1085. Nosocomial Rhinovirus and Parainfluenza Virus Infections in a Children’s Hospital
Session: Poster Abstract Session: Surveillance of HAIs: Implementation and National Perspectives
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Background:

Nosocomial viral respiratory infection (nVRi) due to influenza and respiratory syncytial viruses are well-described. However, descriptions of nosocomial rhinovirus infection (nRVi) and nosocomial parainfluenza virus infection (nPIVi) are limited.

Methods:

In a children’s hospital, nVRis were prospectively monitored. The definition of nRVi and nPIVi required new fever and/or new respiratory symptoms, a positive nucleic acid amplification test, and a minimum time from hospital admission to onset of symptoms of 4.5 and 6 days, respectively. Available medical records were reviewed to evaluate attributable costs including laboratory and radiographic tests, medication prescribed, increased level of supportive care, and extra days of hospitalization.

Results:

Seven patients with nRVi had a median age of 35 months (range, 3 months-11 years), median length of stay of 22 days (range, 9-108 days), and underlying diagnoses of leukemia or bone marrow failure, 4; cardiac surgery, 2; intracranial pathology, 2; and, pulmonary disease, 2.  Due to nRVis, 22 laboratory tests including 12 respiratory viral tests and 1 chest radiograph were performed. Additional therapies due to nRVis included 22 antibiotic-days, 3 days of corticosteroid therapy, and 2 days of increased oxygen therapy.  No patient’s hospital stay was prolonged.

Eight patients with nPIVi (PIV-1, 3; PIV-3, 5) had a median age of 5.8 months (range, 1 month-10 years), median length of stay of 51 days (range, 14-107 days), and underlying diagnoses of leukemia, 2; cardiac surgery, 2; prematurity, enterocolitis, DiGeorge syndrome, Trisomy 21, and intracranial pathology, 1 each.  Due to nPIVis 61 laboratory tests including 24 respiratory viral tests, 18 imaging studies (14 chest radiographs, 4 computed tomography studies), and 1 procedure (bronchoscopy) were performed. Additional therapies due to nPIVis included 47 antibiotic-days, 41 days with pulmonary medications, and 31 days of increased oxygen support.  Duration of hospital stay was prolonged in 3 patients by 4, 7, and 14 days.

Conclusion:

At a children’s hospital, nosocomial RV and PIV infections resulted in additional investigative studies and therapies including antibiotics and nPIVi led to extra days of hospitalization.

Rita Shah, M.D.1, Susan Nullet, R.N.2, Margaret Hill, R.N.2, Anila Thomas3 and Lorry Rubin, M.D.4,5, (1)Pediatric Infectious Diseases, Steven and Alexandra Cohen Children's Medical Center of New York of the North Shore-Long Island Jewish Health System, New Hyde Park, NY, (2)Infection Control, Steven and Alexandra Cohen Children's Medical Center of New York of the North Shore-Long Island Jewish Health System, New Hyde Park, NY, (3)SUNY Downstate School of Medicine, Brooklyn, NY, (4)Pediatric Infectious Diseases, Steven and Alexandra Cohen Children's Medical Center of the North Shore-Long Island Jewish Health System, New Hyde Park, NY, (5)Pediatrics, Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY

Disclosures:

R. Shah, None

S. Nullet, None

M. Hill, None

A. Thomas, None

L. Rubin, None

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