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Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures

Published online by Cambridge University Press:  02 January 2015

Vincent C. C. Cheng ,
Lisa M. W. Wong ,
Josepha W. M. Tai ,
Jasper F. W. Chan ,
Kelvin K. W. To ,
Iris W. S. Li ,
Ivan F. N. Hung ,
K. H. Chan ,
P. L. Ho  and
K. Y. Yuen
Vincent C. C. Cheng
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China Infection Control Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Lisa M. W. Wong
Affiliation:
Infection Control Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Josepha W. M. Tai
Affiliation:
Infection Control Unit, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Jasper F. W. Chan
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Kelvin K. W. To
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Iris W. S. Li
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
Ivan F. N. Hung
Affiliation:
Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China
K. H. Chan
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
P. L. Ho
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
K. Y. Yuen*
Affiliation:
Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
*
Carol Yu Centre for Infection and Division of Infectious Diseases, Department of Microbiology, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China (kyyuen@hkucc.hku.hk)
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Abstract

Background.

Nosocomial outbreaks of norovirus infection pose a great challenge to the infection control team.

Methods.

Between November 1, 2009, and February 28, 2010, strategic infection control measures were implemented in a hospital network. In addition to timely staff education and promotion of directly observed hand hygiene, reverse-transcription polymerase chain reaction for norovirus was performed as an added test by the microbiology laboratory for all fecal specimens irrespective of the request for testing. Laboratory-confirmed cases were followed up by the infection control team for timely intervention. The incidence of hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was compared with the corresponding period in the preceding 12 months, and the incidence in the other 6 hospital networks in Hong Kong was chosen as the concurrent control. Phylogenetic analysis of norovirus isolates was performed.

Results.

Of the 988 patients who were tested, 242 (25%) were positive for norovirus; 114 (47%) of those 242 patients had norovirus detected by our added test. Compared with the corresponding period in the preceding 12 months, the incidence of hospital-acquired norovirus infection decreased from 131 to 16 cases per 1,000 potentially infectious patient-days (P < .001 ), although the number of hospital-acquired infections was low in both the study period (n = 8) and the historical control periods (n = 11). The incidence of hospital-acquired norovirus infection in our hospital network (0.03 cases per 1,000 patient-days) was significantly lower than that of the concurrent control (0.06 cases per 1,000 patient-days) (P = .015). Forty-three (93%) of 46 norovirus isolates sequenced belonged to the genogroup II.4 variant.

Conclusions.

Strategic infection control measures with an added test maybe useful in controlling nosocomial transmission of norovirus.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 3 , March 2011 , pp. 229 - 237
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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