512. RSV Viral Kinetics and Medical Resources Utilization in Hospitalized Infants and Children in Japan
Session: Poster Abstract Session: Respiratory Infections: Pediatric
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Microsoft PowerPoint - OBSERVERSV0002 Poster20151005NT.pdf (671.1 kB)
  • Background:

    Respiratory Syncytial Virus (RSV) is one of the leading causes of acute respiratory infections, frequently requiring hospitalization. Data in young children for daily viral shedding and changes in clinical symptoms during the hospitalization is still limited worldwide and requested to position the clinical development of RSV intervention strategies.

    Methods:

    We prospectively enrolled children who were hospitalized within 5 days of clinical onset of RSV confirmed lower respiratory tract infection at two tertiary hospitals in Japan, between December 2013 and January 2015. Daily nasal swabs were collected from the mid-turbinate region and Clinical Symptom Score (CSS) and Medical Support Score were assessed for maximum 7 days or until discharge.  RSV viral load was measured using quantitative reverse transcriptase polymerase chain reaction.

    Results:

    A total of 49 patients were enrolled. The median age at onset was 7 months (0-48 months) with 18 (36.7%) who were older than 1 year old. There were 13 patients (26.5%) with co-morbidities including, 7 with cardiovascular disease, 5 with asthma and 5 with prematurity. The median time to admission was 4 Days (1-5 days) with a median length of hospitalization of 6 Days. Overall, viral load and CSS gradually decreased in parallel after hospitalization, however viral load (VL) change from day 1 to 3 did not correlate with the length of oxygen supplementation. Comparison of patients according to age, showed that children older than 12 months of age were more likely to have underlying disease (58.8% vs 9.3%), with delayed time to peak VL (2 vs 1 days),  and lower DViral loadd1-d3 (0.3 vs 1.2 log ). Children with underlying disease had a delayed time to peak VL (2.5 vs 2 days), lower D Viral loadd1-d3 (0.3 vs 1.1 log ), longer request for oxygen supplementation.. and higher median viral load at discharge (6.8 vs 6.2 log). A significant proportion of patients (N=14) received systemic corticosteroids for asthma or reactive airway disease, however there was no difference in viral kinetics in presence or absence of corticosteroid treatment.

    Conclusion:

    Children with underlying disease were more represented in the older age group (>12 months), had more viral shedding and longer request for oxygen supplementation.

    Nobuyuki Tetsuka, MD1, Kentaro Tomita, MD2, Kazuya Matsumura, MD2, Masayoshi Shinjoh, MD2, Tomomi Kimura, MD-PhD3, Gabriela Ispas, PhD4, Kenta Ito, MD1, Koichi Mizuguchi, M.D.5, Takanori Funaki, MD1, Munehiro Furuichi, MD1, Hidenori Nakagawa, MD1, Sarah Rusch, MSc4, Nacer Lounis, PhD4, Els Houtmeyers, Msc4, Jacques Bollekens, MD-PhD4, Akira Shishido, MSc6, Yoshikazu Nakayama, MSc6, Schoichiro Goto, PhD6, Takao Takahashi, MD2, Norio Sugaya, MD, PhD7 and Isao Miyairi, MD1, (1)Infectious Disease, National Center for Child Health and Development, Tokyo, Japan, (2)Pediatrics, Keio University School of Medicine, Tokyo, Japan, (3)Janssen Pharmaceutical K.K., Tokyo, Japan, (4)Janssen Infectious Diseases BVBA, Beerse, Belgium, (5)National Center for Child Health and Development, Tokyo, Japan, (6)Janssen Pharmaceutical K.K., Tokyo-to, Japan, (7)Pediatrics, Infection Control,, Keiyu Hospital, Yokohama, Japan

    Disclosures:

    N. Tetsuka, None

    K. Tomita, None

    K. Matsumura, None

    M. Shinjoh, Janssen: Grant Investigator and Scientific Advisor , Consulting fee and Research grant

    T. Kimura, None

    G. Ispas, None

    K. Ito, None

    K. Mizuguchi, None

    T. Funaki, None

    M. Furuichi, None

    H. Nakagawa, None

    S. Rusch, None

    N. Lounis, None

    E. Houtmeyers, None

    J. Bollekens, None

    A. Shishido, None

    Y. Nakayama, None

    S. Goto, None

    T. Takahashi, None

    N. Sugaya, Janssen: Scientific Advisor , Consulting fee

    I. Miyairi, Janssen pharmaceuticals: Grant Investigator and Scientific Advisor , Consulting fee and Research grant

    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.