Hospitalization for bronchiolitis in children aged ≤ 1year, Southern Italy, year 2021: need for new preventive strategies?

Italian Journal of Pediatrics

Research

Maria Chironna¹  Daniela Loconsole¹  Francesca Centrone¹  Lorenzo Quartulli²  Anita Riganti³  Gabriele D’Amato⁴  Giuseppe Latorre⁵  Gianfranco Maffei⁶  Desiree Caselli⁷  Maria Elisabetta Baldassarre⁸  Nicola Laforgia⁸  Angelo Acquafredda⁹  Baldassarre Martire^1,10  Michele Di Noia^1,11 

[1] Hygiene Section, Interdisciplinary Department of Medicine, Aldo Moro University, 70124, Bari, Italy;Neonatology Unit, “A. Perrino” Hospital-ASL, Brindisi, Italy;Neonatology Unit, “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy;Neonatology Unit, “Di Venere” Hospital – ASL BA, Bari, Italy;Neonatology and Intensive Care Unit, “Miulli” Hospital, Acquaviva delle Fonti, Bari, Italy;Neonatology and Intensive Care Unit, “Ospedali Riuniti” Hospital, Foggia, Italy;Pediatric Infectious Diseases Unit, Giovanni XXIII Children Hospital, Azienda Ospedaliero Universitaria Consorziale Policlinico, 70124, Bari, Italy;Unit of Neonatology and Intensive Care, Interdisciplinary Department of Medicine, Aldo Moro University, 70124, Bari, Italy;Unit of Pediatrics and Neonatology, “G. Tatarella” Hospital, Cerignola, Foggia, Italy;Unit of Pediatrics and Neonatology, “Monsignor Dimiccoli” Hospital, Barletta, BT, Italy;Unit of Pediatrics, “Bonomo” Hospital, Andria, BT, Italy;

关键词: Bronchiolitis;    Respiratory syncytial virus (RSV);    Epidemiology;    Children;    Hospitalization;    Intensive care;    nirsevimab;    Preventive strategies;   

DOI  :  10.1186/s13052-023-01455-2

 received in 2022-12-28, accepted in 2023-04-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundBronchiolitis is a major cause of hospitalization in infants, particularly in the first six months of life, with approximately 60–80% of admissions due to respiratory syncytial virus (RSV) infection. Currently, no prophylactic options are available for healthy infants. The present study aimed at describing the demographic, clinical, and epidemiological characteristics of infants hospitalized for bronchiolitis in the Apulia region of Italy in 2021.MethodsFrom January to December 2021, data on children aged 0–12 months admitted for bronchiolitis in nine neonatal or pediatric units covering 61% of pediatric beds of hospitals in the Apulia region of Italy were analyzed. Demographic data, comorbidities, need for oxygen support, length of hospital stay, palivizumab administration, and outcomes were collected. For the purpose of the analysis, patients were divided into those aged 0–3 months and > 3 months. A multivariate logistic regression model was used to explore associations between the need for oxygen support and sex, age, comorbidities, history of prematurity, length of hospital stay, and palivizumab administration.ResultsThis study included 349 children aged 0–12 months admitted for bronchiolitis, with a peak of hospitalization in November (7.4 cases/1,000 children). Of these patients, 70.5% were RSV positive, 80.2% were aged 0–3 months, and 73.1% required oxygen support. Moreover, 34.9% required observation in the sub-intensive care unit, and 12.9% in the intensive care unit. Of the infants who required intensive care, 96.9% were aged 0–3 months and 78.8% were born at term. Three patients required mechanical ventilation and one, who required Extra Corporeal Membrane Oxygenation, died. Children aged 0–3 months were more likely to show dyspnea, need oxygen support, and have a longer hospital stay.ConclusionsThe present study showed that almost all of the children who required intensive care support were aged ≤ 3 months and most were born at term. Therefore, this age group remains the highest risk group for severe bronchiolitis. Preventive measures such as single-dose monoclonal antibody immunoprophylaxis, and maternal and childhood vaccination against RSV, may reduce the high public health burden of bronchiolitis.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

40517_2023_259_Article_IEq45.gif