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Characteristics of Hospital-Acquired Respiratory Syncytial Virus (RSV) Infection in Young Children Prior to the COVID-19 Outbreak

Suchada Ruenglerdpong¹, Keswadee Lapphra¹, Wanatpreeya Phongsamart, Orasri Wittawatmongkol¹, Supattra Rungmaitree¹, Wipaporn Sitthirit², Kanogwan Sinderadard², Kulkanya Chokephaibulkit¹

Affiliation : ¹ Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; ² Centre for Infection Control, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Background: Respiratory syncytial virus (RSV) causes healthcare-associated respiratory infections in pediatric patients. Previous studies in developed countries have identified risk factors associated with hospital-acquired RSV (HA-RSV) infection. Those risk factors have a higher mortality rate than the risk factors of community-acquired RSV (CA-RSV) infection.
Objective: To investigate risk factors, clinical characteristics, and outcomes of RSV infection in young children within hospitals.
Materials and Methods: Data from Siriraj Hospital’s surveillance system between 2014 and 2018 was used to include children under five with laboratory-confirmed HA-RSV infection. Two control groups were formed, the CA-RSV infection and non-RSV hospital-acquired infections (non- RSV HAI), which were time-matched with the study group as a 1:2 ratio.
Results: Fifty-one HA-RSV cases were identified, with the highest infection rate during the rainy season, which was July to December. HA-RSV patients had higher rates of underlying neuromuscular disease and malignancy. Fever was common in HA-RSV, while upper respiratory and gastrointestinal symptoms were less frequent than CA-RSV. Antibiotic and oseltamivir treatment did not differ significantly. HA-RSV patients had longer stays in the intensive care unit and hospital, but transfer rates and mortality did not differ significantly among the groups.
Conclusion: HA-RSV coincides with community outbreaks, being more severe and affecting vulnerable patients. Targeted surveillance during high RSV seasons is crucial for prevention in hospitals.

Received 20 April 2023 | Revised 27 October 2023 | Accepted 6 November 2023
DOI: 10.35755/jmedassocthai.2023.11.13911

Keywords : RSV; Respiratory syncytial virus; Hospital-acquired infection; Healthcare-associated infection


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