Int. J. Hyg. Environ.-Health 211 (2008) 241–250 Nosocomial infection: A risk factor for a complicated course in children with respiratory syncytial virus infection – Results from a prospective multicenter German surveillance study Arne Simon a,Ã , Andreas Mu¨ller a , Karun Khurana b , Steffen Engelhart b , Martin Exner b , Oliver Schildgen c , Anna M. Eis-Hu¨binger c , Wolfgang Kamin d , Thomas Schaible e , Karoline Wadas f , Roland A. Ammann g , Anja Wilkesmann a , DSM RSV Paed Study Group g a Department of Paediatric Hematology and Oncology, Children’s Hospital Medical Center, University of Bonn, Adenauerallee119, 53113 Bonn, Germany b Institute of Hygiene and Public Health, University of Bonn, Germany c Institute for Medical Microbiology, Immunology and Parasitology, University of Bonn, Germany d Johannes Gutenberg University, Children’s Hospital, Mainz, Germany e Children’s Hospital Medical Centre, University of Mannheim-Heidelberg, Germany f St. Johannis Hospital, Duisburg, Germany g University Children’s Hospital, Bern, Switzerland Received 31 October 2006; received in revised form 3 May 2007; accepted 9 July 2007 Abstract Background: Nosocomially acquired respiratory syncytial virus infections (RSV-NI) may cause serious problems in hospitalized paediatric patients. Hitherto, prospectively collected representative data on RSV-NI from multicenter studies in Germany are limited. Methods: The DMS RSV Ped database was designed for the prospective multicenter documentation and analysis of clinically relevant aspects of the management of inpatients with RSV-infection. The study covered six consecutive seasons (1999–2005); the surveillance took place in 14 paediatric hospitals in Germany. Results: Of the 1568 prospectively documented RSV-infections, 6% (n ¼ 90) were NI and 94% (n ¼ 1478) were community acquired (CA). A significantly higher proportion in the NI group displayed additional risk factors like prematurity, chronic lung disease, mechanical ventilation (med. history), congenital heart disease, and neuromuscular impairment. Of all NI, 55% occurred in preterms (30.6% of all RSV-infections in preterms with severe chronic lung disease of prematurity were NI). Illness severity as well as the total mortality, but not the attributable mortality was significantly higher in the NI group. In the multivariate analysis, NI was significantly associated with the combined outcome ‘complicated course of disease’. ARTICLE IN PRESS www.elsevier.de/ijheh 1438-4639/$ - see front matter r 2007 Elsevier GmbH. All rights reserved. doi:10.1016/j.ijheh.2007.07.020 Ã Corresponding author. Tel.: +49 228 287 33254; fax: +49 228 287 33301. E-mail address: asimon@ukb.uni-bonn.de (A. Simon).