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ObjectiveTo explore the clinical features and epidemiological trend of newborns with respiratory syncytial virus (RSV) pneumonia.MethodsTotally 709 newborns with neonatal pneumonia from February, 2009 to March, 2011 were enrolled at our hospital. Laryngeal aspirates were obtained from respiratory tract by aseptic vacuum aspiration. Direct immuno-fluorescence assay was employed to detect seven kinds of viruses’antigens including RSV antigen. All the clinical data were collected, and were divided into different groups based on RSV status and age.Results1. 182 RSV positive samples were identified from the enrolled 709 cases, and the positive rate was 25.7%. In addition, 5 cases of para-influenza virus in type 3, 1 case of influenza virus in type A, and 1 case of adenovirus were identified. Prevalence rates of RSV pneumonia arrived at the peak during October to February, which were 25%, 25%, 37.2%, 32.2%, 42.3%, respectively.2. The percentage of newborns younger than 7d in RSV-positive group was 17.0% (31/182), significantly lower than that in RSV-negative group 26.0% (137/527) (χ~2=6.011, P=0.014). The breastfeeding rate in RSV-positive group was 40.7%(74/182), significantly lower than that in RSV-negative group 49.1%(259/527)(χ~2=3.912, P=0.048). There was no significant difference on constituent ratios of gender, premature and low birth weight between the two groups (P>0.05).3. In terms of the clinical manifestations, the percentages of cough (χ~2=86.957, P=0.000), of fine moist rales (χ~2=17.504, P=0.000) and of wheeze (χ~2=25.293,P=0.000) in RSV-positive group were statistically higher than those in RSV-negative group. Among neonates with RSV pneumonia, the clinical feature of patients younger than 7d subgroup was similar to the subgroup older than 7d (P>0.05).4. In RSV-positive group, 113 cases (62.1%) were co-infected by bacteria, including Escherichia coli in 28 cases (15.4%), Klebsiella pneumoniae in 25 cases (13.7%), Staphylococcus aureus in 23 cases (12.6%), Enterobacter cloacae in 12 cases (6.6%). The constituent ratio of bacteria in RSV-positive group was similar to that in RSV-negative group (P>0.05).5. Compared with RSV-negative group, RSV-positive group had more oxygen use [22.0% vs 9.3%, (χ~2=19.815, P=0.000)], and longer duration of hospitalization [(12.8±4.9) d vs (11.4±4.9) d, (t=2.214,P=0.028)].ConclusionRSV is one of the important pathogen of neonatal pneumonia in autumn and winter in Chongqing. Breastfeeding decreases the susceptibility of RSV infection. The neonates of pneumonia should take the RSV antigen detection during the prevalent seasons of RSV infection, particularly those who are older than 3d, have cough, fine moist rales or wheeze over the lung. Neonates with RSV pneumonia were prone to have concurrent bacterial infections. Considering bacterial spectrum is short of specificity, the use of antibiotics can refer to empirical therapy of neonatal bacterial pneumonia. RSV pneumonia neonates have more oxygen use and longer hospital stay. There is no specific and effective approaches to treating RSV infection, therefore, prophylactic strategies including appropriate isolation are very important.
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