Dataset Information

Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023.

ABSTRACT: We report nine severe neonatal infections caused by a new variant of echovirus 11. All were male, eight were twins. At illness onset, they were 3-5 days-old and had severe sepsis and liver failure. This new variant, detected in France since April 2022, is still circulating and has caused more fatal neonatal enterovirus infections in 2022 and 2023 (8/496; 1.6%, seven associated with echovirus 11) compared with 2016 to 2021 (7/1,774; 0.4%). National and international alerts are warranted.

SUBMITTER: Grapin M

PROVIDER: S-EPMC10236930 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023.

Grapin Mathilde M Mirand Audrey A Pinquier Didier D Basset Aurélie A Bendavid Matthieu M Bisseux Maxime M Jeannoël Marion M Kireche Bérengère B Kossorotoff Manoelle M L'Honneur Anne-Sophie AS Robin Lila L Ville Yves Y Renolleau Sylvain S Lemee Véronique V Jarreau Pierre-Henri PH Desguerre Isabelle I Lacaille Florence F Leruez-Ville Marianne M Guillaume Clémence C Henquell Cécile C Lapillonne Alexandre A Schuffenecker Isabelle I Aubart Mélodie M

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20230601 22

We report nine severe neonatal infections caused by a new variant of echovirus 11. All were male, eight were twins. At illness onset, they were 3-5 days-old and had severe sepsis and liver failure. This new variant, detected in France since April 2022, is still circulating and has caused more fatal neonatal enterovirus infections in 2022 and 2023 (8/496; 1.6%, seven associated with echovirus 11) compared with 2016 to 2021 (7/1,774; 0.4%). National and international alerts are warranted. ...[more]

PMID: 37261730

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Project description:ImportanceRed blood cell (RBC) transfusions are frequently administered to preterm infants born before 32 weeks of gestation in the neonatal intensive care unit (NICU). Two randomized clinical trials (Effects of Transfusion Thresholds on Neurocognitive Outcomes of Extremely Low-Birth-Weight Infants [ETTNO] and Transfusion of Prematures [TOP]) found that liberal RBC transfusion thresholds are nonsuperior to restrictive thresholds, but the extent to which these results have been integrated into clinical practice since publication in 2020 is unknown.ObjectiveTo describe neonatal RBC transfusion practice in Europe.Design, setting, and participantsThis international prospective observational cohort study collected data between September 1, 2022, and August 31, 2023, with a 6-week observation period per center, from 64 NICUs in 22 European countries. Participants included 1143 preterm infants born before 32 weeks of gestation.ExposureAdmission to the NICU.Main outcomes and measuresStudy outcome measures included RBC transfusion prevalence rates, cumulative incidence, indications, pretransfusion hemoglobin (Hb) levels, volumes, and transfusion rates, Hb increment, and adverse effects of RBC transfusion.ResultsA total of 1143 preterm infants were included (641 male [56.1%]; median gestational age at birth, 28 weeks plus 2 days [IQR, 26 weeks plus 2 days to 30 weeks plus 2 days]; median birth weight, 1030 [IQR, 780-1350] g), of whom 396 received 1 or more RBC transfusions, totaling 903 transfusions. Overall RBC transfusion prevalence rate during postnatal days 1 to 28 was 3.4 transfusion days per 100 admission days, with considerable variation across countries, only partly explained by patient mix. By day 28, 36.5% (95% CI, 31.6%-41.5%) of infants had received at least 1 transfusion. Most transfusions were given based on a defined Hb threshold (748 [82.8%]). Hemoglobin levels before transfusions indicated for threshold were below the restrictive thresholds set by ETTNO in 324 of 729 transfusions (44.4%) and TOP in 265 of 729 (36.4%). Conversely, they were between restrictive and liberal thresholds in 352 (48.3%) and 409 (56.1%) transfusions, respectively, and above liberal thresholds in 53 (7.3%) and 55 (7.5%) transfusions, respectively. Most transfusions given based on threshold had volumes of 15 mL/kg (470 of 738 [63.7%]) and were administered over 3 hours (400 of 738 [54.2%]), but there was substantial variation in dose and duration.Conclusions and relevanceIn this cohort study of very preterm infants, most transfusions indicated for threshold were given for pretransfusion Hb levels above restrictive transfusion thresholds evaluated in recent trials. These results underline the need to optimize practices and for implementation research to support uptake of evidence.

Dataset Information

Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023.

Publications

Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023.

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