Respiratory syncytial virus hospitalizations in infants of 28 weeks gestational age and less in the palivizumab era

Objective: To obtain data on respiratory syncytial virus (RSV) associated hospitalization rates in preterm infants of 28 weeks gestational age and less in the era of palivizumab prophylaxis. Methods: Retrospective single-center cohort study including all preterm infants up to 28 weeks + 6 days gestational age and born between 2004 and 2012 at a tertiary care university hospital. Data on RSV related hospitalizations over the first two years of life covering at least two RSV seasons (November-April) were analyzed. Results: Ninety-one of 287 (32%) infants were hospitalized due to respiratory illness, and a total of 17 infants (5.9%) tested RSV positive during the first 2 years of life. Fourteen infants (4.9%) were hospitalized during the first RSV season. RSV hospitalization rate in infants with BPD was 4.5% (2/44) compared to 4.9% (12/243) without BPD. Palivizumab prophylaxis was documented in 74.6% of the infants. Infants with RSV compared to other respiratory tract infection were of younger age (6.8 vs. 9.1 months; p = 0.049), had longer hospital stays (median 11 vs. 5 days; p = 0.043) and more severe respiratory illness (median LRI score 3 vs. 2; p = 0.043). Conclusions: Despite palivizumab prophylaxis the burden of RSV disease and all cause respiratory illness was still remarkable in this vulnerable preterm population and mainly limited to the first season. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.