Acute respiratory tract viral infections in a neonatal intensive care unit: An observational study

Abstract

Background: Respiratory viral infection covers a significant admission in our Neonatal Intensive care unit. However due to limited diagnostic it is often underdiagnosed. Due to this, neonates are treated like bacterial infection, with unnecessary antibiotics and increased hospital stay. This also exposes other admitted neonates to the viral infection. Aim: The aim of our study is to determine the yield of respiratory BioFire in neonates presenting with respiratory symptoms. Materials and Methods: A retrospective observational study was conducted from January 2021 to March 2023 on neonates with respiratory symptoms. Respiratory BioFire panel was performed on nasopharyngeal specimens amongst infants with clinical suspicion of respiratory viral infection Result: During the 16-month study, amongst the 54 neonates for which respiratory BioFire was sent, 55% had positive results. 90% was community-acquired infection, whereas 10% was hospital-acquired infection. Cough and tachypnoea were the common presenting symptoms. Respiratory syncytial virus (RSV) (60%) was the predominant virus detected. 88% of infants with RSV required respiratory support; out of which 2 out of 18(11%) required high-frequency oscillatory ventilation. Amongst term and pre-term neonates, invasive ventilation was required in 7.7% and 41.2%, respectively, amongst the tested positive, only 13% had blood culture positive, due to which antibiotics were never started in 50% and amongst those in which antibiotics were started stopped before 72 h in 40% neonates. It was seen in our study that most (88.6%) of the virus detected were in the winter months (August–January). Conclusion: Acute viral infections are common amongst neonates admitted with respiratory symptoms. Early recognition can rationalise management and reduce unnecessary use of antibiotics.