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Hospital Outbreak of Respiratory Syncytial Virus in Neonatal Intensive Care Unit. What is the Risk of Admitting External Patients?

Lais Bomediano de Souza, Emanuela Ribeiro, Fernando Silva, Marinice Duarte da Ponte, Roberto Carvalho, Hadassa Louback Paranhos, Jose Luis Braga de Aquino, Vania Aparecida Leandro Merhi, Idiberto José Zotarelli Filho, Elisa Teixeira Mendes

Introduction: Acute viral bronchiolitis caused by Respiratory Syncytial Virus (RSV) may be a manifestation of high severity in ICU-Neonatal patients. The metropolitan region of Campinas registered in 2017, a seasonal epidemic of RSV. The Maternity Hospital of Campinas reported an outbreak of the virus in the same period. Objective: It was to report an outbreak of RSV occurring in the Neonatal ICU and to discuss the risk of contact of premature and vulnerable newborns with community-acquired viruses. Methods: Data collection from the evaluation of patient charts with positive nasal lavage for RSV from April to July 2017 at Campinas Maternity and analysis of clinical factors, severity and prognosis of patients. Statistical analysis will be performed with chi-square in the categorical variables and t-student for the continuous variables comparing the newborn (NB) group from the community (external) and infected in the hospital (internal). p<0.05 was considered significant. Results: There were 44 patients with RSV in the period, of whom 32 were external and 12 were internal. The mean Gestational Age of the external ones was 38 weeks and 2 days while the internal gestational age was 29 weeks and 1 day (p<0.001). The hospitalization time was higher in the inpatients (p<0.001). A death associated with infection occurred in the inpatients group. Patients from the community are mostly term-born, with no comorbidities and had a more favorable clinical course. Neonates infected with RSV at the hospital have several risk factors for poor prognosis, with a 13.5% mortality rate reported in the literature. Conclusion: Therefore, it is important to discuss the exposure of this population to community-based infectious agents, mainly viral, and the risk of accepting patients from the community to be admitted to the neonatal ICU.