Viral Respiratory Infections in Pre-term Infants During and After Hospitalization

Caserta, Mary T.; Yang, Hongmei; Gill, Steven R; Holden-Wiltse, Jeanne; Pryhuber, Gloria

OBJECTIVE: To determine the burden of viral respiratory infections in pre-term infants both during and subsequent to Neonatal Intensive Care Unit (NICU) hospitalization and to compare this with term infants living in the community. STUDY DESIGN: From March 2013 through March 2015 we enrolled 189 newborns (96 term and 93 pre-term) into a prospective, longitudinal study obtaining nose/throat swabs within 7 days of birth, weekly while hospitalized and then monthly to four months after hospital discharge. Taqman array cards (TAC) were used to identify 16 viral respiratory pathogens by real time PCR. Demographic, clinical, and laboratory data were gathered from electronic medical records and parent interview while hospitalized with interval histories collected at monthly visits. The hospital course of all pre-term infants who underwent late-onset sepsis evaluations was reviewed. RESULTS: Over 119 weeks, we collected 618 nose/throat swabs from at risk pre-term infants in our Level IV regional NICU. Only four infants had viral respiratory infections, all less than 28 weeks gestation at birth. Two infants were symptomatic with the infections recognized by the clinical team. The daily risk of acquiring a respiratory viral infection in pre-term infants in the NICU was significantly lower than in the full term cohort living in the community. Once discharged from the hospital viral respiratory infections were common in all infants. CONCLUSIONS: Viral respiratory infections are infrequent in a NICU with strict infection prevention strategies, and do not appear to cause unrecognized illness. Both preterm and term infants living in the community quickly acquire respiratory viral infections.