre database. Eur. J. Pediatr. 2007; 166: 1273–1283.
  12. Checchia P.A., Nalysnyk L., Fernandes A.W., Mahadevia P.J., Xu Y., Fahrbach K., Welliver R.C. Sr.. Mortality and and morbidity among infants at high risk for severe respiratory syncytial virus infection receving prophilaxis with palivizumab: A systematic literature review and meta-analysis. Pediatr. Crit. Care Med. 2011; 12 (5): 580–588.
  13. Immunoprophilaxis with palivizumab, a humanized respiratory syncytial virus monoclonal antibody, for prevention of respiratory syncytial virus infection in high risk infants: a consensus opinion. Pediatr. Infect. Dis. J. 1999; 18: 223–231.
  14. Navas L., Wang E., de Carvalho V., Robinson J. Improved outcome of respiratory syncytial virus infection in a high-risk population of Canadian children. J. Pediatr. 1992; 121: 348–353.
  15. Ovsyannikov D.Yu. Acute bronchiolitis in children. Vopr. prakt. pediatrii = Problems of Practical Pediatrics. 2010; 5(2): 75–84.
  16. Hall CB.Respiratory syncytial virus: What we know now. Contemp. Pediatr. 1994; 10: 92–110.
  17. Tatochenko V., Uchaikin V., Gorelov A, Gudkov K., Campbell A., Schulz G. et al. Epidemiology of respiratory syncytial virus in children ≤2 years of age hospitalized with lower respiratory tract infections in the Russian Federation: a prospective, multicenter study. Clin. Epidemiol. 2010 Oct 21; 2: 221-227
  18. Kneyber M.C., Brandenburg A.H., de Groot R., Joosten K.F., Rothbarth P.H., Ott A. et al. Risk factors for respiratory syncytial virus associated apnoea. Eur. J. Pediatr. 1998; 157: 331–335.
  19. Scottish Intercollegiate Guidelines Network (SIGN). Bronchiolitis in children. NHS Quality Improvement Scotland [Internet] Available from // www.sign.ac.uk [cited January 16, 2009].
  20. Breidi M. Respiratornye virusnye infektsii. V kn.: Infektsionnye bolezni u detei. Pod red. D. Mari. Per. s angl [Respiratory Virus Infections. In book Infectious Diseases in Children. Edited by D. Mari. Translated from English]. Moscow, Praktika, 2006. pp. 604–630.
  21. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006; 118: 1774–1793.
  22. Baral'di E., Zankonato S., Karraro S. Lechashchii vrach = Practicing Doctor. 2011; 6: 12–20.
  23. Hall C.B., Douglas R.G., Geiman J.M., Messner M.K. Nosocomial respiratory syncytial virus infections. N. Engl. J. Med. 1975; 293: 1343–1346.
  24. Halasa N.B., Williams J.V., Wilson G.J., Walsh W.F., Schaffner W., Wright P.F. Medical and economic impact of a respiratory syncytial virus outbreak in a neonatal intensive care unit. Paediatr. Infect. Dis. J. 2005; 24: 1040–1044.
  25. Silva C.A., Dias L., Baltieri S.R., Rodrigues T.T., Takagi N.B., Richtmann R. Respiratory syncytial virus outbreak in neonatal intensive care unit: Impact of infection control measures plus palivizumab use. Antimicrob. Resist. Infect. Control. 2012; doi: 10.1186/2047-2994-1-16
  26. O'Connell K., Boo T.W., Keady D., Niriain U., O’Donovan D., Commane M. et al. Use of palivizumab and infection control measures to control an outbreak of respiratory syncytial virus in a neonatal intensive care unit confirmed by real-time polymerase chain reaction. J. Hosp. Infect. 2011; 77: 338–342.
  27. Abadesso C., Almeida H.I., Virella D., Carreiro M.H., Machado M.C. Use of palivizumab to control an outbreak of syncytial respiratory virus in a neonatal intensive care unit. J. Hosp. Infect. 2004; 58: 38–41.
  28. Dizdar E.A., Aydemir C., Erdeve O., Sari F.N., Oquz S., Uras N. et al. Respiratory syncytial virus outbreak defined by rapid screening in a neonatal intensive care unit. J. Hosp. Infect. 2010; 75: 292–294.
  29. Cox R.A., Rao P., Brandon-Cox C. The use of palivizumab monoclonal antibody to control an outbreak of respiratory syncytial virus infection in a special care baby unit. J. Hosp. Infect. 2001; 48: 186–192.
  30. Kilani R.A. Respiratory syncytial virus outbreak in the NICU: description of eight cases. J. Trop. Paediatr. 2002; 48: 118–122.
  31. Kurz H., Herbich K., Janata O., Sterniste W., Bauer K. Experience with the use of palivizumab together with infection control measures to prevent respiratory syncytial virus outbreaks in neonatal intensive care units. J. Hosp. Infect. 2008; 70: 246–252.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 1970 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies