Respiratory syncytial virus infection in preterm

Introduction:In some hospitals the outcome of mechanically ventilated neonates may be more bad than good. This is mainly due to acquired nosocomial pneumonia during the period of mechanical ventilation. Some recent studies said that there is a clear role of viruses in respiratory infections related to mechanical ventilation and the commonest one is RSV.The aim of the work:Is to determine the incidence of infection by RSV as a nosocomial respiratory infection in preterm infants submitted to mechanical ventilation in the neonatal intensive care units (NICUS) of Zagazig University Hospital and Benha Children Hospital.Subjects and Methods :The study was done in a period of 11 months during the period from November 2005 to September 2006, included fifty preterm babies admitted to the NICU with acute respiratory failure and submitted to mechanical ventilation . All cases were subjected to the following : history taking- clinical examination – investigations included( CBC, CRP, blood gases, blood culture, tracheal aspirate culture, and detection of RSV IgM antibodies by indirect immunofluorescent technique throught two blood serum samples were collected during the mechanical ventilation period , with 7-10 days interval between the two samples).Results:All cases were negative for RSV IgM antibodies in the two blood samples . The most frequent complication among our cases was newly developed sepsis in 29 cases (58%), followed by ventilator associated pneumonia (VAP) in 16 cases(32%). The bacteriological profile of the positive blood cultures of the patients showed that there were positive blood cultures in 21 cases (42%) and the most prevalent microorganism was Staph. Aures in 7 cases (14%) followed by E. coli in 6 cases (12%).Conclusion:There is no significant incidence of respiratory syncytial virus infection among our preterm neonates submitted to mechanical ventilation . Bacterial pathogens are the main aetiological organism in the acquired nosocomial infection in our NICU. VAP is a frequent complication of mechanical ventilation among studied neonates . The most frequent complication among the studied neonates was sepsis with predominance of Staph.aures followed by E. coli and Klebsilla.