尼塞韦单抗与1岁以下婴儿急性细支气管炎住院情况

Nirsevimab and Acute Bronchiolitis Admissions in Infants Under One Year of Age.

作者信息

Andina Martínez David, Claret Teruel Gemma, Gijón Mediavilla Manuel, Fernández Mozo Esther, Cámara Otegui Amaia, Baños López Laura, Jiménez de la Jara Beatriz, Ferrero García-Loygorri Clara, Sánchez Tatay Victoria, Pavlovic Nesic Svetlana, González Arza Nerea, Gimeno-Hernández Garza Verónica, Guerra Diez Jose Lorenzo, Ranera Málaga Adrián, Escalada Pellitero Silvia, Barrueco Ramos Clara, Alonso-Cadenas Jose Antonio

机构信息

Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Instituto de Investigación Sanitaria, Hospital Universitario La Princesa, Madrid, Spain.

出版信息

Pediatr Pulmonol. 2025 Aug;60(8):e71249. doi: 10.1002/ppul.71249.

DOI:10.1002/ppul.71249

PMID:40811215

Abstract

BACKGROUND AND OBJECTIVES

Spain was among the first countries to implement universal prophylaxis for respiratory syncytial virus (RSV) using nirsevimab, leading to a 60%-80% reduction in bronchiolitis hospital admissions. The main objective of this study was to describe the characteristics of infants admitted with bronchiolitis after RSV prophylaxis had been established.

METHODS

A retrospective study was conducted in 15 Spanish pediatric emergency departments during the 2023-2024 RSV season. We reviewed medical records coded as "acute bronchiolitis" of infants aged less than 12 months who were hospitalized.

RESULTS

A total of 947 infants with bronchiolitis were included. Of these, 198 (20.9%) were ineligible for immunization because they were older than 6 months and had no comorbidities. Among the 749 (79.1%) infants who met the criteria for immunization, 377 (50.3%) received nirsevimab, of whom 159 (42.1%) tested positive for RSV, while 372 (49.7%) were not immunized, with 322 (86.5%) testing positive for RSV (p < 0.001). Among infants who were not immunized, the most common reason for not receiving nirsevimab was family refusal. Among infants with RSV bronchiolitis, there were no significant differences in PICU admission rates or length of stay between those who were immunized and those who were not.

CONCLUSION

During the first nirsevimab campaign, most bronchiolitis admissions involved healthy children over 6 months of age who were not included in the target population, eligible infants who were not immunized, and immunized infants with non-RSV bronchiolitis. Further studies are needed to analyze the characteristics of immunized patients who are admitted with RSV bronchiolitis.

摘要

背景与目的

西班牙是最早使用尼塞韦单抗对呼吸道合胞病毒（RSV）进行普遍预防的国家之一，这使得毛细支气管炎住院率降低了60%-80%。本研究的主要目的是描述在建立RSV预防措施后因毛细支气管炎入院的婴儿的特征。

方法

在2023-2024年RSV流行季节，对西班牙15个儿科急诊科进行了一项回顾性研究。我们查阅了年龄小于12个月住院婴儿的编码为“急性毛细支气管炎”的病历。

结果

共纳入947例毛细支气管炎婴儿。其中，198例（20.9%）不符合免疫接种条件，因为他们年龄大于6个月且无合并症。在符合免疫接种标准的749例（79.1%）婴儿中，377例（50.3%）接受了尼塞韦单抗，其中159例（42.1%）RSV检测呈阳性，而372例（49.7%）未接种，322例（86.5%）RSV检测呈阳性（p<0.001）。在未接种疫苗的婴儿中，未接受尼塞韦单抗的最常见原因是家长拒绝。在患有RSV毛细支气管炎的婴儿中，接种疫苗和未接种疫苗的婴儿在儿科重症监护病房（PICU）的入住率或住院时间方面没有显著差异。