Document Detail


Use of palivizumab to control an outbreak of syncytial respiratory virus in a neonatal intensive care unit.
MedLine Citation:
PMID:  15350712     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the safety and effectiveness of a humanized respiratory syncytial virus (RSV) monoclonal antibody (palivizumab) to control an outbreak of RSV in a neonatal intensive care unit (NICU), we retrospectively analysed two RSV outbreaks. Between 11 November 1998 and 18 March 1999, two separate RSV outbreaks occurred in a large (26 beds) NICU. All procedures for preventing nosocomial spread of RSV (including the use of palivizumab in the second outbreak) were retrospectively analysed. The cumulative incidence (CI), secondary attack rate (SAR) and risk ratio of infection were determined before and after the use of palivizumab for all patients and for those with gestational age below and above 32 weeks in the NICU during the second outbreak. Standard infection control measures were effective in the first outbreak (three cases). In the second outbreak, after three index cases, five additional infants were newly RSV-infected within one month. Three infants had RSV pneumonia and required mechanical ventilation; one infant died. Standard infection control procedures were initiated from the beginning of this outbreak. Palivizumab was given to all infants in the NICU after the fifth case was identified. CI was 2.4% in the first 15 days and 10.5% in the second, and SAR was 2.9 per thousand in the first 15 days and 14.1 per thousand in the second, both dropping to zero after the administration of palivizumab. The risk ratio of infection was 4.65 times higher in infants under 32 weeks gestational age. After the use of palivizumab, there were no additional identified cases. In addition to careful infection control procedures, the use of palivizumab might have contributed to arresting the outbreak of RSV infection in the NICU, suggesting that it could be an additional resource in the control of severe nosocomial RSV outbreaks.
Authors:
C Abadesso; H I Almeida; D Virella; M H Carreiro; M C Machado
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hospital infection     Volume:  58     ISSN:  0195-6701     ISO Abbreviation:  J. Hosp. Infect.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-07     Completed Date:  2004-11-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007166     Medline TA:  J Hosp Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  38-41     Citation Subset:  IM    
Affiliation:
Department of Paediatrics, Hospital Fernando Fonseca, IC 19 2700 Amadora, Lisbon, Portugal.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / therapeutic use*
Antiviral Agents / therapeutic use*
Cross Infection / epidemiology,  prevention & control*
Disease Outbreaks / prevention & control*
Humans
Incidence
Infant, Newborn
Intensive Care Units, Neonatal
Portugal / epidemiology
Respiratory Syncytial Virus Infections / epidemiology,  prevention & control*
Retrospective Studies
Safety
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antiviral Agents; 0/palivizumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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