Background and objectives: Recently the American Academy of Pediatrics has dramatically narrowed the indications for RSV prophylaxis, while in Israel the guidelines have not changed. We assessed the prevalence and severity of RSV infection among preterm infants (PI), compared with late preterm infants (LPTI) and term infants (TI).
Methods: Data of all children aged 0-14 years hospitalized with PCR positive RSV in a single tertiary center from 2010 and 2014 were collected. 793 children were included and divided into 3 groups: 637 born as TI, 105 were LPTI and 50 PI. The incidence of hospitalization due to RSV infection relative to the local birth rate was compared between the 3 groups as well as the clinical course, including intensive care unit (ICU) hospitalization and length of hospitalization.
Results: Hospitalization rate due to RSV infection was 5.2%, 3.5% and 1.3% among PI, LPTI and TI, respectively. Hospitalization in ICU was 24%, 7.6%, 3% among PI, LPTI and TI, respectively (P<0.05). Length of hospitalization was almost 3 times higher among PI - 12.3% compared to TI – 4.4% and was significantly higher than LPTI – 5.7% (P< 0.05), but no significant difference was found between LPTI and TI groups. None of the hospitalized children died due to RSV.
Conclusion: RSV infection is still a major cause of morbidity among children born prematurely even after RSV prophylaxis. Our results do not support the current AAP guidelines. Further local studies are needed to optimize the prophylaxis approach for both PI and LPTI.
