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American Academy of Pediatrics National Conference and Exhibition
October 26, 2012
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Infants with rhinovirus hospitalized longer than children with RSV

SAN DIEGO — Infants aged younger than 90 days diagnosed with rhinovirus stayed in the hospital longer than infants with respiratory syncytial virus, according to results of a retrospective study presented here at ID Week.

Rhinovirus is a common cause of respiratory illness in children. Infants aged younger than 1 year have the highest rates of acute respiratory illness per year. The effect of rhinovirus on infants aged younger than 90 days remains unclear and is often overlooked as a major source of morbidity, according to background information in the study.

The objective of the study was to detail the clinical features of hospitalized infants aged younger than 90 days with laboratory-confirmed rhinovirus or respiratory syncytial virus (RSV).

Researchers hypothesized that there would be little clinical difference between rhinovirus and RSV for infants aged younger than 90 days, according to the study results.

Researchers tested and identified 245 hospitalized children aged younger than 90 days with respiratory virus nucleic acid amplification panel (Luminex) from August 2010 to October 2011 at Kaiser Permanente in Southern California.

Jeffrey M. Bender, MD, assistant professor of pediatrics in the division of infectious diseases at Children’s Hospital Los Angeles, and colleagues found rhinovirus in 52 infants compared with 79 infants (24%) with RSV (OR=0.85; 95% CI, 0.44-2.17).

Infants hospitalized with rhinovirus were younger (median age 29 days) compared with RSV (42 days; P=.032).

According to results from the study, 33 of 52 (63%) infants hospitalized with rhinovirus were evaluated for serious bacterial infections compared with 26 of 79 infants hospitalized with RSV (OR=3.54; 95% CI, 1.60-7.89).

Infants with rhinovirus stayed at the hospital longer (median 4 days; interquartile range [IQR], 3-6 days) compared with RSV (3 days; IQR, 2-4 days; P=.009).

Researchers identified four bacterial infections in blood and urine from infants with rhinovirus (7.7%) compared with one bacterial infection in an infant with RSV (OR=4.8; 95% CI, 0.52-44.7).

Researchers did not find a difference in the use of antibiotics (OR=0.98; 95% CI, 0.44-2.17) or need for ICU level care (OR=2.00; 95% CI, 0.60-6.42).

Infants with rhinovirus were less likely to require oxygen (31%) compared with infants with RSV (56%; P=.007).

Bender and colleagues reported zero fatalities.

According to the study data, infants with rhinovirus were younger, stayed in the hospital longer and may be attributed with more coinfections than infants with RSV.

Evaluating febrile infants remains a challenge for pediatricians and those caring for children, Bender and colleagues said.

“Early laboratory recognition of rhinovirus may be useful in the evaluation, treatment and risk-stratification of infants 1-90 days old hospitalized with rhinovirus infections,” they concluded in the study.

For more information:

Bender JM. Abstract #1138. Presented at: ID Week; Oct. 17-21, 2012; San Diego.

Disclosure: Bender reports no relevant financial disclosures.