Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-17T16:28:03.872Z Has data issue: false hasContentIssue false
  • English
  • Français

Primary Cytomegalovirus Infection in Pediatric Nurses: A Meta-Analysis

Published online by Cambridge University Press:  21 June 2016

R.H. Flowers III ,
James C. Torner  and
Barry M. Farr
R.H. Flowers III
Affiliation:
Departments of Medicine, University of Virginia, Charlottesville, Virginia
James C. Torner
Affiliation:
Departments of Medicine, University of Virginia, Charlottesville, Virginia Departments of Neurosurgery, University of Virginia, Charlottesville, Virginia
Barry M. Farr*
Affiliation:
Departments of Medicine, University of Virginia, Charlottesville, Virginia
*
Box 473, University of Virginia Medical Center, Charlottesville, VA 22908
Get access Rights & Permissions [Opens in a new window]

Abstract

A meta-analysis of six controlled studies was performed to evaluate the risk of cytomegalovirus (CMV) infection among pediatric nurses. The pooled risk ratio for CMV infection in pediatric nurses using cumulative incidence data was statistically significant (risk ratio [RR] 2.7; 95% confidence interval [CI] 1.33 - 5.52), but person-year analysis taking account of follow-up periods demonstrated a trend toward increased risk that failed to reach statistical significance (RR 1.8; 95% CI 0.88 - 3.55). Despite pooling, there was low statistical power for comparing person-year rates. The studies included in this analysis failed to provide data on several potential confounding variables. We conclude that studies published prior to the widespread adoption of universal precautions suggest that pediatric nurses may have been at increased risk for CMV infection due to occupational exposure, but inadequate design and sample size of the studies prevent a definitive conclusion. Well-designed, controlled studies are still needed to define the occupational risk of CMV infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 9 , Issue 11 , November 1988 , pp. 491 - 496
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Haldane, EV, van Rooyen, CE, Embil, JA, et al: A search for transmissible birth defects of virologic origin in members of the nursing profession. Am J Obstet Gynecol 1969; 105:1032–1040.CrossRefGoogle ScholarPubMed
2. Yeager, AS: Longitudinal, serological study of cytomegalovirus infections in nurses and in personnel without patient contact. J Clin Microbiol 1975; 2:448–452.CrossRefGoogle ScholarPubMed
3. Ahlfors, K, Ivarsson, S-A, Johnsson, T, et al: Risk of cytomegalovirus infection in nurses and congenital infection in their offspring. Acta Paediatr Scand 1981; 70:819–823.CrossRefGoogle ScholarPubMed
4. Dworsky, ME, Welch, K, Cassady, G, et al: Occupational risk for- primary cytomegalovirus infection among pediatric health-rare workers. N Engl J Med 1983; 309:950–953.CrossRefGoogle Scholar
5. Friedman, HM. Lewis, MR. Nemerofsky, DM, et al: Acquisition of cytomegalovirus infection among female employees at a pediatric hospital. Pediatr Infect Dis 1984: 3:233–235.CrossRefGoogle Scholar
6. Balfour, CL. Balfour, HH Jr: Cytomegalovirus is not an occupational risk for nurses in renal transplant and neonatal units: Results of a prospective surveillance study. JAMA 1986; 256:1909–1914.CrossRefGoogle Scholar
7. Hatherley, LI: Is primary cytomegalovirus infection an occupational hazard for obstetric nurses? A serologic study. Infect Control 1986; 7:452–455.CrossRefGoogle Scholar
8. Sacks, HS. Berrier, J, Reitman, D, et al: Meta-analysis of randomized controlled trials. N Engl J Med 1987; 316:450–455.CrossRefGoogle Scholar
9. L'Abbe, KA, Detsky, AS, O'Rourke, K: Meta-analysis in clinical research. Ann Intern Med 1987; 107:224–233.CrossRefGoogle ScholarPubMed
10. Thacker, SB: Meta-anaysis: A quantitative approach to research integration. JAMA 1988; 259:1685–1689.CrossRefGoogle Scholar
11. Haneberg, B, Bertnes, E, Haukenes, G: Antibodies to cytomegalovirus among personnel at a children's hospital. Acta Paediatr Stand 1980; 69:407–409.CrossRefGoogle ScholarPubMed
12. Hatherley, LI: Prevalence of cytomegalovirus antibodies in obstetric nurses. Med J Australia 1985: 142:186–189.CrossRefGoogle ScholarPubMed
13. Adler, SP: Nosocomial transmission of cytomegalovirus. Pediatr Infect Dis 1986; 5:239–246.CrossRefGoogle ScholarPubMed
14. Adler, SP, Baggett, J, Wilson, M, et al: Molecular epidemiology of cytomegalovirus in a nursery: Lack of evidence for nosocomial transmission. J Pediatr 1986; 108:117–123.CrossRefGoogle Scholar
15. Demmler, GJ, Yow, MD, Spector, SA, et al: Nosocomial cytomegalovirus infections within two hospitals caring for infants and children. J Infect Dis 1987; 156:9–16.CrossRefGoogle ScholarPubMed
16. Brady, MT, Demmler, GJ, Anderson, DC: Cytomegalovirus infection in pediatric house officers: Susceptibility to and rate of primary infection. Infect Control 1987; 8:329–332.CrossRefGoogle ScholarPubMed
17. Kleinbaum, DG, Kupper, LL, Morgenstern, H: Epidemiologic Research: Principles and Quantitative Methods. London, Lifetime Learning Publications, 1982, p 359.Google Scholar
18. Breslow, NE, Day, NE: Statistical Analysis in Cancer Research Vol I: Thr Analysis of Case Control Studies. Lyon, France, International Agency for Research on Cancer. 1980, p 142.Google Scholar
19. Miettinen, OS: Theoretical Epidemiology: Principles of Occurrence Research in Medicine. New York, John Wiley, 1985, p 152.Google Scholar
20. Meinert, CL: Clinical Trials: Design, Conduct and Analysis. New York, Oxford University Press, 1986, p 83.CrossRefGoogle Scholar
21. Spector, SA, Spector, DH: Molecular epidemiology of cytomegalovirus infections in premature twin infants and their mother. Pediatr Infect Dis 1982; 1:405–409.CrossRefGoogle ScholarPubMed
22. Stagno, S, Cloud, G, Pass, RF. et al: Factor-s associated with primary cytomegalovirus infection during pregnancy. J Med Virol 1984: 13:347–353.CrossRefGoogle Scholar
23. Taber, LA, Frank, AL, Yow, MD, et al: Acquisition of cytomegaloviral infections in families with young children: A serologic study. J Infect Dis 1985; 151:948–952.CrossRefGoogle Scholar
24. Adler, SP: Molecular epidemiology of cytomegalovirus. Evidence for viral transmission to parents from children infected in a day care center. Pediatr Infect Dis 1986; 5:315–318.CrossRefGoogle Scholar
25. Pass, RF, Hutto, C, Ricks, R. et al: Increased rate of cytomegalovirus infection among parents of children attending day-care centers. N Engl J Med 1986; 314:1414–1418.CrossRefGoogle ScholarPubMed
26. Pass, RF, Little, EA, Stagno, S, et al: Young children as a probable source of maternal and congenital cytomegalovirus infection. N Engl J Med 1987; 316:1366–1370.CrossRefGoogle ScholarPubMed
27. Horodniceanu, F, Michelson, S: Assessment of human cytomegalovirus antibody detection techniques. Arch Virol 1980; 64:287–301.CrossRefGoogle ScholarPubMed
28. Onorato, IM. Morens, DM, Martone, WJ, et al: Epidemiology of cytomegalovirus infections: Recommendations for prevention and control. Rev Infect Dis 1985; 7:479–497.CrossRefGoogle ScholarPubMed
29. Adler, SP: Molecular epidemiology of cytomegalovirus: Transmission among children in a day care center, their families arid caretakers (abstract no. 1093), in Program and Abstracts of 27th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC, American Society for Microbiology, 1987. p 288.Google Scholar
30. Handsfield, HH, Chandler, SH. Caine, V 4, et al: Cytomegalovirus infection in sex partners: Evidence of sexual transmission. J Infect Dis 1985; 151:344–348.CrossRefGoogle ScholarPubMed
31. Stagno, S: Cytomegalovirus infection: A pediatricians perspective. Cun Probl Pediatr 1986; 16:629–667.Google Scholar
32. Brady, MT, Demmler, GJ, Anderson, DC: Cytomegalovirus infection in pediatric house officers: Susceptibility and risk of primary infection. Pediatr Res 1985; 19:197A.CrossRefGoogle Scholar
33. Pass, RF, August, AM. Dworsky, M, et al: Cytomegalovirus infection in a day-care center. N Engl J Med 1982; 307:477–479.CrossRefGoogle Scholar
34. Adler, SP: The molecular epidemiology of cytomegalovirus transmission among children attending a day care center. J Infect Dis 1985; 152:760–768.CrossRefGoogle ScholarPubMed
35. Yow, MD, Lakeman, AD. Stagno, S, et al: Use of restriction enzymes to investigate the source of primary cytomegalovirus infection in a pediatric nurse. Pediatrics 1982: 70:713–716.CrossRefGoogle Scholar
36. Wilfert, CM, Huang, E-S, Stagno, S: Restriction endonuclease analysis of cytomegalovirus deoxyribonucleic acid as an epidemiologic tool. Pediatrics 1982; 70:717–721.CrossRefGoogle ScholarPubMed
37. Williams, WW: CDC guideline for infection control in hospital personnel. Infect Control 1983: 4:326–349.Google ScholarPubMed
38. Valenti, WM: Infection control and the pregnant health care worker. Am J Infect Control 1986; 14:20–27.CrossRefGoogle ScholarPubMed
39. Plotkin, S 4: Cytomegalovirus in hospitals. Pediatr Infect Dis 1986; 5:177–178.CrossRefGoogle ScholarPubMed
40. Votra, EM, Rutala, WA. Sarubhi, FA: Recommendations for pregnant employee interaction with patients having communicable infections diseases. Am J Infect Control 1983; 11:10–19.CrossRefGoogle Scholar
41. Brady, MT: Cytomegalovirus infections: Occupational risk for health professionals. Am J Infect Control 1986: 14: 197–203.CrossRefGoogle ScholarPubMed
42. Patterson, WB, Craven, DE, Schwartz, DA: Occupational hazards to hospital personnel. Ann Intern Med 1985; 102:658–680.CrossRefGoogle ScholarPubMed
43. Recommendations for prevention of human immunodeficiency virus transmission in health care settings. MMWR 1987; 36:2S–18S.Google Scholar
44. Update: Universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus and other bloodborne pathogens in health-care settings. MMWR 1988; 37:377–388.Google Scholar
45. Garner, JS, Hughes, JM: Options for isolation precautions. Ann Intern Med 1987: 107:248–250.CrossRefGoogle ScholarPubMed
46. Lynch, P, Jackson, MM, Cummings, MJ, et al: Rethinking the role of isolation practices in the prevention of nosocomial infections. Ann Intern Med 1985: 107:243–246.CrossRefGoogle Scholar