Subscribe to RSS
Viral Infections in Neonates with Suspected Late-Onset Bacterial Sepsis—A Prospective Cohort Study
05 January 2016
21 March 2016
16 May 2016 (online)
Objective The aim of our study was to evaluate the occurrence of viral infections in infants with suspected late-onset bacterial sepsis in a neonatal intensive care unit.
Methods In a prospective study, infants with suspected late-onset bacterial sepsis underwent viral testing alongside routine blood culture sampling. Using a multiplex reverse transcription-polymerase chain reaction enzyme-linked immunosorbent assay, nasopharyngeal aspirates were analyzed for adenovirus, respiratory syncytial virus (RSV), influenza virus A and B, H1N1 virus, parainfluenza virus 1 to 4, metapneumovirus, coronavirus, and picornavirus. Stools were examined for adenovirus, rotavirus, norovirus, and enterovirus.
Results Between August 2010 and March 2014, data of 88 infants with 137 episodes of suspected late-onset bacterial sepsis were analyzed. Six infants were diagnosed with a respiratory viral infection (2 × RSV, 4 × picornavirus). Blood culture–proven bacterial sepsis was detected in 15 infants. Neither viral–bacterial coinfections nor polymerase chain reaction positive stool samples were found.
Conclusion Respiratory viruses can be detected in a considerable number of neonates with suspected late-onset bacterial sepsis. In contrast, gastrointestinal viral or enterovirus infections appear uncommon in such cases.
The main results of the present study have been orally presented at the 5th International Conference on Clinical Neonatology (Torino, Italy, September 11–13, 2014).
- 1 Adams-Chapman I, Stoll BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Curr Opin Pediatr 2002; 14 (2) 157-164
- 2 Gastmeier P, Geffers C, Schwab F, Fitzner J, Obladen M, Rüden H. Development of a surveillance system for nosocomial infections: the component for neonatal intensive care units in Germany. J Hosp Infect 2004; 57 (2) 126-131
- 3 Kasper DC, Altiok I, Mechtler TP , et al. Molecular detection of late-onset neonatal sepsis in premature infants using small blood volumes: proof-of-concept. Neonatology 2013; 103 (4) 268-273
- 4 Leistner R, Piening B, Gastmeier P, Geffers C, Schwab F. Nosocomial infections in very low birthweight infants in Germany: current data from the National Surveillance System NEO-KISS. Klin Padiatr 2013; 225 (2) 75-80
- 5 Gelber SE, Ratner AJ. Hospital-acquired viral pathogens in the neonatal intensive care unit. Semin Perinatol 2002; 26 (5) 346-356
- 6 Verboon-Maciolek MA, Krediet TG, Gerards LJ, Fleer A, van Loon TM. Clinical and epidemiologic characteristics of viral infections in a neonatal intensive care unit during a 12-year period. Pediatr Infect Dis J 2005; 24 (10) 901-904
- 7 Steiner M, Strassl R, Straub J, Böhm J, Popow-Kraupp T, Berger A. Nosocomial rhinovirus infection in preterm infants. Pediatr Infect Dis J 2012; 31 (12) 1302-1304
- 8 Stein A, Keller M, Ross S , et al. Pandemic A/H1N1(2009) influenza infections in very-low-birth-weight infants—a case series from the German Neonatal Network. Klin Padiatr 2011; 223 (5) 267-270
- 9 van Piggelen RO, van Loon AM, Krediet TG, Verboon-Maciolek MA. Human rhinovirus causes severe infection in preterm infants. Pediatr Infect Dis J 2010; 29 (4) 364-365
- 10 Kujari A-M, Waris M, Lehtonen L, Ruuskanen O. Respiratory viral infections are not uncommon in neonatal intensive care units. Acta Paediatr 2014; 103 (5) e225-e228
- 11 Civardi E, Tzialla C, Baldanti F, Strocchio L, Manzoni P, Stronati M. Viral outbreaks in neonatal intensive care units: what we do not know. Am J Infect Control 2013; 41 (10) 854-856
- 12 Halasa NB, Williams JV, Wilson GJ, Walsh WF, Schaffner W, Wright PF. Medical and economic impact of a respiratory syncytial virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J 2005; 24 (12) 1040-1044
- 13 Krause JC, Panning M, Hengel H, Henneke P. The role of multiplex PCR in respiratory tract infections in children. Dtsch Arztebl Int 2014; 111 (38) 639-645
- 14 Meerhoff TJ, Houben ML, Coenjaerts FEJ , et al. Detection of multiple respiratory pathogens during primary respiratory infection: nasal swab versus nasopharyngeal aspirate using real-time polymerase chain reaction. Eur J Clin Microbiol Infect Dis 2010; 29 (4) 365-371
- 15 Kidszun A, Hansmann A, Winter J , et al. Detection of respiratory viral infections in neonates treated for suspicion of nosocomial bacterial sepsis: a feasibility study. Pediatr Infect Dis J 2014; 33 (1) 102-104
- 16 Ronchi A, Michelow IC, Chapin KC , et al. Viral respiratory tract infections in the neonatal intensive care unit: the VIRIoN-I study. J Pediatr 2014; 165 (4) 690-696
- 17 Bennett NJ, Tabarani CM, Bartholoma NM , et al. Unrecognized viral respiratory tract infections in premature infants during their birth hospitalization: a prospective surveillance study in two neonatal intensive care units. J Pediatr 2012; 161 (5) 814-818
- 18 Puppe W, Weigl J, Gröndahl B , et al. Validation of a multiplex reverse transcriptase PCR ELISA for the detection of 19 respiratory tract pathogens. Infection 2013; 41 (1) 77-91
- 19 Gonzalez-Carrasco E, Calvo C, García-García ML , et al. Viral respiratory tract infections in the Neonatal Intensive Care Unit [in Spanish]. An Pediatr (Barc) 2015; 82 (Suppl. 04) 242-246
- 20 Pavia AT. Viral infections of the lower respiratory tract: old viruses, new viruses, and the role of diagnosis. Clin Infect Dis 2011; 52 (Suppl. 04) S284-S289
- 21 van Benten I, Koopman L, Niesters B , et al. Predominance of rhinovirus in the nose of symptomatic and asymptomatic infants. Pediatr Allergy Immunol 2003; 14 (5) 363-370
- 22 Rhedin S, Lindstrand A, Rotzén-Östlund M , et al. Clinical utility of PCR for common viruses in acute respiratory illness. Pediatrics 2014; 133 (3) e538-e545
- 23 Jacques J, Bouscambert-Duchamp M, Moret H , et al. Association of respiratory picornaviruses with acute bronchiolitis in French infants. J Clin Virol 2006; 35 (4) 463-466
- 24 Luoto R, Ruuskanen O, Waris M, Kalliomäki M, Salminen S, Isolauri E. Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized, placebo-controlled trial. J Allergy Clin Immunol 2014; 133 (2) 405-413
- 25 Zaas AK, Burke T, Chen M , et al. A host-based RT-PCR gene expression signature to identify acute respiratory viral infection. Sci Transl Med 2013; 5 (203) 203ra126
- 26 Davis J, Fairley D, Christie S, Coyle P, Tubman R, Shields MD. Human parechovirus infection in neonatal intensive care. Pediatr Infect Dis J 2015; 34 (2) 121-124
- 27 Kidszun A, Klein L, Hansmann A , et al. 5ICCN_006: Viral infections in neonates with suspected nosocomial bacterial sepsis. Early Hum Dev 2014; 90 (Suppl. 02) S63