Mahboob Quershi
Toruo University, USA
Title: Control and prevention of nosocomial RSV pneumonia in neonates and immunocompromised adult population
Biography
Biography: Mahboob Quershi
Abstract
RSV bronchiolitis and pneumonia is a common cause of pediatric hospitalization in the USA and all over the world. Severity
of RSV pneumonia is exacerbated in the premature neonates and those with congenital cardiopulmonary pathologies.
Additionally, adults with hematopoietic malignancies and particularly those receiving stem cell transplants often become
predisposed to RSV pneumonia. Breakouts of RSV-pneumonia in community often pre-herald those at the nosocomial
settings. Attempts to minimize the incidence frequencies and severity of these nosocomial events require multifactorial
approach including screening of staff and visitors, screening on admission, visitor restriction, compliance monitoring and
finally use of personal protective equipment which yet generates variable results. Prophylactic use of monoclonal antibody
palivizumab has been reported with variable responses. RSV and other respiratory viral infections among stem cell transplant
recipients are commonly encountered after allogenic transplant, which often poses a significant challenge for patient recovery
and transplant survival. Prospective studies confirming the efficacy of Ribavarin use in these patients preventing progression
to life threatening pneumonia are yet to be properly done. Thus, it leaves the scope for prospective studies utilizing alternate
therapeutic approaches. Osteopontin (OPN) is an immunomodulatory molecule originally reported to be involved with
osteogenesis and only later have been implicated in modulating immune response polarizing the response towards a Th1 type.
Recently, several research groups in the USA and other countries have reported immune-modulatory effects of OPN in RSV
infections. RSV-infected infants develop a hyperactive airway (Th2 bias) response which has been shown to be prevented in
experimental animal models by prophylactic administration of OPN. It is yet to be established whether prophylactic use of
OPN in nosocomial setting has a similar effect in preventing progression to severe pneumonia and minimize mortality. Use of
OPN in combination with the existing multifactorial approaches may prove wise and worthwhile to prevent the untimely death
of the RSV-infected neonates, as well as those immunosuppressed hematopoietic stem cell recipients.