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Nosocomial Respiratory Syncytial Virus Infections Prevention and Control in Bone Marrow Transplant Patients

Published online by Cambridge University Press:  02 January 2015

Ricardo Garcia ,
Issam Raad ,
Dima Abi-Said ,
Gerald Bodey ,
Richard Champlin ,
Jeffrey Tarrand ,
Lou Anne Hill ,
Jan Umphrey ,
Joyce Neumann  and
Janet Englund
...Show all authors
Ricardo Garcia
Affiliation:
Sections of Infectious Diseases, Houston, Texas
Issam Raad*
Affiliation:
Sections of Infectious Diseases, Houston, Texas
Dima Abi-Said
Affiliation:
Sections of Infectious Diseases, Houston, Texas
Gerald Bodey
Affiliation:
Sections of Infectious Diseases, Houston, Texas
Richard Champlin
Affiliation:
Department of Medical Specialties, the Section of Bone Marrow Transplantation, Houston, Texas
Jeffrey Tarrand
Affiliation:
Department of Hematology, Division of Laboratory Medicine, Houston, Texas
Lou Anne Hill
Affiliation:
Infection Control, Houston, Texas
Jan Umphrey
Affiliation:
Infection Control, Houston, Texas
Joyce Neumann
Affiliation:
Department of Medical Specialties, the Section of Bone Marrow Transplantation, Houston, Texas
Janet Englund
Affiliation:
University of Texas M.D. Anderson Cancer Center, Houston, Texas Baylor College of Medicine, Houston, Texas
Estella Whimbey
Affiliation:
Sections of Infectious Diseases, Houston, Texas
*
Section of Infectious Diseases (Box 47), The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030
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Abstract

Objective:

To assess the effectiveness of a multi-faceted infection control strategy in limiting the nosocomial transmission of respiratory syncytial virus (RSV) infection to patients in a bone marrow transplant (BMT) unit.

Design:

Before/after trial.

Setting:

University-affiliated tertiary cancer center.

Patients:

Adult BMT recipients hospitalized during two consecutive wintertime community outbreaks of RSV infection.

Interventions:

An infection control strategy against nosocomial RSV infection was implemented in the BMT unit in February 1993. The strategy involved prompt identification, isolation, and cohorting of RSV-infected patients; prompt therapy with aerosolized ribavirin; use of masks and gloves by anyone entering an infected BMT patient's room; screening visitors for respiratory symptoms; restricting visitation by all children under 12 years of age and all family members and other visitors with RSV symptoms; and restricting symptomatic hospital staff from working in the BMT unit.

Results:

After implementation of the multifaceted infection-control strategy, there were four cases of nosocomial RSV infection in 3,870 patient days (incidence density, 1.0 case/1,000 patient days) compared with 14 cases of nosocomial RSV infection in 3,152 patient days (incidence density, 4.4 cases/1,000 patient days) during the 1992-1993 RSV season (rate ratio, 4.4; 95% confidence interval [CI95], 1.4-17.9; P<.01). This decrease in incidence occurred despite a comparable prevalence of community-acquired RSV cases between the two seasons (2.2% vs 3.2% in 1992-1993 and 1993-1994, respectively; prevalence ratio, 0.7; CI95, 0.2-2.1; P=0.5)

Conclusion:

Institution of a multifaceted infection control strategy significantly reduced the frequency of nosocomial RSV infection in a high-risk group of adult BMT recipients

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 6 , June 1997 , pp. 412 - 416
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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