Respiratory syncytial virus acute respiratory infection-associated hospitalizations in preterm Mexican infants: A cohort study
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Background: Respiratory syncytial virus (RSV) is the leading cause of severe acute respiratory infections (ARI) in preterm infants. The incidence of RSV-associated hospitalizations has not been defined in Mexico. Objectives: To determine the incidence of ARI- and RSV-associated hospitalizations in preterm infants during the first year of life. Methods: Prospective cohort study of 294 preterm infants followed up through monthly telephone calls and routine outpatient visits. Hospitalized children were identified through daily visits to pediatric wards of participating hospitals and through telephone calls. Respiratory samples were tested for RSV by RT-PCR. Results: Mean gestational age of participating infants was 33 weeks. Ninety-six infants were diagnosed with bronchopulmonary dysplasia (BPD) and 17 with congenital heart disease (CHD); 11 had both conditions. There were 71 hospitalization episodes in 53 infants. Respiratory samples for RSV detection were available in 44 hospitalization episodes, and the result was positive in 16 (36.3%25). At least one hospitalization for ARI was recorded in 33 of 96 participants with BPD, in seven of 17 with CHD, and 18 of 192 infants without these diagnoses. Five (71.4%25) of CHD infants who required admission also had BPD. RSV-confirmed hospitalization rates were 9.4%25, 5.9%25, and 2.6%25 for infants with BPD, CHD, and otherwise healthy preterm infants, respectively. Attributable RSV admission frequencies were estimated to be 13.6%25, 16.5%25, and 4.1%25, respectively. Conclusions: Mexican preterm infants, particularly those with BPD, have high rates of ARI- and RSVassociated hospitalizations. Specific interventions to reduce the incidence of severe infections in this highrisk group are required. © 2019 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley %26 Sons Ltd.
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acute respiratory infection; preterm infants; respiratory syncytial virus Article; cohort analysis; controlled study; disease severity; female; gestational age; heart disease; high risk population; hospitalization; human; Human respiratory syncytial virus; incidence; infant; lung dysplasia; major clinical study; male; Mexican; Mexico; pediatric ward; prematurity; priority journal; prospective study; respiratory tract infection; reverse transcription polymerase chain reaction; risk factor; drug effect; isolation and purification; newborn; pathogenicity; prematurity; respiratory syncytial virus infection; respiratory tract infection; antivirus agent; palivizumab; Antiviral Agents; Cohort Studies; Female; Hospitalization; Humans; Incidence; Infant; Infant, Newborn; Infant, Premature; Male; Mexico; Palivizumab; Prospective Studies; Respiratory Syncytial Virus Infections; Respiratory Syncytial Virus, Human; Respiratory Tract Infections
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