503. SENTINEL 1: An Observational Study of Respiratory Syncytial Virus Hospitalizations Among US Infants Born at 29–35 Weeks’ Gestational Age Not Receiving Immunoprophylaxis
Session: Poster Abstract Session: Respiratory Infections: Pediatric
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • 503_IDWPOSTER.pdf (184.0 kB)
  • Background: The epidemiology of severe respiratory syncytial virus (RSV) disease in US preterm infants has not been recently studied. The objective of the SENTINEL1 observational study is to characterize RSV hospitalizations (RSVHs) among US preterm infants born at 29–35 weeks' gestational age (wGA) not receiving RSV immunoprophylaxis (IP).

    Methods: At participating hospitals, all laboratory-confirmed RSVHs among preterm infants 29–35 wGA <12 months of age, hospitalized ≥24 hours during the 2014–2015 RSV season, and who did not receive RSV IP within 35 days before the onset of RSV disease symptoms were systematically identified (NCT02273882). Measures included infant wGA, birth month, hospital length of stay (LOS), intensive care unit (ICU) admission, ICU LOS, mechanical ventilation (MV), and survival. Exploratory statistical comparisons were conducted using the Wilcoxon rank-sum test.

    Results: Data were collected from 39 hospitals between October 1, 2014 and April 30, 2015. 606 RSVHs were identified: 210 infants 29–32 wGA, 237 infants 33–34 wGA, and 159 infants 35 wGA. Case characteristics are presented in Table 1. Death occurred in one 29-wGA infant. Chronological age (median; interquartile range [IQR]) of infants 29–35 wGA who required ICU admission (2 mo; 1–4 mo) or MV (2 mo; 1–3 mo) was younger than those who did not require ICU admission (4 mo; 2–6 mo) or MV (3 mo; 2–6 mo); P<0.001 for both. Infants <6 mo accounted for 75% of RSVHs observed, 83% of ICU admissions, and 89% of those requiring MV (Figure 1). Infants 29-32 wGA were overrepresented relative to their prevalence in US births (Figure 2).

    Table 1.

    Variable

    29–32 wGA (n=210)

    33–34 wGA (n=237)

    35 wGA (n=159)

    Median (IQR) age at admission, mo

    3 (2–6)

    2 (1–5)

    3 (1–5)

    Median (IQR) hospital LOS, d

    6 (3–13)

    5 (3–10)

    5 (3–7)

    ICU admission, n (%)

    112 (53)

    100 (42)

    51 (32)

    Median (IQR) ICU LOS, d

    8 (3–14)

    6 (3–12)

    6 (3–9)

    MV among all admissions, n (%)

    56 (27)

    42 (18)

    21 (13)

     

     

    Conclusion: Among preterm infants born at 29–35 wGA not receiving RSV IP, RSV illness can be severe, frequently resulting in ICU admissions and MV, particularly during the first few months of life. Consistent with previous RSVH studies, RSV disease severity is greater in infants born at earlier gestational ages.

    This study was sponsored by AstraZeneca.

     

    Leonard R. Krilov, MD1, Natasha Halasa, MD, MPH, FPIDS2, Neal J. Thomas, MD3, Evan J. Anderson, MD4, Pia S. Pannaraj, MD, MPH5, Michael L. Forbes, MD6, Tsoline Kojaoghlanian, MD7, Paul a. Checchia, MD8, Andrew M. Atz, MD9, Eric A. F. Simões, MB; BS, DCH, MD10, Joseph B. Domachowske, MD11, Stephen D. Kicklighter, MD12, Anchalee Yuengsrigul, MD13, Michael Lamacchia, MD14, Scott J. Mcbride, MA15, Veena R. Kumar, MD, MPH16, Kimmie K. Mclaurin, MS16 and Christopher S. Ambrose, MD16, (1)Winthrop University Hospital, Mineola, NY, (2)School of Medicine, Vanderbilt University, Nashville, TN, (3)Penn State Hershey Children’s Hospital, Hershey, PA, (4)Emory University School of Medicine, Atlanta, GA, (5)Children's Hospital Los Angeles, Los Angeles, CA, (6)Akron Children's Hospital, Akron, OH, (7)Children's Hospital at Montefiore, Bronx, NY, (8)Texas Children’s Hospital, Houston, TX, (9)Medical University of South Carolina, Charleston, SC, (10)Children's Hospital of Colorado, Aurora, CO, (11)SUNY Upstate Medical University, Syracuse, NY, (12)WakeMed Health & Hospitals, Raleigh, NC, (13)Children’s Hospital of Orange County, Orange, CA, (14)St. Joseph's Children's Hospital, Paterson, NJ, (15)United BioSource Corp, Ann Arbor, MI, (16)AstraZeneca, Gaithersburg, MD

    Disclosures:

    L. R. Krilov, AstraZeneca (MedImmune): Grant Investigator , Research support
    Pfizer: Grant Investigator , Research support

    N. Halasa, AstraZeneca: Grant Investigator , Grant recipient
    Sanofi Pasteur: Grant Investigator , Grant recipient
    Pfizer: Grant Investigator , Grant recipient
    Gilead: Grant Investigator , Grant recipient

    N. J. Thomas, Discovery Labs: Scientific Advisor , Consulting fee
    Ikaria: Scientific Advisor , Consulting fee
    FDA: Reseach Grant R01 , Research grant

    E. J. Anderson, Abbvie: Consultant , Consulting fee

    P. S. Pannaraj, AstraZeneca: Research Contractor , Research support

    M. L. Forbes, AstraZeneca: Speaker's Bureau , Speaker honorarium

    T. Kojaoghlanian, None

    P. A. Checchia, AstraZeneca: Research Grant , Grant recipient

    A. M. Atz, None

    E. A. F. Simões, MedImmune: Grant Investigator and Scientific Advisor , Consulting fee and Research grant

    J. B. Domachowske, AstraZeneca: Collaborator , Consultant , Investigator , Scientific Advisor and Speaker's Bureau , Educational grant , Grant recipient and Speaker honorarium

    S. D. Kicklighter, None

    A. Yuengsrigul, None

    M. Lamacchia, None

    S. J. Mcbride, None

    V. R. Kumar, AstraZeneca: Employee , Salary

    K. K. Mclaurin, AstraZeneca: Employee , Salary

    C. S. Ambrose, AstraZeneca: Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.