Nosocomial viral infections in the neonatal intensive care unit
- Leonard E Weisman, MD
Leonard E Weisman, MD
- Section Editor — Neonatology
- Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Steven A Abrams, MD
Steven A Abrams, MD
- Section Editor — Neonatology
- Professor, Department of Pediatrics
- Dell Medical School at the University of Texas at Austin
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
Although the published incidence of viral neonatal nosocomial infection is considerably lower than bacterial nosocomial infection , significant mortality and morbidity occur in the estimated 1 percent of infants who acquire a viral infection after admission to the neonatal intensive care unit (NICU) .
The epidemiology, and the viruses and their clinical manifestations of nosocomial viral infection in the NICU will be reviewed here.
The incidence of neonatal nosocomial viral infections has probably been underestimated because viral studies are not routinely obtained in neonates. The lack of testing for viral infection is due to the overlap of clinical signs and symptoms of viral infections from other conditions seen in the critically ill neonate, the difficulty in obtaining laboratory confirmation of a viral infection, and the lack of effective therapeutic interventions.
Prospective data demonstrate that the frequency of detected respiratory viral infections in infants evaluated for sepsis ranges from 6 to 10 percent.
●In a prospective study conducted in two neonatal intensive care units (NICUs) in the United States from 2012 to 2013, a respiratory viral infection was identified in 8 cases of the 135 sepsis evaluations (6 percent) . During the 13-month study period, viruses detected by polymerase chain reaction (PCR) included enterovirus/rhinovirus (n = 2), rhinovirus (n = 2), coronaviruses (n = 2), and parainfluenza virus (n = 3).
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- ETIOLOGY AND CLINICAL MANIFESTATIONS
- Respiratory viruses
- - Respiratory syncytial virus
- - Parainfluenza virus
- - Influenza virus
- - Adenovirus
- - Other respiratory viral agents
- Gastrointestinal viruses
- - Rotavirus
- Sepsis-like illness and meningitis/encephalitis
- - Enterovirus
- - Parechovirus