133. Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) Study of Respiratory Syncytial Virus-Associated Deaths in Pediatric Patients in Canada: A Retrospective Review from 2003 to 2013
Session: Poster Abstract Session: Big Viruses in Little People (Pediatric Viral Diseases)
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDSA 2016 Poster_PICNIC RSV_FINAL.pdf (5.5 MB)
  • Background: Respiratory syncytial virus (RSV) is a major cause of pneumonia and the major cause of bronchiolitis in infancy. Mortality rates in previously healthy infants with RSV pneumonia and bronchiolitis are less than 0.5%, but rates are higher in severely immunocompromised patients. While mortality is rare, such cases do occur. To this end, data are lacking for the risk factors associated with mortality from RSV infection among children in Canada. The objective of this study was to determine the number of RSV-related deaths and the factors associated with these deaths among children hospitalized with RSV infection in Canadian pediatric centres.

    Methods: Retrospective review of all RSV-associated deaths at centres affiliated with the Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) over the period 2003-2013, inclusive. Cases were identified using similar ICD codes to capture all deaths where a diagnosis of RSV infection was also present.

    Results: Overall, 8 centres reported 66 RSV-associated deaths. RSV was regarded as primarily responsible for deaths in 27 (41%) of cases. The median age of children who died was 11 months (range < 1 month to 16 years). Twenty-five patients (38%) were male. Thirteen deaths (20%) occurred among patients with no known risk factors for severe RSV. Thirty-eight deaths (58%) were among patients who had underlying chronic medical conditions without known immune deficiency, while 14 (21%) occurred among immunocompromised hosts. Community-acquired infections accounted for 43 deaths (65%). Fifty-five subjects (83%) were admitted to an intensive care unit and received mechanical ventilation. Palivizumab use was reported in 4 (6.1%) and 3 (4.6%) for prophylaxis and treatment, respectively. Ribavirin use for treatment was reported in 8 (12%).

    Conclusion: RSV-associated deaths were predominantly associated with chronic medical conditions and immunocompromised states among infants. However, 1 out of every 5 deaths occurred among infants with no known risk factors for severe RSV. Deaths associated with nosocomially-acquired infections were observed. Further study of the factors (e.g., immunogenetic) associated with deaths is warranted.

    Jennifer Tam, BSc(Pharm), MD1, Jesse Papenburg, MD, MSc2, Sergio Fanella, MD, FRCPC3, Sandra Asner, MD, MSc4, Michelle Barton, MBBS5, Shalini Desai, MD6, Cheryl Foo, MD, FRCPC7, Joanne M. Langley, MD, FRCPC, FSHEA8, Kirk Leifso, MD, MSc, FRCPC9, Jeffrey Pernica, MD, MSc, FRCPC6, Joan Robinson, MD10, Roopi Singh, BSc, BASc1, Bruce Tapiero, MD11, Upton Allen, MD, FIDSA1 and Cybele Bergeron, .12, (1)The Hospital for Sick Children, Toronto, ON, Canada, (2)The Montreal Children's Hospital, Montreal, QC, Canada, (3)Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada, (4)Pediatrics, Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada, (5)University of Western Ontario, London, ON, Canada, (6)Pediatrics, McMaster University, Hamilton, ON, Canada, (7)University of Manitoba, Winnipeg, MB, Canada, (8)IWK Health Centre, Halifax, NS, Canada, (9)Kingston General Hospital, Kingston, ON, Canada, (10)Stollery Children's Hospital, Edmonton, AB, Canada, (11)Department of Pediatrics, Division of Infectious Diseases, CHU Sainte-Justine – University of Montreal, Montreal, QC, Canada, (12)CIUSSS de l’Estrie-CHUS Fleurimont, Sherbrooke, QC, Canada

    Disclosures:

    J. Tam, None

    J. Papenburg, Becton, Dickenson & Co.: Investigator , Research grant
    RPS Diagnostics: Board Member , Consulting fee
    AbbVie Inc.: Board Member , Consulting fee

    S. Fanella, None

    S. Asner, None

    M. Barton, None

    S. Desai, None

    C. Foo, None

    J. M. Langley, GSK: Investigator , Research support

    K. Leifso, None

    J. Pernica, None

    J. Robinson, None

    R. Singh, None

    B. Tapiero, None

    U. Allen, None

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