TY - JOUR
T1 - Nosocomial RSV-related In-hospital Mortality in Children
T2 - A Global Case Series
AU - RSV GOLD study group
AU - Löwensteyn, Yvette N
AU - Willemsen, Joukje E
AU - Mazur, Natalie I
AU - Scheltema, Nienke M
AU - van Haastregt, Nynke C J
AU - Buuren, Amber A A Ten
AU - van Roessel, Ichelle
AU - Scheepmaker, Dunja
AU - Nair, Harish
AU - van de Ven, Peter M
AU - Bont, Louis J
N1 - Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - BACKGROUND: According to the World Health Organization, the global burden of nosocomial infections is poorly characterized as surveillance systems are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on community-acquired infection. We aimed to characterize children with nosocomial RSV-related mortality and to understand the potential impact of RSV immunization strategies.MATERIALS: RSV GOLD is a global registry of children younger than 5 years who died with laboratory-confirmed RSV infection. We compared clinical and demographic characteristics of children with nosocomial and community-acquired RSV in-hospital mortality.RESULTS: We included 231 nosocomial and 931 community-acquired RSV-related in-hospital from deaths from 65 countries. Age at death was similar for both groups (5.4 vs. 6 months). A higher proportion of nosocomial deaths had comorbidities (87% vs. 57%; P < 0.001) or was born preterm (46% vs. 24%; P < 0.001) than community-acquired deaths. The proportion of nosocomial deaths among all RSV deaths was lower in LMICs than in upper-middle-income countries (UMICs) and HICs (12% vs. 18% and 26%, respectively).CONCLUSIONS: This is the first global case series of children dying with nosocomial RSV infection. Future infant-targeted immunization strategies could prevent the majority of nosocomial RSV-related deaths. Although nosocomial RSV deaths are expected to occur at highest rates in LMICs, the number of reported nosocomial RSV deaths was low in these countries. Hospital-based surveillance is needed to capture the full burden of nosocomial RSV mortality in LMICs.
AB - BACKGROUND: According to the World Health Organization, the global burden of nosocomial infections is poorly characterized as surveillance systems are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on community-acquired infection. We aimed to characterize children with nosocomial RSV-related mortality and to understand the potential impact of RSV immunization strategies.MATERIALS: RSV GOLD is a global registry of children younger than 5 years who died with laboratory-confirmed RSV infection. We compared clinical and demographic characteristics of children with nosocomial and community-acquired RSV in-hospital mortality.RESULTS: We included 231 nosocomial and 931 community-acquired RSV-related in-hospital from deaths from 65 countries. Age at death was similar for both groups (5.4 vs. 6 months). A higher proportion of nosocomial deaths had comorbidities (87% vs. 57%; P < 0.001) or was born preterm (46% vs. 24%; P < 0.001) than community-acquired deaths. The proportion of nosocomial deaths among all RSV deaths was lower in LMICs than in upper-middle-income countries (UMICs) and HICs (12% vs. 18% and 26%, respectively).CONCLUSIONS: This is the first global case series of children dying with nosocomial RSV infection. Future infant-targeted immunization strategies could prevent the majority of nosocomial RSV-related deaths. Although nosocomial RSV deaths are expected to occur at highest rates in LMICs, the number of reported nosocomial RSV deaths was low in these countries. Hospital-based surveillance is needed to capture the full burden of nosocomial RSV mortality in LMICs.
KW - child mortality
KW - community-acquired infection
KW - global health
KW - nosocomial infection
KW - respiratory syncytial virus
U2 - 10.1097/INF.0000000000003747
DO - 10.1097/INF.0000000000003747
M3 - Article
C2 - 36476518
SN - 0891-3668
VL - 42
SP - 1
EP - 7
JO - The Pediatric Infectious Disease Journal
JF - The Pediatric Infectious Disease Journal
IS - 1
ER -