Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy
Abstract Background Respiratory syncytial virus (RSV) is the main cause of hospitalization for bronchiolitis among infants. RSV is classified into two subtypes, A and B, whose predominance alternates during different epidemic seasons. The clinical impact of viral factors is controversial and many ev...
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doaj-43b2c2d83edc4c42a4a3ea0654bed3102020-11-25T03:41:18ZengBMCItalian Journal of Pediatrics1824-72882019-08-014511810.1186/s13052-019-0704-0Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in ItalyC. Ciarlitto0A. C. Vittucci1L. Antilici2C. Concato3C. Di Camillo4P. Zangari5A. Villani6Academic Department of Pediatrics, Tor Vergata University of RomeAcademic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (OPBG)Academic Department of Pediatrics, Tor Vergata University of RomeVirology Unit, Bambino Gesù Children’s Hospital (OPBG)Academic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (OPBG)Academic Department of Pediatrics, Research Unit in Congenital and Perinatal Infection, Immune and Infection Disease Division, Children’s Hospital Bambino Gesù (OPBG)Academic Department of Pediatrics, Pediatric and Infectious Disease Unit, Children’s Hospital Bambino Gesù (OPBG)Abstract Background Respiratory syncytial virus (RSV) is the main cause of hospitalization for bronchiolitis among infants. RSV is classified into two subtypes, A and B, whose predominance alternates during different epidemic seasons. The clinical impact of viral factors is controversial and many evidences suggest a critical role for the immune host response. Premature children are at the highest risk for severe RSV infection. The main aim of this study is to identify the different RSV subtypes circulating in the last three epidemic seasons and to evaluate whether any of them was associated with poor prognosis in term and preterm infants. Methods We performed a retrospective analysis of medical records for all patients aged less than one year which were hospitalized during the winter season between November 2015 and April 2018 with clinical diagnosis of bronchiolitis and nasopharyngeal aspirates positive for RSV. Results We enrolled 422 children, of which 50 were born preterm. During the analysis period, we observed a significant increase in the rates of oxygen supplementation and admission to intensive care unit. The evidence shows an alternating pattern in the prevalence of RSV subtypes among term born; in each epidemic season, the prevalent serotype is the cause of the majority of the cases requiring intensive care. Conversely, RSV-A is always prevalent in preterm children and caused most of the cases requiring intensive care. Conclusions During the 3 seasons analyzed, we observed an alternating prevalence of RSV A and B. While there are no differences in severity between RSV A and B in term population, RSV-A is prevalent and causes most of the severe cases in the premature group. Furthermore, an increase in RSV-related oxygen therapy and PICU admission has been documented not only in the premature population. Considering the absence of appropriate therapeutic strategies, our work emphasizes the importance of implementing prophylaxis measures against RSV and highlights the urgent need to gain knowledge about immune response to the virus, also in premature children.http://link.springer.com/article/10.1186/s13052-019-0704-0BronchiolitisPretermRespiratory syncytial virusHospitalization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
C. Ciarlitto A. C. Vittucci L. Antilici C. Concato C. Di Camillo P. Zangari A. Villani |
spellingShingle |
C. Ciarlitto A. C. Vittucci L. Antilici C. Concato C. Di Camillo P. Zangari A. Villani Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy Italian Journal of Pediatrics Bronchiolitis Preterm Respiratory syncytial virus Hospitalization |
author_facet |
C. Ciarlitto A. C. Vittucci L. Antilici C. Concato C. Di Camillo P. Zangari A. Villani |
author_sort |
C. Ciarlitto |
title |
Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy |
title_short |
Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy |
title_full |
Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy |
title_fullStr |
Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy |
title_full_unstemmed |
Respiratory Syncityal Virus A and B: three bronchiolitis seasons in a third level hospital in Italy |
title_sort |
respiratory syncityal virus a and b: three bronchiolitis seasons in a third level hospital in italy |
publisher |
BMC |
series |
Italian Journal of Pediatrics |
issn |
1824-7288 |
publishDate |
2019-08-01 |
description |
Abstract Background Respiratory syncytial virus (RSV) is the main cause of hospitalization for bronchiolitis among infants. RSV is classified into two subtypes, A and B, whose predominance alternates during different epidemic seasons. The clinical impact of viral factors is controversial and many evidences suggest a critical role for the immune host response. Premature children are at the highest risk for severe RSV infection. The main aim of this study is to identify the different RSV subtypes circulating in the last three epidemic seasons and to evaluate whether any of them was associated with poor prognosis in term and preterm infants. Methods We performed a retrospective analysis of medical records for all patients aged less than one year which were hospitalized during the winter season between November 2015 and April 2018 with clinical diagnosis of bronchiolitis and nasopharyngeal aspirates positive for RSV. Results We enrolled 422 children, of which 50 were born preterm. During the analysis period, we observed a significant increase in the rates of oxygen supplementation and admission to intensive care unit. The evidence shows an alternating pattern in the prevalence of RSV subtypes among term born; in each epidemic season, the prevalent serotype is the cause of the majority of the cases requiring intensive care. Conversely, RSV-A is always prevalent in preterm children and caused most of the cases requiring intensive care. Conclusions During the 3 seasons analyzed, we observed an alternating prevalence of RSV A and B. While there are no differences in severity between RSV A and B in term population, RSV-A is prevalent and causes most of the severe cases in the premature group. Furthermore, an increase in RSV-related oxygen therapy and PICU admission has been documented not only in the premature population. Considering the absence of appropriate therapeutic strategies, our work emphasizes the importance of implementing prophylaxis measures against RSV and highlights the urgent need to gain knowledge about immune response to the virus, also in premature children. |
topic |
Bronchiolitis Preterm Respiratory syncytial virus Hospitalization |
url |
http://link.springer.com/article/10.1186/s13052-019-0704-0 |
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