1545. Respiratory Illness among Residents of Pediatric Long-Term Care Facilities during Influenza Season
Session: Poster Abstract Session: Infections in Non-Acute Healthcare Settings
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background:

Respiratory illnesses are common in residents of pediatric long-term care facilities (PLTCFs).  Morbidity and mortality can result from such infections due to complex chronic comorbid conditions.  The purpose of this study is to describe the burden of respiratory infections in this unique population. 

Methods:

From Sept 2012 - Feb 2013, we conducted weekly chart reviews for all children in a 54-bed, a 97-bed, and a 137-bed PLTCF.  Clinician diagnosis of respiratory infection, results of PCR assays to detect viral pathogens, and bacterial cultures were collected.

Results:

Physicians and/or nurse practitioners diagnosed 117 respiratory infections in 73 of 341 residents (21%). Laboratory testing was conducted on 85 (72%) of 117 infections; 38 (44%) specimens were positive for viruses, 19 (23%) were positive for a potential bacterial pathogen, 15 (18) were positive for 2 organisms and 13 (15%) were negative (Table).

Conclusion:

Respiratory illness is a significant burden for children in PLTCF; 30% of subjects had ≥1 respiratory infection diagnosed during the study. Rapid viral diagnostic testing identified a viral pathogen in ~45% of illnesses of which influenza was identified in ~4%. This suggests that testing for viruses is useful in PLTCF as it can guide treatment and infection control practices. 

Table.  Organisms associated with respiratory illness in children residing in pediatric long-term care facilities

Organism

Count, N=95

Bacteria

 

Beta hemolytic Streptococcus, Group G

1

Beta hemolytic Streptococcus, Group A

17

Haemophilus influenzae (nontypeable)

0

Moraxella catarrhalis

0

Proteus mirabilis

0

Pseudomonas aeruginosa

1

Serratia marcescens

0

Stenotrophomonas maltophilia

0

Streptococuss pneumoniae

0

Viruses

 

Adenovirus

2

Coronavirus

1

Human metapneumovirus

0

Influenza A

3

Influenza B

2

Parainfluenza

1

Rhino/enterovirus

28

Respiratory syncytial virus

1

Polymicrobial

 

Beta hemolytic Streptococcus, Group A and Rhino/enterovirus

6

Beta hemolytic Streptococcus, Group A and Adenovirus

1

Pseudomonas aeruginosa and Serratia marcescens

1

Haemophilus influenzae (nontypeable) and Moraxella catarrhalis

1

Pseudomonas aeruginosa and Stenotrophomonas maltophilia

1

Parainfluenza and Rhino/enterovirus

3

Adenovirus and Rhino/enterovirus

2

Meghan Murray, MPH1, Bevin Cohen, MPH1, Amanda Buet, MPH2, Mary Keenan, RN, MS, CNS3, Marianne Pavia, MT(ASCP), CLS, CIC4, Gordon Hutcheon, MD2, Edwin Simpser, MD4, Linda Mosiello, RN, LNHA3, Elaine Larson, PhD, RN, FIDSA, FSHEA1, Lisa Saiman, MD, MPH, FSHEA5 and Natalie Neu, MD, MPH6, (1)School of Nursing, Columbia University Medical Center, New York, NY, (2)Elizabeth Seton Pediatric Center, South Yonkers, NY, (3)Sunshine Children’s Home and Rehab Center, Ossining, NY, (4)St. Mary’s Healthcare System for Children, Bayside, NY, (5)Columbia University College of Physicians & Surgeons, New York, NY, (6)Department of Pediatrics, Columbia University Medical Center, New York, NY

Disclosures:

M. Murray, None

B. Cohen, Deb Worldwide Healthcare Inc.: Investigator, Research support

A. Buet, None

M. Keenan, None

M. Pavia, None

G. Hutcheon, None

E. Simpser, None

L. Mosiello, None

E. Larson, Deb Worldwide Healthcare Inc.: Grant Investigator, Research grant

L. Saiman, Deb Worldwide Healthcare Inc.: Grant Investigator, Research grant

N. Neu, None

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