1230. Surveillance of Pediatric Healthcare-Associated Viral Respiratory Infections (HA-VRI) from 2005-2009 in the Canadian Nosocomial Infection Surveillance Program (CNISP)
Session: Poster Abstract Session: RSV and Other Viral Respiratory Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1


Healthcare-associated viral respiratory tract infections (HA-VRI) are important causes of morbidity and mortality in pediatric settings. Objectives of this surveillance were to determine rates of laboratory-confirmed HA-VRI over time, describe characteristics of affected children and determine if cases affected by respiratory syncytial virus (RSV) and influenza viruses were eligible for and received appropriate prophylaxis.  



Prospective surveillance was conducted from January 1st to April 30th in 2005 and 2007 and from November 1st to April 30th in 2007-2008 and 2008-2009.  Participating hospitals included those which admit pediatric patients (<18 years) and were part of the Canadian Nosocomial Infection Surveillance Program (CNISP).  Patients from normal newborn nurseries, psychiatry and chronic care wards were excluded. Cases were patients who developed onset of respiratory tract infection symptoms at least 72 hours after admission to hospital, and had laboratory confirmation of VRI.



358 viruses were identified in 322 cases from 11 hospitals across Canada. HA-VRI were most common on medical wards (39%), followed by the pediatric intensive care unit (17%). Average age was 2.9 years (3 days to 17 years) and 57% were male. 251 cases (82%) had a chronic medical condition (CMC) and of these, 66 had multiple CMCs. HA-VRI rates are shown in Table 1.  RSV was the most common pathogen 151/358 (42%) followed by parainfluenza (18%) and influenza A (12%). Forty RSV cases were eligible for RSV monoclonal antibody and 25 (63%) received prophylaxis; 27 Influenza cases were eligible for vaccine and 3 received it. Immunization status was unknown for 10 RSV cases and 14 influenza cases. 



Rates of HA-VRI varied during the surveillance periods.  Most children affected had chronic conditions. RSV is the major pathogen causing HA-VRI. Results suggest many HA-VRI may have been prevented if eligible children received appropriate prophylaxis.

Table 1. HA-VRI rates


Number of cases

HA-VRI rate per 1000 patient admissions

HA-VRI rate per 10 000 patient days

















Note: Rates are based on hospitals that provided both numerator & denominator data


Subject Category: P. Pediatric and perinatal infections

Joseph Vayalumkal, MD1, Joanne Embree, MD2, Sarah Forgie, MD3, Joanne Langley, MD4, Nicole Le Saux, MD5, Anne Matlow, MD6, Dorothy Moore, MD PhD7, Eva Thomas, MD8, Yasmine Chagla, MSc9, Linda Pelude, MSc10, Katie Rutledge-Taylor, MPH10 and Jayson Shurgold, BSc10, (1)Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada, (2)Health Sciences Centre, University of Manitoba, Winnipeg, MB, Canada, (3)Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada, (4)IWK Health Centre, Dalhousie University, Halifax, NS, Canada, (5)Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada, (6)The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada, (7)Montreal Children's Hosp. of the MUHC, Montreal, QC, Canada, (8)Children's and Women's Health Centre, Vancouver, BC, Canada, (9)London Health Sciences Centre, University Hospital, London, ON, Canada, (10)Public Health Agency of Canada, Ottawa, ON, Canada


J. Vayalumkal, None

J. Embree, None

S. Forgie, None

J. Langley, None

N. Le Saux, None

A. Matlow, None

D. Moore, None

E. Thomas, None

Y. Chagla, None

L. Pelude, None

K. Rutledge-Taylor, None

J. Shurgold, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.