title: Epidemiological and clinical profiles of respiratory syncytial virus infection in hospitalized neonates in Suzhou, China.
abstract: BACKGROUND
  This study was designed to explore the epidemiological and clinical profiles of respiratory syncytial virus (RSV) infection in neonates from the Suzhou area of China, taking into consideration how climate factors influence disease.
  
  
  METHODS
  From 2010 to 2014, nasopharyngeal aspirates (NPA) collected from hospitalized neonates with lower respiratory tract infections (LRIs) were screened for seven common respiratory viruses including RSV by direct immunofluorescence assay. Human bocavirus, human metapneumovirus, and mycoplasma pneumoniae were detected by polymerase chain reaction.
  
  
  RESULTS
  Of the 1803 hospitalized neonates analyzed, 20.74 % were found to be infected with RSV. Interestingly, 30 subjects were identified as being coinfected with other viruses. The rate of RSV infection was highestduring thewinter and early spring seasons; however, infection was negatively associated with monthly mean temperature (rs = -0.821, P < 0.0001), total rainfall (rs = -0.406, P = 0.002), and sum of sunshine (rs = -0.386, P = 0.001). Monthly mean temperature was the only independent factor associated with RSV activity, as determined using multivariate regression analysis. Compared with non-RSV neonates, neonates with RSV infection presented more frequently with tachypnea,moist rales, and abnormal chest X-rays requiring supplemental oxygen and extended hospitalization postpartum. Neonatal admittance into the NICU was determined based on prematurity and coinfection with other viruses; two independent risk factors for RSV disease, as determined by multivariate logistic analysis.
  
  
  CONCLUSIONS
  Important as a major cause of LRIs in hospitalized neonate, we found that the subtropical climate of the Suzhou area was associated with RSV activity. The identified risk factors ofsevere disease in neonates with RSV infection should be taken into consideration when implementing disease health interventions.
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou, 215003, China. adolfhua@126.com.
authors.forename: Lianghua
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China. yyd3060@126.com.
authors.forename: Yongdong
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Clinical Lab, Children's Hospital of Soochow University, Suzhou, 215003, China. 15106218220@163.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou, 215003, China. xzh195678@sina.com.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Department of Neonatology, Children's Hospital of Soochow University, Suzhou, 215003, China. xing_feng66@hotmai.com.
authors.forename: Xing
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China. wang_yu_qing@126.com.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China. szdxjiwei@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Ji
authors.affiliation: Department of Cell Biology and Immunology, UNT Health Science Center at Fort Worth, Fort Worth, TX, 76107, USA. maximillion.mize@gmail.com.
authors.forename: Maximillion
authors.initials: M
authors.lastname: Mize
authors.affiliation: Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China. hcl_md@163.com.
authors.forename: Chuangli
authors.initials: C
authors.lastname: Hao
authors.affiliation: Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China. chen_zheng_rong@163.com.
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Chen
mesh_terms: D002681:China / Q000453:epidemiology; D060085:Coinfection / Q000150:complications / Q000175:diagnosis; D003710:Demography; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D009305:Nasopharynx / Q000821:virology; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D012307:Risk Factors; D012621:Seasons