Infection

, Volume 42, Issue 2, pp 343–350

Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children

  • T. F. Leung
  • D. S. Y. Lam
  • T. Y. Miu
  • K. L. Hon
  • C. S. K. Chau
  • S. W. Ku
  • R. S. Y. Lee
  • P. Y. Chow
  • W. K. Chiu
  • D. K. K. Ng
  • on behalf of the Hong Kong Society of Paediatric Respirology (HKSPR) RSV Concern Group
Clinical and Epidemiological Study

Abstract

Purpose

Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infection in young children. However, there are limited data on severe RSV infection requiring pediatric intensive care unit (PICU) admission. This retrospective study described features of RSV-associated PICU admissions in Hong Kong and investigated factors for mortality and duration of PICU stay.

Methods

Children with laboratory-confirmed RSV infection and admitted to the PICUs of all eight government hospitals in Hong Kong between January 2009 and June 2011 were identified from computerized auditing systems and PICU databases. RSV in respiratory samples was detected by direct immunofluorescence and/or viral culture. The relationships between mortality and PICU duration and demographic and clinical factors were analyzed.

Results

A total of 118 (2.4 %) PICU admissions were identified among 4,912 RSV-positive pediatric cases in all hospitals. Sixty-five (55.6 %) patients were infants. PICU admissions were higher between October and March. Eight (6.8 %) patients died, but only two were infants. RSV-associated mortality was related to prior sick contact, presence of older siblings, neurodevelopmental conditions, chromosomal and genetic diseases, and bacterial co-infections, but none was significant following logistic regression analyses (odds ratio 9.36, 95 % confidence interval 0.91–96.03 for prior sick contact, p = 0.060). Chronic lung disease was the only risk factor for the duration of PICU admission (β = 0.218, p = 0.017).

Conclusions

The majority of RSV-infected children do not require PICU support. There is winter seasonality for RSV-associated PICU admission in Hong Kong. Prior sick contact is the only risk factor for RSV-associated mortality, whereas the presence of chronic lung disease is associated with longer PICU stay. The current risk-based approach of RSV prophylaxis may not be effective in reducing severe RSV infections.

Keywords

Mortality Pediatric intensive care Respiratory syncytial virus Seasonality 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • T. F. Leung
    • 1
  • D. S. Y. Lam
    • 2
  • T. Y. Miu
    • 3
  • K. L. Hon
    • 1
  • C. S. K. Chau
    • 4
  • S. W. Ku
    • 5
  • R. S. Y. Lee
    • 6
  • P. Y. Chow
    • 7
  • W. K. Chiu
    • 8
  • D. K. K. Ng
    • 7
  • on behalf of the Hong Kong Society of Paediatric Respirology (HKSPR) RSV Concern Group
  1. 1.Department of PediatricsThe Chinese University of Hong KongShatinHong Kong
  2. 2.Department of Pediatrics and Adolescent MedicineTuen Mun HospitalTuen MunHong Kong
  3. 3.Department of PediatricsQueen Elizabeth HospitalKowloonHong Kong
  4. 4.Department of Pediatrics and Adolescent MedicineQueen Mary HospitalPokfulamHong Kong
  5. 5.Department of Pediatrics and Adolescent MedicinePamela Youde Nethersole Eastern HospitalChai WanHong Kong
  6. 6.Department of Pediatrics and Adolescent MedicinePrincess Margaret HospitalKowloonHong Kong
  7. 7.Department of PediatricsKwong Wah HospitalKowloonHong Kong
  8. 8.Department of Pediatrics and Adolescent MedicineUnited Christian HospitalKowloonHong Kong

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