Introduction There is very little data available on the impact that respiratory viral infections (RVI) have on neonatal morbidity and mortality in the UK.

Aims Define the epidemiology and impact of RVIs in a UK NICU population.

Methods We conducted a retrospective case review of all NICU patients, at two large tertiary centres, with multiplex PCR confirmed RVIs between 2007 and 2013. Additionally, suspect/proven RVIs were identified in a local population (Nottingham area, 2 large teaching hospitals).

Results 15,907 respiratory samples were analysed by PCR with 7941 positive (50%) of which 52% were in children. 806 samples from NICU patients (76334 inpatient days) yielded 158 (19.6%) positives in 90 babies (median gestation 29 weeks, IQR 26–34). There were no differences in the number of RVIs between Spring/Summer (n = 46) and Autumn/Winter (n = 44) periods. 71% of babies positive for RVIs had rhinovirus, 8% RSV and 6% H1N1. Almost half of all infected babies required escalation of respiratory support especially those <28 weeks gestation who required ventilation or ECMO (38%). Three babies died, one with rhinovirus and 2 (of 5 infected) with H1N1. 35% of preterm infants required home oxygen.

Discussion This is the largest UK series detailing RVIs in NICU patients. Although RVIs are uncommon, our study demonstrates significant associated morbidity, especially with rhinovirus, and significant mortality during the H1N1 pandemic. Subclinical RVIs can occur in the NICU¹ and coupled with our data suggests we need to explore better ways of minimising the impact of RVIs in this vulnerable population.

Reference

1. Bennett, et al. J Peds 2012;161(5):814–18