An Outbreak of Human Rhinovirus Species C Infections in a Neonatal Intensive Care Unit

Reid, Alistair; Anderson, Tara; Cooley, Louise; Williamson, Jan; McGregor, Alistair

doi:10.1097/inf.0b013e31822938d7

Cited by 35 publications

(30 citation statements)

References 17 publications

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“…Therefore, bronchiolitis research should include viral testing for both RSV and RV, which may in turn yield important insights for the management of bronchiolitis. For clinicians, as RV nosocomial outbreaks have been reported, 41,42 our inferences challenge the conventional cohorting efforts relying on RSV and influenza virus testing alone; disregard of RV status has the potential to increase the risk of co-infections with RV and thereby contribute to patient morbidity. Furthermore, our findings also suggest a new line of research that may one day improve the ability of clinicians to create more personalized discharge counseling for parents and guardians.…”

Section: Discussionmentioning

confidence: 95%

Multicenter Study of Viral Etiology and Relapse in Hospitalized Children With Bronchiolitis

Hasegawa

Mansbach

Teach

et al. 2014

Pediatric Infectious Disease Journal

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Background It is unclear whether the infectious etiology of severe bronchiolitis affects short-term outcomes, such as post-hospitalization relapse. We tested the hypothesis that children hospitalized with rhinovirus (RV) bronchiolitis, either as a sole pathogen or in combination with respiratory syncytial virus (RSV), are at increased risk of relapse. Methods We performed a 16-center, prospective cohort study of hospitalized children age <2 years with bronchiolitis. During the winters of 2007 to 2010, researchers collected clinical data and nasopharyngeal aspirates from study participants; the aspirates were tested using real-time polymerase chain reaction. The primary outcome was bronchiolitis relapse (urgent bronchiolitis visit or scheduled visit at which additions to the bronchiolitis medications were made) during the 2 weeks after hospital discharge. Results Among 1836 enrolled children with 2-week follow-up data, the median age was 4 months and 60% were male. Overall, 48% had sole RSV infection, 8% had sole RV infection, and 13% had RSV/RV co-infection. Compared with children with sole RSV infection, and adjusting for 10 demographic and clinical characteristics and clustering of patients within hospitals, children with sole RV infection did not differ in their likelihood of relapse (OR, 0.99; 95%CI, 0.52–1.90; P=0.98), whereas those with RSV/RV co-infection were more likely to have relapse (OR, 1.54; 95%CI, 1.03–2.30; P=0.03). Conclusions In this prospective, multicenter, multiyear study of children hospitalized with bronchiolitis, we found that RSV/RV co-infection was independently associated with a higher likelihood of bronchiolitis relapse. Present data support the concept that the infectious etiology of severe bronchiolitis affects short-term outcomes.

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Section: Discussionmentioning

confidence: 95%

Multicenter Study of Viral Etiology and Relapse in Hospitalized Children With Bronchiolitis

Hasegawa

Mansbach

Teach

et al. 2014

Pediatric Infectious Disease Journal

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“…Despite similar baseline demographics and the Charlson comorbidity score, significantly more patients hospitalized for HRV infection were elderly home residents, which was also one of the independent risk factors associated with 1-year mortality. Major HRV outbreaks in health care facilities resulted in severe infections, and death has been reported [12,13,14,15,16]. Household transmission of HRV infection was 1 case per person among 17 siblings [17].…”

Section: Discussionmentioning

confidence: 99%

“…HRV is predominantly transmitted via droplets or by indirect contact with contaminated fomites. Major rhinovirus outbreaks in health care facilities have been reported [12,13,14,15,16]. …”

Section: Introductionmentioning

confidence: 99%

Unexpectedly Higher Morbidity and Mortality of Hospitalized Elderly Patients Associated with Rhinovirus Compared with Influenza Virus Respiratory Tract Infection

Hung

Zhang

et al. 2017

IJMS

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Rhinovirus is a common cause of upper and lower respiratory tract infections in adults, especially among the elderly and immunocompromised. Nevertheless, its clinical characteristics and mortality risks have not been well described. A retrospective analysis on a prospective cohort was conducted in a single teaching hospital center over a one-year period. We compared adult patients hospitalized for pneumonia caused by rhinovirus infection with those hospitalized for influenza infection during the same period. All recruited patients were followed up for at least 3 months up to 15 months. Independent risk factors associated with mortality for rhinovirus infection were identified. Between 1 March 2014 and 28 February 2015, a total of 1946 patients were consecutively included for analysis. Of these, 728 patients were hospitalized for rhinovirus infection and 1218 patients were hospitalized for influenza infection. Significantly more rhinovirus patients were elderly home residents and had chronic lung diseases (p < 0.001), whereas more influenza patients had previous stroke (p = 0.02); otherwise, there were no differences in the Charlson comorbidity indexes between the two groups. More patients in the rhinovirus group developed pneumonia complications (p = 0.03), required oxygen therapy, and had a longer hospitalization period (p < 0.001), whereas more patients in the influenza virus group presented with fever (p < 0.001) and upper respiratory tract symptoms of cough and sore throat (p < 0.001), and developed cardiovascular complications (p < 0.001). The 30-day (p < 0.05), 90-day (p < 0.01), and 1-year (p < 0.01) mortality rate was significantly higher in the rhinovirus group than the influenza virus group. Intensive care unit admission (odds ratio (OR): 9.56; 95% confidence interval (C.I.) 2.17–42.18), elderly home residents (OR: 2.60; 95% C.I. 1.56–4.33), requirement of oxygen therapy during hospitalization (OR: 2.62; 95% C.I. 1.62–4.24), and hemoglobin level <13.3 g/dL upon admission (OR: 2.43; 95% C.I. 1.16–5.12) were independent risk factors associated with 1-year mortality in patients hospitalized for rhinovirus infection. Rhinovirus infection in the adults was associated with significantly higher mortality and longer hospitalization when compared with influenza virus infection. Institutionalized older adults were particularly at risk. More stringent infection control among health care workers in elderly homes could lower the infection rate before an effective vaccine and antiviral become available.

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“…Adenovirus and rhinovirus, for example, have been implicated in such isolated events. 64,65 Thus, clinicians may not test for community respiratory viruses in a closed NICU, among a population of infants already at risk of respiratory symptoms due to lung disease associated with prematurity. Some studies suggest that apart from nosocomial outbreaks, viral respiratory infections are uncommon in the NICU.…”

Section: Respiratory Viruses In the Neonatal Intensive Care Unitmentioning

confidence: 99%

Human metapneumovirus in the preterm neonate: current perspectives

Maitre

Williams

2016

RRN

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Premature birth (<37 weeks gestation) occurs in ~11% of all births in the US. These infants are at risk of chronic lung disease and respiratory conditions, including bronchopulmonary dysplasia. Respiratory viruses are important causes of acute respiratory illness (ARI) in preterm infants, leading to rehospitalization, increased health care burden, and long-term morbidity. Human metapneumovirus (HMPV) is a paramyxovirus discovered in 2001 that is related to respiratory syncytial virus. Epidemiologic studies show that HMPV is a leading cause of ARI in children and adults worldwide. Prematurity is a major risk factor for severe HMPV disease, requiring hospitalization. Moreover, limited data suggest that HMPV infection during infancy is associated with asthma and recurrent wheezing, which are common long-term pulmonary complication of prematurity. HMPV causes nosocomial outbreaks of ARI in hospitals and long-term care facilities, although there are few studies of the prevalence of HMPV in neonatal intensive care unit populations. HMPV is a common and important virus in premature infants, and caregivers for preterm infants should consider this virus in patients with acute respiratory symptoms.

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An Outbreak of Human Rhinovirus Species C Infections in a Neonatal Intensive Care Unit

Cited by 35 publications

References 17 publications

Multicenter Study of Viral Etiology and Relapse in Hospitalized Children With Bronchiolitis

Multicenter Study of Viral Etiology and Relapse in Hospitalized Children With Bronchiolitis

Unexpectedly Higher Morbidity and Mortality of Hospitalized Elderly Patients Associated with Rhinovirus Compared with Influenza Virus Respiratory Tract Infection

Human metapneumovirus in the preterm neonate: current perspectives

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