Characteristics of Hospital-Acquired Respiratory Syncytial Virus (RSV) Infection in Young Children Prior to the COVID-19 Outbreak

Abstract

Background: Respiratory syncytial virus (RSV) causes healthcare-associated respiratory infections in pediatric patients. Previous studies in developed countries have identified risk factors associated with hospital-acquired RSV (HA-RSV) infection as a higher mortality rate than community-acquired RSV (CA-RSV) infection. Objective: To investigate risk factors, clinical characteristics, and outcomes of RSV infection in young children within hospitals. Materials and Methods: Data from Siriraj Hospital’s surveillance system (2014-2018) included children under 5 with laboratory-confirmed HA-RSV infection. Two control groups were formed: CA-RSV infection and non-RSV hospital-acquired infections (non-RSV HAI), time-matched with the study group (1:2 ratio). Results: Fifty-one HA-RSV cases were identified, with the highest infection rate during the rainy season (July to December). HA-RSV patients had higher rates of underlying neuromuscular disease and malignancy. Fever was common in HA-RSV, while upper respiratory and gastrointestinal symptoms were less frequent than CA-RSV. Antibiotic and oseltamivir treatment did not differ significantly. HA-RSV patients had longer stays in the intensive care unit and hospital, but transfer rates and mortality did not differ significantly among the groups. Conclusion: HA-RSV coincides with community outbreaks, being more severe and affecting vulnerable patients. Targeted surveillance during high RSV seasons is crucial for prevention in hospitals. Keywords: RSV; Respiratory syncytial virus; Hospital-acquired infection; Healthcare-associated infection