Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-25T17:14:44.978Z Has data issue: false hasContentIssue false
  • English
  • Français

Reduction in Rate of Nosocomial Respiratory Virus Infections in a Children’s Hospital Associated With Enhanced Isolation Precautions

Published online by Cambridge University Press:  14 January 2018

Lorry G. Rubin ,
Nina Kohn ,
Susan Nullet  and
Margaret Hill
Lorry G. Rubin*
Affiliation:
Division of Infectious Diseases, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York Division of Infection Control and Prevention, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York
Nina Kohn
Affiliation:
Biostatistics Unit, Feinstein Institute for Medical Research of Northwell Health, Manhasset, New York
Susan Nullet
Affiliation:
Division of Infection Control and Prevention, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York
Margaret Hill
Affiliation:
Division of Infection Control and Prevention, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York
*
Address correspondence to Lorry G Rubin, MD, Cohen Children’s Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY 11040 (lrubin4@northwell.edu).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To determine whether the use of enhanced isolation precautions (droplet and contact precautions) for inpatients with respiratory tract viral infections is associated with a reduction in rate of nosocomial viral respiratory infections.

DESIGN

Quasi-experimental study with the rate of nosocomial respiratory virus infection as the primary dependent variable and rate of nosocomial Clostridium difficile infection as a nonequivalent dependent variable comparator.

SETTING

Cohen Children’s Medical Center of NY, a tertiary-care children’s hospital attached to a large general hospital.

INTERVENTION

During years 1 and 2 (July 2012 through June 2014), the Centers for Disease Control and Prevention/Healthcare Infection Control Practices Advisory Committee’s recommended isolation precautions for inpatients with selected respiratory virus infections were in effect. Enhanced isolation precautions were in effect during years 3 and 4 (July, 2014 through June, 2016), except for influenza, for which enhanced precautions were in effect during year 4 only.

RESULTS

During the period of enhanced isolation precautions, the rate of nosocomial respiratory virus infections with any of 4 virus categories decreased 39% from 0.827 per 1,000 hospital days prior to enhanced precautions to 0.508 per 1,000 hospital days (P<.0013). Excluding rhinovirus/enterovirus infections, the rates decreased 58% from 0.317 per 1,000 hospital days to 0.134 per 1,000 hospital days during enhanced precautions (P<.0014). During these periods, no significant change was detected in the rate of nosocomial C. difficile infection.

CONCLUSIONS

Enhanced isolation precautions for inpatients with respiratory virus infections were associated with a reduction in the rate of nosocomial respiratory virus infections.

Infect Control Hosp Epidemiol 2018;39:152–156

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 2 , February 2018 , pp. 152 - 156
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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.)

Footnotes

PREVIOUS PRESENTATION. Some of these results were presented as “Reduction in rate of nosocomial respiratory virus infections associated with enhanced isolation precautions in a children’s hospital” at ID Week 2016 in San Diego, California, on October 8, 2015; in abstract form (poster presentation) as “Reduction in rate of nosocomial respiratory virus infections with enhanced isolation precautions in a children’s hospital” at the Solutions for Patient Safety (SPS) meeting in Orlando, Florida, on September 13-15, 2016; and as “Reduction in rate of nosocomial respiratory virus infections associated with enhanced isolation precautions in a children’s hospital” at ID Week 2016 in New Orleans, Louisiana, on October 27, 2016.

References

REFERENCES

1. Quach, C, Shah, R, Rubin, LG. Burden of healthcare-associated viral respiratory infections in children’s hospitals. J Ped Infect Dis 2016:piw072. doi: 10.1093/jpids/piw072.Google Scholar
2. Rutledge-Taylor, K, Matlow, A, Gravel, D, et al. A point prevalence survey of health care associated infections in Canadian pediatric inpatients. Am J Infect Control 2012;40:491–496.CrossRefGoogle ScholarPubMed
3. Lo, MS, Lee, GM, Gunawardane, N, Burchett, SK, Lachenauer, CS, Lehmann, LE. The impact of RSV, adenovirus, influenza, and parainfluenza infection in pediatric patients receiving stem cell transplant, solid organ transplant, or cancer chemotherapy. Pediatr Transplant 2013;17:133–143.Google Scholar
4. Zinna, S, Lakshmanan, A, Tan, S, et al. Outcomes of nosocomial viral respiratory infections in high-risk neonates. Pediatrics 2016;138:e20161675.CrossRefGoogle ScholarPubMed
5. Hall, CB, Douglas, R Jr, Geiman, JM, Messner, MK. Nosocomial respiratory syncytial virus infections. N Engl J Med 1975;293:1343–1346.Google Scholar
6. Goldmann, DA. Epidemiology and prevention of pediatric viral respiratory infections in health-care institutions. Emerg Infect Dis 2001;7:249–253.CrossRefGoogle ScholarPubMed
7. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L, the Healthcare Infection Control Practices Advisory Committee. Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Centers for Disease Control and Prevention website. https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html/ Published 2007. Accessed June 9, 2017.Google Scholar
8. “Clostridium difficile LabID events” using Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN). Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/pscmanual/12pscmdro_cdadcurrent.pdf. Published 2016. Accessed December 19, 2016.Google Scholar
9. Kleinbaum, DG, Kupper, LL, Morgenstern, H. Epidemiologic Research: Principles and Quantitative Methods. Hoboken NJ: Wiley; 1982.Google Scholar
10. Self, WH, Williams, DJ, Zhu, Y, et al. Respiratory viral detection in children and adults: comparing asymptomatic controls and patients with community-acquired pneumonia. J Infect Dis 2016;15(213):584–591.Google Scholar
11. Advani, S, Sengupta, A, Forman, M, Valsamakis, A, Milstone, AM. Detecting respiratory viruses in asymptomatic children. Pediatr Infect Dis J 2012 Dec;31:1221–1226.Google Scholar
12. van den Bergh, MR, Biesbroek, G, Rossen, JW, et al. Associations between pathogens in the upper respiratory tract of young children: interplay between viruses and bacteria. PLoS One 2012;7:e47711.Google Scholar
13. Prevention strategies for seasonal influenza in healthcare settings: guidelines and recommendations. Centers for Disease Control and Prevention website. https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm. Updated 2016. Accessed January 20, 2017.Google Scholar
14. Couch, RB, Cate, TR, Douglas, RG Jr, Gerone, PJ, Knight, V. Effect of route of inoculation on experimental respiratory viral disease in volunteers and evidence for airborne transmission. Bacteriol Rev 1966;30:517–529.Google Scholar
15. Dick, EC, Jennings, LC, Mink, KA, Wartgow, CD, Inhorn, SL. Aerosol transmission of rhinovirus colds. J Infect Dis 1987;156:442–448.Google Scholar
16. Gwaltney, JM Jr, Moskalski, PB, Hendley, JO. Hand-to-hand transmission of rhinovirus colds. Ann Intern Med 1978;88:463–467.Google Scholar
17. Hall, CB. Nosocomial respiratory syncytial virus infections: the “Cold War” has not ended. Clin Infect Dis 2000;31:590–596.Google Scholar
18. Agah, R, Cherry, JD, Garakian, AJ, Chapin, M. Respiratory syncytial virus (RSV) infection rate in personnel caring for children with RSV infections. Routine isolation procedure vs routine procedure supplemented by use of masks and goggles. Am J Dis Child 1987;141:695–697.Google Scholar