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A multicenter investigation of respiratory syncytial viral infection in children with hematopoietic cell transplantation
Author(s) -
Rowan Courtney M.,
Gertz Shira J.,
Zinter Matt S.,
Moffet Jerelyn,
Bajwa Rajinder P. S.,
Barnum Jessie L.,
Kong Michele
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12882
Subject(s) - medicine , mechanical ventilation , ribavirin , palivizumab , retrospective cohort study , intensive care unit , cohort , transplantation , epidemiology , hematopoietic stem cell transplantation , pediatric intensive care unit , cohort study , pediatrics , risk factor , intensive care medicine , respiratory system , immunology , virus , hepatitis c virus
Background Hematopoietic cell transplant ( HCT ) may be a risk factor for morbidity and mortality from respiratory syncytial virus ( RSV ). Previous studies have been limited by small sample size. We took a multicenter approach with the goal of better understanding the epidemiology, risk factors, treatment, morbidity, and mortality associated with RSV infections among children with HCT in the United States. Methods A retrospective, multicenter, cohort study of pediatric HCT recipients were diagnosed with RSV infection between January 2010 and December 2014. Results Of the 1522 HCT , 47 (3%) patients were diagnosed with RSV . Of those with RSV , 9 (19.1%) were admitted to the pediatric intensive care unit ( PICU ), 6 (12.8%) received invasive mechanical ventilation, and 1 died. Prophylactic palivizumab was uncommon. All who required critical care received ribavirin vs 7.3% of those who did not ( P = .004). Cobacterial infections were found in 16 patients and were not associated with the need for critical care. We examined potential risk factors for severity of RSV disease. In those who received invasive ventilation, 100% had one of the preidentified risk factors. Half of those requiring mechanical ventilation were diagnosed with RSV during their conditioning for transplant as opposed to only 2.4% of those that did not require invasive mechanical ventilation ( P = .005). Conclusions In this multicenter cohort, RSV was not common in children following HCT . Few children infected with RSV required critical care and mortality was low. Those diagnosed with RSV during conditioning for transplant were at higher risk for invasive mechanical ventilation.