C20-3133-346-2662

C20 abstract preview

(#346) Breakthrough Respiratory Syncytial Virus (Rsv) Infection Post Palivizumab Prophylaxis In Paediatrics Population Of Hospital Tuanku Ja’afar Seremban (HTJS)

Abstract:

Introduction: Respiratory syncytial virus (RSV) is the common cause for hospitalization in infants. It causes significant mortality and morbidity among infants and young children less than 2 years of age. Palivizumab prophylaxis in high-risk infants is an effective prevention from development of severe disease.

Objectives: This study aims to investigate rate of breakthrough RSV infection and factors affecting it, post Palivizumab prophylaxis.

Methods: A retrospective cohort with universal sampling was conducted in Hospital Tuanku Ja’afar Seremban (HTJS). Palivizumab recipients from December 2014 to January 2017 were identified from registry. After screening through inclusion and exclusion criteria, a total of 50 infants were identified and followed-up until they are 2 years old for any positive RSV infection.

Results: 50 infants with mean gestational age of 31 ± 4.9 weeks and mean birth weight was of 1.6 ± 0.9kg were included in this study. A total of 88% (n=44) completed 5 doses of Palivizumab. Post Palivizumab prophylaxis, 30% (n=15) were re-hospitalized with RSV positive infection and 13.3% (n=2) resulted in PICU admission. 80% (n=12) of the RSV positive infants were infected within 11 months of Palivizumab prophylaxis. With Palivizumab prophylaxis, infants of more than 32 weeks gestational age (wGA) had highest RSV breakthrough infection (50%, n=8, p<0.05) than infants of ≤32wGA. Infants with ≥2 risk factors had more breakthrough RSV infection than those with <2 risk factors (P<0.05).

Conclusion: In sum, after 5 doses of Palivizumab prophylaxis, 24% infants had breakthrough RSV infection. Furthermore, preterm infants born ≤32 weeks gestational age and having ≥2 risks for severe RSV infection showed significant benefit from Palivizumab prophylaxis.

Keywords:

Keyword: Palivizumab, Respiratory Syncytial Virus, paediatric

Abstract document:

xabstract-935.docx

Does this research add new knowledge to the existing literature?:

Yes.
There were many available literatures on Palivizumab use as Respiratory Synctial Virus(RSV) prophylaxis internationally but none conducted in Malaysia.
RSV infections were reported as a frequent viral cause of hospital admission and mortality among those under 5 years of age. Mortality rates were significantly higher in developing countries. Acute lower respiratory tract infections (ALRIs) caused by RSV are a leading cause of hospitalization in infants.

Has the knowledge been translated into practice?:

Yes.
This study outcome demonstrates groups that benefitted more from Palivizumab prophylaxis. Thus, helping our facility to come out with policy or set criteria for infants in need. A better selection of infants before initiation treatment can be carried out.

Does your research fit the conference theme?:

Yes.
This study showed the importance of RSV prophylaxis in preterm infants <32wGA. It can be used in a step to establish our own population data to better characterize infants who will benefit from Palivizumab prophylaxis. It also helps in better decision making for the initiation of Palivizumab prophylaxis.

Research track:

Optimization of therapy

Preference of presentation:

Oral
Submitted by OH AI LING on Tue, 24/03/2020 - 6:18pm
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Comment: 
A sentence shall not start with number ie 50 infants, 80%, shall be written in words. 1st objective was answered. However, 2nd objective was not answered clearly. The risk factors shall be further elaborated. Methods: What's the statistical test used in this study? Comparison shall be made between the number of doses of Palivizumab given. This could be one of the determinant factor for breakthrough RSV infection Results showed that those with ≥2 risk factors had more breakthrough RSV infection than those with <2 risk factors post Palivizumab prophylaxis. How does this generate the conclusion that having ≥2 risks for severe RSV infection showed significant benefit from Palivizumab prophylaxis as the comparison was not made between the risk factors to determine the outcome of Palivizumab prophylaxis. Conclusion: after 5 doses of Palivizumab prophylaxis, 24% infants had breakthrough RSV infection (This shall fall under Results)
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