Alexander Domnich , Francesco Lapi , Andrea Orsi , Piero Luigi Lai , Luca Pestarino , Pier Claudio Brasesco , Marta Vicentini , Anna Puggina , Alen Marijam , Carlo-Simone Trombetta , Giada Garzillo , Giulia Guarona , Federica Stefanelli , Valentina Ricucci , Donatella Panatto , Giancarlo Icardi
{"title":"探讨成人门诊患者呼吸道合胞病毒的病例定义和自然史：第一季的呼吸器-50研究结果","authors":"Alexander Domnich , Francesco Lapi , Andrea Orsi , Piero Luigi Lai , Luca Pestarino , Pier Claudio Brasesco , Marta Vicentini , Anna Puggina , Alen Marijam , Carlo-Simone Trombetta , Giada Garzillo , Giulia Guarona , Federica Stefanelli , Valentina Ricucci , Donatella Panatto , Giancarlo Icardi","doi":"10.1016/j.jiph.2025.102653","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Data on the natural history of the community-acquired RSV in adult outpatients are limited. It is also unclear whether the existing influenza surveillance platforms based on influenza-like illness (ILI) case definitions are efficient for RSV. The two-season RESPIRA-50 study was established in 2023 to identify an optimal RSV case definition and to explore the natural history of RSV. Here, the first-season results are reported.</div></div><div><h3>Methods</h3><div>The study was conducted in Genoa (Italy) during the 2023/2024 RSV season. Twenty-four general practitioners were randomized 1:1 to enroll adults aged ≥ 50 years seeking care for acute respiratory infection (ARI) or ILI, respectively. Both syndromes were defined according to the European criteria. All subjects were tested by real-time polymerase chain reaction (RT-PCR) for RSV and other pathogens. RSV-positive adults were followed for up to 30 days.</div></div><div><h3>Results</h3><div>Of 517 subjects included, 7.0 % [95 % confidence interval (CI): 4.9–9.5 %)] tested positive for RSV. RSV prevalence in the ARI group (8.0 %; 95 % CI: 5.0–12.1 %) was higher than in the ILI group (6.0 %; 95 % CI: 3.5–9.5 %) with an odds ratio of 1.36 (95 % CI: 0.69–2.70). Conversely, positivity for influenza (10.4 % vs 12.4 %) and SARS-CoV-2 (12.4 % vs 16.9 %) were lower in the ARI group and the corresponding ORs were 0.82 (95 % CI: 0.48–1.42) and 0.70 (95 % CI: 0.43–1.15), respectively. The mean duration of an RSV episode was 18.8 ± 8.0 days and two thirds of individuals were prescribed antibiotics. A total of 33.3 % (95 % CI: 18.6–51.0 %) of RSV-positive individuals developed complications, of which bronchitis (13.9 %) and pneumonia (8.3 %) were the most frequent.</div></div><div><h3>Conclusions</h3><div>Compared with ARI, ILI-based surveillance may underestimate the burden of RSV in community-dwelling adults aged ≥ 50 years. A high proportion of RSV-positive adult outpatients develops complications, which lead to substantial resource consumption.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 3","pages":"Article 102653"},"PeriodicalIF":4.7000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploring case definitions and the natural history of respiratory syncytial virus in adult outpatients: First-season results of the RESPIRA-50 study\",\"authors\":\"Alexander Domnich , Francesco Lapi , Andrea Orsi , Piero Luigi Lai , Luca Pestarino , Pier Claudio Brasesco , Marta Vicentini , Anna Puggina , Alen Marijam , Carlo-Simone Trombetta , Giada Garzillo , Giulia Guarona , Federica Stefanelli , Valentina Ricucci , Donatella Panatto , Giancarlo Icardi\",\"doi\":\"10.1016/j.jiph.2025.102653\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Data on the natural history of the community-acquired RSV in adult outpatients are limited. It is also unclear whether the existing influenza surveillance platforms based on influenza-like illness (ILI) case definitions are efficient for RSV. The two-season RESPIRA-50 study was established in 2023 to identify an optimal RSV case definition and to explore the natural history of RSV. Here, the first-season results are reported.</div></div><div><h3>Methods</h3><div>The study was conducted in Genoa (Italy) during the 2023/2024 RSV season. Twenty-four general practitioners were randomized 1:1 to enroll adults aged ≥ 50 years seeking care for acute respiratory infection (ARI) or ILI, respectively. Both syndromes were defined according to the European criteria. All subjects were tested by real-time polymerase chain reaction (RT-PCR) for RSV and other pathogens. RSV-positive adults were followed for up to 30 days.</div></div><div><h3>Results</h3><div>Of 517 subjects included, 7.0 % [95 % confidence interval (CI): 4.9–9.5 %)] tested positive for RSV. RSV prevalence in the ARI group (8.0 %; 95 % CI: 5.0–12.1 %) was higher than in the ILI group (6.0 %; 95 % CI: 3.5–9.5 %) with an odds ratio of 1.36 (95 % CI: 0.69–2.70). Conversely, positivity for influenza (10.4 % vs 12.4 %) and SARS-CoV-2 (12.4 % vs 16.9 %) were lower in the ARI group and the corresponding ORs were 0.82 (95 % CI: 0.48–1.42) and 0.70 (95 % CI: 0.43–1.15), respectively. The mean duration of an RSV episode was 18.8 ± 8.0 days and two thirds of individuals were prescribed antibiotics. A total of 33.3 % (95 % CI: 18.6–51.0 %) of RSV-positive individuals developed complications, of which bronchitis (13.9 %) and pneumonia (8.3 %) were the most frequent.</div></div><div><h3>Conclusions</h3><div>Compared with ARI, ILI-based surveillance may underestimate the burden of RSV in community-dwelling adults aged ≥ 50 years. 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Exploring case definitions and the natural history of respiratory syncytial virus in adult outpatients: First-season results of the RESPIRA-50 study
Background
Data on the natural history of the community-acquired RSV in adult outpatients are limited. It is also unclear whether the existing influenza surveillance platforms based on influenza-like illness (ILI) case definitions are efficient for RSV. The two-season RESPIRA-50 study was established in 2023 to identify an optimal RSV case definition and to explore the natural history of RSV. Here, the first-season results are reported.
Methods
The study was conducted in Genoa (Italy) during the 2023/2024 RSV season. Twenty-four general practitioners were randomized 1:1 to enroll adults aged ≥ 50 years seeking care for acute respiratory infection (ARI) or ILI, respectively. Both syndromes were defined according to the European criteria. All subjects were tested by real-time polymerase chain reaction (RT-PCR) for RSV and other pathogens. RSV-positive adults were followed for up to 30 days.
Results
Of 517 subjects included, 7.0 % [95 % confidence interval (CI): 4.9–9.5 %)] tested positive for RSV. RSV prevalence in the ARI group (8.0 %; 95 % CI: 5.0–12.1 %) was higher than in the ILI group (6.0 %; 95 % CI: 3.5–9.5 %) with an odds ratio of 1.36 (95 % CI: 0.69–2.70). Conversely, positivity for influenza (10.4 % vs 12.4 %) and SARS-CoV-2 (12.4 % vs 16.9 %) were lower in the ARI group and the corresponding ORs were 0.82 (95 % CI: 0.48–1.42) and 0.70 (95 % CI: 0.43–1.15), respectively. The mean duration of an RSV episode was 18.8 ± 8.0 days and two thirds of individuals were prescribed antibiotics. A total of 33.3 % (95 % CI: 18.6–51.0 %) of RSV-positive individuals developed complications, of which bronchitis (13.9 %) and pneumonia (8.3 %) were the most frequent.
Conclusions
Compared with ARI, ILI-based surveillance may underestimate the burden of RSV in community-dwelling adults aged ≥ 50 years. A high proportion of RSV-positive adult outpatients develops complications, which lead to substantial resource consumption.
期刊介绍：
The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other.
The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners.
It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.
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