Viral Infections in Neonates with Suspected Late-Onset Bacterial Sepsis—A Prospective Cohort Study

Kidszun, André MD
Klein, Lena
Winter, Julia MD
Schmeh, Isabella MD
Gröndahl, Britta PhD
Gehring, Stephan MD, PhD
Knuf, Markus MD, PhD
Weise, Kerstin MD
Mildenberger, Eva MD, PhD

¹ Department of Neonatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
² Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
³ Children's Hospital, Dr. Horst Schmidt Klinik, Ludwig-Erhard-Strasse, Wiesbaden, Germany
⁴ Institute for Virology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany

Address for correspondence André Kidszun, MD, Department of Neonatology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany, [email protected]

received January, 05, 2016

accepted after revision March, 21, 2016

published online May, 16, 2016

American Journal of Perinatology 34(1):p 1-7, January 2017. | DOI: 10.1055/s-0036-1584150

Abstract

Objective

The aim of our study was to evaluate the occurrence of viral infections in infants with suspected late-onset bacterial sepsis in a neonatal intensive care unit.

Methods

In a prospective study, infants with suspected late-onset bacterial sepsis underwent viral testing alongside routine blood culture sampling. Using a multiplex reverse transcription-polymerase chain reaction enzyme-linked immunosorbent assay, nasopharyngeal aspirates were analyzed for adenovirus, respiratory syncytial virus (RSV), influenza virus A and B, H1N1 virus, parainfluenza virus 1 to 4, metapneumovirus, coronavirus, and picornavirus. Stools were examined for adenovirus, rotavirus, norovirus, and enterovirus.

Results

Between August 2010 and March 2014, data of 88 infants with 137 episodes of suspected late-onset bacterial sepsis were analyzed. Six infants were diagnosed with a respiratory viral infection (2 × RSV, 4 × picornavirus). Blood culture-proven bacterial sepsis was detected in 15 infants. Neither viral-bacterial coinfections nor polymerase chain reaction positive stool samples were found.

Conclusion

Respiratory viruses can be detected in a considerable number of neonates with suspected late-onset bacterial sepsis. In contrast, gastrointestinal viral or enterovirus infections appear uncommon in such cases.