Clinical characteristics and outcomes of respiratory syncytial virus infection in pregnant women.

Autor: Hause AM; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States; Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, United States. Electronic address: anne.hause@emory.edu., Avadhanula V; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Maccato ML; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States; Pediatrics, Baylor College of Medicine, Houston, TX 77030, United States; Woman's OB/GYN Specialists, Houston, TX 77054, United States., Pinell PM; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States; Pediatrics, Baylor College of Medicine, Houston, TX 77030, United States; Woman's OB/GYN Specialists, Houston, TX 77054, United States., Bond N; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Santarcangelo P; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Ferlic-Stark L; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Ye X; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Iwuchukwu O; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Maurer L; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Aideyan L; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Dao K; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., McBride T; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States., Piedra PA; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States; Pediatrics, Baylor College of Medicine, Houston, TX 77030, United States. Electronic address: ppiedra@bcm.edu., Munoz FM; Departments of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, United States; Pediatrics, Baylor College of Medicine, Houston, TX 77030, United States. Electronic address: florm@bcm.edu.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2019 Jun 06; Vol. 37 (26), pp. 3464-3471. Date of Electronic Publication: 2019 May 10.
DOI: 10.1016/j.vaccine.2019.04.098
Abstrakt: Objective: To describe the clinical presentation and laboratory diagnosis of pregnant women with respiratory syncytial virus (RSV) infection.
Methods: Pregnant women in their second and third trimester were enrolled during the course of routine prenatal care visits when they were asymptomatic within the preceding two weeks (healthy controls) or when they reported symptoms of acute respiratory illness (ARI) of ≤7 days of duration (cases). Clinical outcomes were assessed at enrollment and two weeks after. Re-enrollment was allowed. Nasal-pharyngeal secretions were evaluated for respiratory pathogens by real-time reverse transcription polymerase chain reaction (PCR). Sera were tested for RSV-specific antibody responses by Western Blot, microneutralization assay, and palivizumab competitive antibody assay.
Results: During the 2015-2016 respiratory virus season, 7 of 65 (11%) pregnant women with ARI at their initial enrollment and 8 of 77 (10%) pregnant women with ARI during the study period (initial or re-enrollment) had PCR-confirmed RSV infection. Four (50%) PCR-confirmed RSV ARI cases reported symptoms of a lower respiratory tract illness (LRTI), one was hospitalized. Combining PCR and serology data, the RSV attack rate at initial enrollment was 12% (8 of 65), and 13% (10 of 77) based on ARI episodes. Among healthy controls, 28 of 88 (32%) had a Western Blot profile suggestive of a recent RSV infection either in the prior and/or current season.
Conclusion: RSV had an attack rate of 10-13% among ambulatory pregnant women receiving routine prenatal care during the respiratory virus season. The serology results of healthy controls suggest a potentially higher attack rate. Future studies should be aware of the combined diagnostic strength of PCR and serology to identify RSV infection. As maternal RSV vaccine candidates are evaluated to protect young infants, additional priority should be placed on outcomes of pregnant women.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: