NICU Casilino General Hospital, Rome, Italy.
Ital J Pediatr. 2018 Jan 16;44(1):11. doi: 10.1186/s13052-018-0454-4.
Acute bronchiolitis is the most common cause of hospitalizations in infants < 12 months of age and preventive efforts remain the most important strategy to date. Recently prophylaxis with palivizumab (PLV) was limited to preterm infants with < 29 weeks gestational age (wGA).We performed a single center analysis in preterm infants (GA between 30 and 32 weeks) and age < 12 months to compare prophylaxis with PLV and frequency and characteristics of bronchiolitis and bronchiolitis-related hospitalization in two consecutive epidemic seasons (S1 vs S2).We found a rising trend in rate of bronchiolitis and bronchiolitis-related hospitalization in S1 vs S2. Among hospitalization, we found an increased morbidity with an increase in the rate of mechanical ventilation in S2. Additionally, hospitalization occurred in subjects with younger chronological age in S2 compared with S1.Our result cannot be generalized because deriving from a single Center and further evaluation on wider simple size are warranted, but it suggests an increase in the incidence, gravity and precocity of bronchiolitis in 29-32 wGE preterm infants with the change in National guidelines for prophylaxis.
急性细支气管炎是<12 月龄婴儿住院的最常见原因,预防措施仍是迄今为止最重要的策略。最近,帕利珠单抗(PLV)预防仅限于<29 周妊娠龄(wGA)的早产儿。我们对<30-32 周妊娠龄的早产儿(GA)和年龄<12 个月的婴儿进行了单中心分析,比较了在两个连续流行季节(S1 与 S2)中使用 PLV 预防与细支气管炎和细支气管炎相关住院的频率和特征。我们发现 S1 与 S2 相比,细支气管炎和细支气管炎相关住院率呈上升趋势。在住院治疗中,我们发现 S2 中机械通气率增加,发病率也随之增加。此外,与 S1 相比,S2 中住院治疗的患儿年龄较小。由于该结果仅来源于单一中心,且需要更大的样本量进一步评估,因此不能推广,但它提示随着国家预防指南的改变,29-32 wGE 早产儿的细支气管炎发病率、严重程度和发病提前。