Respiratory outcome of prematurely born infants following human rhinovirus A and C infections.
Human rhinoviruses (HRVs) are a common cause of lower respiratory tract infections (LRTIs) and are associated with chronic respiratory morbidity. Our aim was to determine whether HRV species A or C were associated with chronic respiratory morbidity and increased health care utilisation in prematurely born infants. A number of 153 infants with a median gestational age of 34 (range 23-35) weeks were prospectively followed. Nasopharyngeal aspirates were collected whenever the infants had LRTIs regardless of hospitalisation status. Parents completed a respiratory diary card and health questionnaire about their infant when they were 11 and 12 months corrected age, respectively. The health-related cost of care during infancy was calculated from the medical records using the National Health Service (NHS) reference costing scheme and the British National Formulary for children. There were 32 infants that developed 40 HRV LRTIs; samples were available from 23 of the 32 infants for subtyping. Nine infants had HRV-A LRTIs, 13 HRV-C LRTIs, and one infant had a HRV-B LRTI. Exclusion of infants who also had RSV LRTIs revealed that the infants who had a HRV-C LRTI were more likely to wheeze (p < 0.0005) and use respiratory medications (p < 0.0005) and had more days of wheeze (p = 0.01) and used an inhaler (p = 0.02) than the no LRTI group. In addition, the respiratory cost of care was greater for the HRV-C LRTI than the no LRTI group (p < 0.0005).


CONCLUSIONS
Our results suggest HRV-C is associated with chronic respiratory morbidity during infancy in prematurely born infants.
Division of Asthma, Allergy and Lung Biology, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Simon B
SB
Drysdale
Mireia
M
Alcazar
Theresa
T
Wilson
Melvyn
M
Smith
Mark
M
Zuckerman
Ina L
IL
Lauinger
Cheuk Y W
CY
Tong
Simon
S
Broughton
Gerrard F
GF
Rafferty
Sebastian L
SL
Johnston
Anne
A
Greenough
D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009305:Nasopharynx / Q000821:virology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000821:virology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012229:Rhinovirus / Q000302:isolation & purification*; D006113:United Kingdom