title: Increased risk for respiratory syncytial virus-associated, community-acquired alveolar pneumonia in infants born at 31-36 weeks of gestation.
abstract: BACKGROUND
  We compared hospitalization and pediatric intensive care unit (PICU) admission rates for community-acquired alveolar pneumonia (CAAP) and respiratory syncytial virus (RSV)-associated CAAP (RSV-CAAP) in non-RSV-immunized children <24-month-old born at 31-36 weeks gestational age (GA) versus those born at term (>36 weeks GA).
  
  
  METHODS
  Nasopharyngeal samples for RSV were obtained prospectively (2004-2011) during RSV season, from hospitalized children with radiographic-diagnosed CAAP. Soroka University Medical Center is the only hospital in the region, enabling population-based rate calculation. Relative risks (RR) and 95% confidence intervals (95% CI) were calculated comparing RSV-CAAP incidence in 31-36 weeks GA with >36 weeks GA children.
  
  
  RESULTS
  CAAP hospitalization incidences (per 1000 population) were 23.6 and 9.4 (RR: 2.52; 95% CI: 2.13-2.68), respectively; the respective incidences of PICU admission for overall CAAP were 1.8 and 0.2 (RR: 7.88; 95% CI: 4.59-11.83). The RRs (and 95% CI) for RSV-CAAP hospitalizations and PICU admission rates were (after extrapolation) 15.2 and 5.8 (RR: 2.79; 95% CI: 2.31-3.06) and 1.1 and 0.1 (RR: 9.14; 95% CI: 4.93-16.96), respectively. In a multiregression analysis in patients with RSV-CAAP versus CAAP, 31-36 weeks GA was an independent risk factor for hospitalization (RR: 1.485; 95% CI: 1.03-2.14).
  
  
  CONCLUSIONS
  Children <24-month-old born at 31-36 weeks GA are at increased risk for hospitalization and PICU admission for both overall CAAP and RSV-associated CAAP compared with those born at >36 weeks GA. Moreover, in late premature children, RSV represented a 50% increased risk for CAAP compared with infants born at term.
authors.affiliation: From the *Pediatric Infectious Disease Unit, Soroka University Medical Center; †Ben-Gurion University of the Negev; ‡Neonatal Department, Soroka University Medical Center, Beer-Sheva; and §Department of Radiology, Hadassah University Medical Center, Jerusalem, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.forename: Eilon
authors.initials: E
authors.lastname: Shany
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar-Ziv
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
mesh_terms: D018912:Arabs / Q000706:statistics & numerical data; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000208:ethnology; D007234:Infant, Premature; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data; D008297:Male; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000208:ethnology; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000208:ethnology; D012307:Risk Factors