title: Clinical course of community-acquired respiratory syncytial virus pneumonia in newborns hospitalized in neonatal intensive care unit.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) is a major cause of pneumonia in infants worldwide. We aimed to evaluate the clinical course of community-acquired RSV pneumonia in newborns hospitalized in neonatal intensive care unit.
  
  
  METHODS
  All the newborns diagnosed as pneumonia were prospectively evaluated for RSV infection between November 2010 and April 2011. Fifty-four specimens of nasopharyngeal secretions were tested in parallel with the RAT and the multiplex real time polymerase chain reaction (RT- PCR). Downes' score was used to assess the disease severity in patients with pneumonia.
  
  
  RESULTS
  RAT has a sensitivity of 90% and a specificity of 78.5%, as the PCR technique target assay. Four of the patients with RSV pneumonia had secundum atrial septal defect (ASD) and all of four needed mechanical ventilation support. The first day Downes' score was positively correlated with time of intravenous fluid requirement (p= 0.001, r= 0.48), total oxygen need (p= 0.000, r= 0.63), and re-enteral feeding (p= 0.001, r= 0.46). Blood pH (p= 0.031, r= 0.46) were negatively correlated with Downes' score. The second day Downes' score was higher in patients with ASD than those of without ASD (3.8 ± 2.6 vs. 2 ± 1.1, p= 0.01). The most possible risk factor for longer hospital stay was the higher second day Downes' score (p= 0.02 OR: 1.9, CI 95% (1.1-3.2). All infants were discharged from hospital in a good health.
  
  
  CONCLUSIONS
  RAT is sensitive and specific in detecting RSV infections in newborns. Physicians may use Downes' score for evaluation of disease severity in infants with RSV pneumonia. In these patients, ASD has increased the disease severity.
authors.affiliation: Clinic of Neonatology, Dr. Sami Ulus Maternity and Children Health and Diseases Training and Research Hospital, Ankara, Turkey. dilekdilli2@yahoo.com.
authors.forename: Banu
authors.initials: B
authors.lastname: Aydın
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Zenciroğlu
authors.forename: Dilek
authors.initials: D
authors.lastname: Dilli
authors.forename: Nurullah
authors.initials: N
authors.lastname: Okumuş
authors.forename: M Sah
authors.initials: MS
authors.lastname: İpek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydın
authors.forename: Nuran
authors.initials: N
authors.lastname: Uzunalıç
authors.forename: Nilay
authors.initials: N
authors.lastname: Hakan
authors.forename: Ahmet Afşin
authors.initials: AA
authors.lastname: Kundak
authors.forename: Arzu
authors.initials: A
authors.lastname: Dursun
authors.forename: Nilgün
authors.initials: N
authors.lastname: Karadağ
authors.forename: Gülay
authors.initials: G
authors.lastname: Korukluoğlu
mesh_terms: D017714:Community-Acquired Infections / Q000175:diagnosis / Q000821:virology; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000821:virology; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D012720:Severity of Illness Index